Critique A Qualitative/ Quantitative Article Using Research Critique rubric and other components

6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest

https://search-proquest-com.ezproxy.brenau.edu:2040/docview/2132190303?accountid=9708 1/10

Abstract

Full Text

AIM The purpose of this study was to examine, on a national level, nursing students' perceptions after

experiencing a patient death. BACKGROUND Death is a highly stressful experience for nursing students.

Debriefing, which routinely occurs with a patient's demise in the simulation setting, typically does not happen in

actual death situations. METHOD A mixed-methods design using quantitative and qualitative questions as part

of an anonymous survey was sent to the membership of the National Student Nurses' Association. Of

approximately 55,000 members, 2,480 responded to the survey. RESULTS Experiencing a patient death as a

student occurred for 41 percent of participants in the nationally representative sample. Of those who

experienced a patient death, 64 percent did not receive any debriefing. CONCLUSION Most nursing students did

not feel prepared to care for a dying patient and the patient's family. Students need and want more education on

end-of-life nursing care.

Headnote

Abstract

AIM The purpose of this study was to examine, on a national level, nursing students' perceptions after

experiencing a patient death.

BACKGROUND Death is a highly stressful experience for nursing students. Debriefing, which routinely occurs

with a patient's demise in the simulation setting, typically does not happen in actual death situations.

METHOD A mixed-methods design using quantitative and qualitative questions as part of an anonymous survey

was sent to the membership of the National Student Nurses' Association. Of approximately 55,000 members,

2,480 responded to the survey.

RESULTS Experiencing a patient death as a student occurred for 41 percent of participants in the nationally

representative sample. Of those who experienced a patient death, 64 percent did not receive any debriefing.

CONCLUSION Most nursing students did not feel prepared to care for a dying patient and the patient's family.

Students need and want more education on end-of-life nursing care.

My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death Heise, Barbara A; Wing, Debra K; Hullinger, Amy H R.

Nursing Education Perspectives; New York  Vol. 39, Iss. 6,  (Nov/Dec 2018): 355-

359.

DOI:10.1097/01.NEP.0000000000000335

>

6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest

https://search-proquest-com.ezproxy.brenau.edu:2040/docview/2132190303?accountid=9708 2/10

KEYWORDS Death Education - Debriefing - Nursing Education - Nursing Students - Death Education - Debriefing

Most nurses experience patient death during the course of their careers. The nurse is the primary health care

provider involved in caring for patients and their families at the endof-life (EOL) and throughout the dying

process, including postmortem care (Bryant, 2008). Nurses promote a "good death" by providing physical,

emotional, and spiritual care while also advocating for the cultural preferences of dying patients and their

families.

Death is an emotionally charged issue for anyone. For registered nurses, death is also a high-stress situation

(Leighton & Dubas, 2009; Zheng, Lee, & Bloomer, 2016), with most experienced nurses able to vividly recall their

first death of a patient (Anderson, Kent, & Owens, 2015; Kent, Anderson, & Owens, 2012). For nursing students

who are just learning the RN role and responsibilities, the death of a patient is often a foreign, frightening, and

overwhelming experience that may have long-term effects on their professional and personal lives (Kent etal.,

2012).

LITERATURE REVIEW

Patient death is a commonly reported source of stress and anxiety for nursing students (Allchin, 2006; Carson,

2010; Edo-Gual, TomásSábado, Bardallo-Porras, & Monforte-Royo, 2014; Gallagher et al., 2014; Parry, 2011; Zheng

et al., 2016). Nursing students' reactions to their first patient death often include negative emotions, such as fear,

sadness, frustration, anxiety, helplessness, and guilt (Neiderriter, 2009; Parry, 2011; Poultney, Berridge, & Malkin,

2013; Zheng et al., 2016). Although many students experience a patient death during their education, few feel

adequately prepared to interact with a dying patient and his or her family in the clinical setting and to cope with

the experience (Gallagher et al., 2014; Zheng et al., 2016). Current nursing education is generally considered

inadequate to prepare nursing students for EOL care (Cavaye & Watts, 2012; Gillan, van der Riet, & Jeong, 2014;

Kent et al., 2012; Schlairet, 2009; Wallace et al., 2009). After their first death experiences, students frequently

state that they were not ready to provide EOL care, expressed difficulty communicating with the dying patient or

family, and did not receive sufficient support from clinical instructors and staff. Nursing students reported

increased stress and anxiety due to feelings of inadequacy and lack of preparation (Cavaye & Watts, 2012; Dos

Santos & Bueno, 2011; Gallagher et al., 2014; Huang, Chang, Sun, & Ma, 2010; Parry, 2011; Zheng et al., 2016).

