Title : Undergraduate nursing self-care and end-of-life simulation: An integrative review
Abstract:
Background: Undergraduate nursing students feel uncomfortable and unprepared to provide end-of-life care (EOLC). Palliative and hospice care are one of the spheres of nursing practice (AACN, 2021). Entry-level nurses must be competent in end-of-life nursing care. Unresolved discomfort about EOLC and lack of palliative care competency can lead to compassion fatigue, burnout, and negative patient outcomes. Simulation is an effective tool to develop nursing students’ knowledge, skills, and attitudes required to deliver best evidenced-based palliative care nursing practice.
Purpose: To identify teaching strategies implemented in the simulation setting to guide pre-licensure students with managing the emotional impact of providing end-of-life care.
Methodology: Whittemore and Knafl integrative review.
Findings: From January to March 2023, a systematic search was conducted through databases CINAHL complete, EBSCO, ERIC, PubMed, and Cochrane. Search terms included varying terms of undergraduate nursing students, simulation, and end-of-life. 302 articles were extracted from the literature. The author conducted critical appraisals using the MacMaster Critical Review form for quantitative studies, the Qualitative studies, Oxford’s Center for Evidence Based Medicine (EBM) Critical Appraisal of Qualitative studies, and the Mixed-method Assessment Tool (MMAT). 18 articles met inclusion criteria, 7 quantitative studies, 7 qualitative studies, 3 mixed-method studies, and 1 observational study. Reflective practices, journaling, are methods used in EOL simulation to close the theory-to-practice gap of undergraduate nursing students’ self-reflection and self-care.
Implications for Practice: End-of-life simulation can improve undergraduate nursing students’ reflective thinking and self-care tools while caring for the dying patient. Nurse educators should design simulations that promote self-reflection and coping strategies throughout the simulation process. An end-of-life care simulation model would attempt to close the theory-to-practice gap of self-care among nursing students and novice nurses by (1) designing an end-of-life simulation based on standards of best practice, (2) improving students' attitudes toward end-of-life care through reflective thinking, a satisfying experience, and formulation of appropriate coping strategies, and (3) developing coping strategies in accordance with the new primary palliative care nursing competency model. Future research is needed to develop such a model.
