Nurses’ experiences of accompanying patients dying during the COVID-19 pandemic: A qualitative descriptive study

Aims: The aim was to explore nurses' experiences of caring for and accompanying patients dying without the presence of family during the COVID-19 pandemic. Design: A qualitative descriptive design was used. Methods: A purposive sample of registered nurses, caring for dying patients in Italian health-care settings during the COVID-19 pandemic, were selected. To capture a broad range of experiences, a maximum variety of participants about workplace, age, gender and work experience were included. A total of 31 nurses agreed to participate in the study; 28 participants were female; participants were aged 41 on average (range 25-63 years) and worked in hospitals and nursing homes in the Northern and Central Italian regions. Six focus groups were conducted from August to December 2020 through Microsoft Teams, reaching data saturation. The transcripts were analysed through inductive content analysis. The COREQ checklist was followed for study reporting. Results: Four main categories emerged describing nurses' experiences: hugely increased deaths in time of COVID-19; ensuring physical, emotional, interpersonal and spiritual care for dying patients and supporting their families despite difficulties; ensuring care procedures of patients' bodies after death and psychological consequences of caring for dying people during the pandemic. Conclusion: Registered nurses provided physical, spiritual and emotional care to dying patients during the pandemic, despite limited resources and knowledge, standing in for relatives who were not allowed to visit them; the experiences of caring for dying patients in the absence of the family caused emotional distress in nurses. Impact: Health-care systems should develop guidelines aiming to meet the psychological needs of dying people in case of restrictions on patients' family visits. Health-care administrators should offer services to support the grieving process of relatives who cannot accompany dying patients and to reduce emotional distress in nurses caring for dying patients.