Understanding bladder management on a palliative care unit: a grounded theory study

Int J Palliat Nurs. 2017 Mar 16;23(3):144-151. doi: 10.12968/ijpn.2017.23.3.144.

Abstract

Background: Research regarding factors associated with nursing-initiated changes to bladder management at end-of-life is sparse.

Objectives: To explore the process of Palliative Care Unit (PCU) nurses' approach to bladder management changes.

Methods: Nursing staff from one PCU in London, Canada were interviewed regarding bladder management care practices. A constructivist grounded theory was generated.

Results: Four interconnected themes emerged: humanity (compassionate support of patients); journey (making the most of a finite timeline); health condition (illness, functional decline); and context (orders, policies, supplies). These overlapping themes must be considered in light of ongoing changes which prompt recycling through the framework. While bladder management necessitates shared decision-making and individualised care, nurses' phronetic experience may serve to detect the presence of change and the need to consider other alternatives.

Conclusion: End-of-life bladder management requires nurses to continually reconsider the significance of humanity, journey, health condition and context in light of ongoing changes.

Keywords: Bladder management; End-of-life; Nursing.

MeSH terms

  • Canada
  • Decision Making
  • Diapers, Adult
  • Empathy
  • Grounded Theory
  • Hospice and Palliative Care Nursing*
  • Humans
  • Mobility Limitation*
  • Personhood
  • Precision Medicine
  • Qualitative Research
  • Terminal Care*
  • Urinary Catheterization
  • Urinary Incontinence / nursing*