The Experience of Registered Nurses in Engaging in Advance Care Planning

Abstract

Advance care planning (ACP) is an essential process of care in which nurses play a pivotal role within the healthcare team in providing palliative care. However, there is limited understanding about experiences of nurses engaging ACP in their practice. This descriptive qualitative research aimed to describe the experiences of nurses participating in advance care planning. A total of twenty informants who were professional nurses, with the majority working in medical wards were recruited by purposive sampling. The data were collected using semi-structure through in-depth individual interviews. Data were analyzed by descriptive statistics and content analysis.

The research findings revealed four main themes as follows: 1) meaning of advance care planning, 2) process of practice (involving three stages: initiation, conversation, and follow-up), 3) challenges in implementing advance care planning (arising from nurses’ self-perceptions, hospital contexts, and the culture of patients and families), and 4) enhancing capacity and collaboration in advance care planning (highlighting the need for palliative care knowledge, teamwork, communication skills, and advocacy mindset for patients’ rights). The findings of this study indicated the importance of knowledge, understanding of the meaning of advance care planning, attitudes towards the role and responsibilities, and communication skills to ensure confidence in practice. Therefore, organizations should implement policies to provide knowledge and training to practitioners as well as develop nursing practice guidelines for implementation advance care planning.