Dimensions of Futility at the End of Life: Nurses’ Experiences in Intensive Care Units

Document Type: Original Article

Authors

1 Assistant Professor, Faculty of Nursing and Midwifery, Ghazvin University of Medical Sciences, Qazvin, Iran

2 Professor, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Assistant Professor, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Associate Professor, Faculty of Biostatistics, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background and aims: The concept and meaning of futile care depends on the existing culture, values,
religion, beliefs, medical achievements, and emotional status of a country. In Iran, futile care has
become a challenge for nurses working in intensive care units (ICUs). Considering the differences
observed in defining futile care based on the patients’ conditions and the nurses’ personal values,
we aimed to define the dimensions of futility at the end of life from the viewpoints of nurses working
in ICUs. This qualitative phenomenological study was done to understand the experiences of nurses
working in ICUs with respect to the dimensions of futility.
Methods: this research was a qualitative phenomenological study. The statistical population of this
study included nurses working in the ICUs of 11 teaching hospitals and hospitals affiliated to the Social
Security Organization in Qazvin province, northwest of Iran. Personal interviews and observations of
25 nurses working in the ICUs of 11 hospitals were collected. All interviews were recorded and codes
and themes were extracted using Van Manen’s analysis method.
Results: Initially 80 codes were extracted. During data analysis and comparison, the codes were
reduced to 65. Ultimately, one theme and 2 sub-themes, and 5 categories were emerged: “futile
medical orders, futile diagnostic procedures, and category of nursing which included futile nursing
interventions and irrelevant duties to nursing”.
Conclusion: Considering that nurses play a key role in managing futile care, being aware of their
experiences in this regard could be the initial operational step for compiling useful care and
educational programs in ICUs.

Keywords