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Decision Making Near End of Life: A Qualitative Exploration of the Lived Experiences of Jordanian Healthcare Providers.

BACKGROUND
Discussions related to a patient's prognosis and interventions near end of life are challenging and stressful for healthcare providers. Many reported experiencing emotional distress and discomfort during the decision-making process.


OBJECTIVES
The aim of this study was to describe the lived experience of nurses and physicians who participate in decision making near the end of a patient's life.


METHODS
A descriptive, phenomenological approach was used with a purposive sample of 7 nurses and 6 physicians from 2 palliative and end-of-life care institutions in Jordan. Data derived from focus group discussions conducted online via the ZOOM video communication application, and analysis followed Colaizzi's qualitative methodology.


RESULTS
Three major themes emerged from the healthcare providers' experiences. Initially, the participants described how they "strive toward optimal decision-making near end of life," "the overwhelming experience of decision making near end of life," and finally, their struggle in sharing details about the end of life when patients ask and whether to tell or not to tell them as "the time for hard talk."


CONCLUSIONS
The healthcare providers' experiences revealed several issues of decision making near a patient's end of life, such as a lack of appropriate training and administrative support, emotional distress, fear of legal liability, and the burden of a hard talk with patients. These findings necessitate institutional support of setting appropriate policies and guidelines, staff counseling, and healthcare provider support.


IMPLICATIONS FOR PRACTICE
Institutions providing palliative and end-of-life care can use this study's findings to support their staff by setting appropriate practice guidelines and providing staff training and counseling.