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

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.