Nurses Experiences and Perceptions of Providing Futile Care to Patients in the Critical Care Unit at Kenyatta National Hospital

Abstract

and expensive resources. However, sometimes patients in the intensive care unit receive care that is ultimately not beneficial to them. Nurses are the majority care givers and consequently give care to these patients. Studies done in the developed world have reported the existence of futility of care in the Intensive Care Unit and how nurses perceive futile care as useless, time wasting and prolonging suffering. In our setup, futile care is provided but nurse’s experiences and perceptions regarding futility of care have not been explored. Main objective: To explore the nurses experiences and perceptions of providing futile care to patients in the critical care unit at Kenyatta National Hospital. Methods: The study utilized a descriptive qualitative approach and was conducted in the intensive care unit at Kenyatta National hospital. Purposive sampling technique was used to select ten nurses who met the inclusion criteria. In-depth individual interviews and participant observation by the researcher were used to collect data. The interviews were audio-recorded and transcribed verbatim. Data was inductively analyzed through the manual coding process and codes condensed into themes and sub themes. Results: Three themes emerged from the analysis of the data: non beneficial treatment, wastage of resources and distress, under these major themes there were six sub themes. Nurses considered futile care as non-beneficial to the patient in relation to their physiological conditions. The nurses also expressed that since futile care was not beneficial to the patients, this amounted to wastage of resources. It was also established that providing futile care to patients lead to distress among the nurses and patients families because of unclear admission criteria and lack of DNR protocols. Conclusion: Nurses in KNH ICU perceived futile care as non-beneficial and felt that continued provision of the same was a waste of resources and lead to distress among the nurses and patients’ families. Recommendations: There is need to review the admission policies in the unit, to develop and implement DNR protocols, to train the nurses on end of life care and to institute supportive measures to the nurses so as to mitigate the moral distress that they experience as a result of providing futile care to patients.