The experience of nurses being confronted with tiredness of life in older persons: a qualitative study

Background: Nurses frequently encounter older persons who are tired of life (ToL). Studies on the nurses’ perspective are virtually non-existent. Therefore, the aim of this study was to gain insight in what it is to be a nurse (in home care or nursing home) taking care of older persons being tired of life.Methods: A qualitative design, based on the principles of the Grounded Theory approach (Charmaz, 2014).Results: 25 nurses (20 female), with an average age of 38.4 years (range: 22-56 years) participated. The semi-structured interviews had a mean duration of 49 minutes (range 30-62 minutes). Powerlessness and uncertainty were the dominant feelings experienced by nurses as ToL is challenging one’s capacity to help. Nurses experienced tensions between comprehension and incomprehension, between confirming and disconfirming, between mastering and remitting. Key was their ability to reframe their feelings of helplessness and powerlessness as this influenced the way they responded to the ToL. Participants attested of an acknowledgment continuum, ranging from not discussing tiredness of life (a procedural, action-oriented perspective) to open acknowledgment (a presencing and more-dialogue focused perspective).Discussion: The nurses’ feelings of powerlessness should trigger individual and team-based reflexivity on appropriateness of care and the meaning of good care in case of ToL. Strengths of this study are the data analysis method and researcher triangulation. However, this study also has some limitations. First, findings of this study cannot be generalized to speak for all nurses’ experiences, nevertheless, nurses other than those in these contexts may, however, be expected to have similar experiences. Second, the study relied on nursing staffs’ verbal accounts and not on observation of actual practices (data triangulation).Conclusions: Our findings indicate that nurses aim to provide good care, sensitive to the older person’s needs, but this process is devoid of ambivalence.