Nurses’ Conversations with HIV Patients at End of Life Juliette Shellman, Ph.D., Betty Morgan, Ph.D., Marisa Shuman, BSN, RN, & Jenna Connolly University of Massachusetts Lowell

Background Respectful care at end of life. Dignified dying

Reminiscence Recollection of past experiences Unstructured process of life review Informal therapy that may increase EOL patient’s life satisfaction and decrease depression

Specific Aims Explore nurses' experiences when reminiscing with HIV patients at end of life.

Methods Design: Qualitative Study Setting: Urban Hospitals and Community Centers Sample: Advanced Practice Nurses Methodology: Face to Face Interviews Graduate students trained to conduct interviews.

Preliminary Findings Connectedness Humanization Acceptance Forgiveness of self and others

Connectedness “That we knew something about him as a human being that just elicited a different connection, a different level of connection with patients that you know I believe is really important at end of life. People need to feel valued and cared about as they’re passing out of this world and that I think [reminiscence] helps facilitate this process…”

Seeing the Person “Just think there are so many particularly with the substance abusers that I’ve worked with, you know healthcare professionals don’t like them. They’ve destroyed relationships with their families. They’re shunned by society. They don’t feel good about themselves and so it’s a process where they can get in touch with a very ya know a very human part of themselves that other people relate to and you know that connection can be made.”

Forgiveness of Self and Others “ So it was mixed, it was sad for him but it was also I could’ve been one of your colleagues you know I could’ve worked with you, so there was a part of him that wasn’t so sad and his recognition that you know drugs really ruined his life. …and for lots of substance abusers that’s a hard acknowledgement that they’ve ruined their life, that I was an okay person who had some abilities at one point.”

“Letting go” “I wasn’t listening to subtle changes, but he was my teacher because every step of the way he would gradually recognize for himself that he was not doing well.” “I think the fact that we had reminisced, we had only talked about her relationship with me, but then we talked about her relationship (experienes?)with other patients she had been close to. This helped her let go.”

Discussion Unstructured, natural process Benefits for nurses/patients Nurses may not be aware

Implications for Practice Training programs to facilitate the process Referrals

Future Directions