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

Reminiscence Recollection of past experiencesRecollection of past experiences Unstructured process of life reviewUnstructured process of life review Informal therapy that may increase EOL patient’s life satisfaction and decrease depressionInformal 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 he was a human being that you know just elicited a different connection a different level of connection with people that you know I believe is really important at end of life. That people need to feel valued and cared about as they’re passing out of this world and that I think helps facilitate this process…”

Humanization “ 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 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.”

Acceptance “He was just able to talk in very clear articulate ways how much joy art brought to his life. Um and so in his hospital room as he was dying that joy was right there in that room and he had made us part of that kind of journey with him and so it was incredibly moving. the picture that his mom brought into the hospital was so simple it was like a still life vase with flowers but he would say every morning he woke up he felt great looking at that picture just brought him joy and it was an incredible experience I will never ever forget this man.”

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