Nursing students who had positive first death experiences indicated that helpful factors included a supportive

clinical instructor or staff member, role modeling, and postclinical debriefing (Carson, 2010; Gallagher et al.,

2014; Huang et al., 2010). Debriefing is commonly included in simulated EOL training but often does not occur in

the clinical setting (Thompson, 2005). The opportunity to discuss the death experience with an instructor may

help nursing students cope with the experience and increase competence and confidence for future care of dying

patients.

Nursing students must receive adequate preparation and support to provide quality EOL care in the clinical

setting and be equipped to cope with patient death. Most studies on nursing students and their experience with

patient death have involved small samples of nursing students. This survey is the first to examine nursing

students' perceptions of their first experiences with patient death on a national level. By understanding students'

experiences and the need for suitable preparation, support, and debriefing, nurse educators may be better able to

guide nursing students through their first experiences with EOL care and patient death.

THEORETICAL FRAMEWORK >

6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest

https://search-proquest-com.ezproxy.brenau.edu:2040/docview/2132190303?accountid=9708 3/10

Benner's (1982) seminal work, From Novice to Expert, delineates five levels of nursing proficiency. Although

Benner's theory of nursing did not include nursing students, her delineation provides insight on a prelicensure

nursing student who could be classified at a prenovice level. Level 1 is the novice RN who has no experience in

clinical situations such as EOL care. At this level, the novice nurse does not have the discretionary judgment to

determine which parts of the situation are most relevant. The novice nurse feels most comfortable with objective

tasks, such as taking vital signs, rather than a more advanced skill of helping the dying patient and family to

cope. Level 2 is the advanced beginner who has marginally acceptable performance. Nurses at Levels 1 and 2

need mentoring by expert nurses.

At Level 3, the competent nurse has been providing EOL care for approximately two to three years. Typically, this

nurse provides conscious, deliberate planning to achieve efficiency and organization, and no mentoring is

needed. However, the competent nurse is still unable to recognize which parts of the EOL situation are most

important.

At Level 4, the proficient nurse is able to see EOL care for the dying patient and the family as a whole. This nurse

knows what to typically expect during EOL care and can modify the plan as needed.

Finally, at Level 5, the nurse is an expert who intuitively hones in on salient issues. Expert nurses have a deep

understanding of EOL care and the many ways that dying patients and their families approach death. They offer

many ways to understand, cope, and accept the final phase of life, which, for most people, is a totally uncharted

passage. Expert nurses in EOL care often stay in this field because they feel they can coach patients and families

through a very difficult and often not discussed part of life.

Nursing students do not have the experience to perform the advanced roles of an expert nurse caring for the

dying person and family. Along with competent clinical skills, expert nursing skills required during EOL care

include advanced communication skills to determine patient preferences, advocacy for patient and family to

promote dignity, advanced pain management skills, comprehensive supportive care to the patient and family to

alleviate suffering, constant assessment to ensure interventions are congruent with patient wishes, and

promoting the dying patient's autonomy and right to self-determination.

Some nursing students have previously experienced the death of a family member. However, the death of a

patient is different and may require a level of responsibility that was not present for the family member. In

addition, caring for someone who is dying, as well as caring for the dying patient's family, requires advanced

clinical skills that a nursing student does not yet possess.

METHOD

A cross-sectional descriptive survey design was used for this study. Following approval from the university

institutional review board and National Student Nurses' Association administration, nursing student members of

National Student Nurses' Association (approximately 55,000 members) were emailed a brief description of the

research project and an invitation to participate with a link to the online questionnaire. An implied consent form

was available to be viewed by participants before beginning the survey. Participant responses were collected

using Qualtrics online survey software.

Participants were asked to answer six demographic questions and 14 survey questions about their experience

regarding a patient death during their time as a nursing student. Two open-ended questions asked participants

to describe their experience and indicate what they would have liked to be taught regarding EOL care of a patient.>

6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest

https://search-proquest-com.ezproxy.brenau.edu:2040/docview/2132190303?accountid=9708 4/10

Estimated time commitment for participants was 15 to 20 minutes. This article reports the results of the

quantitative questions in the survey.

After the response period had ended, quantitative data were downloaded from Qualtrics to SPSS version 22 (IBM

Corp., 2013). Quantitative data were reviewed for missing values and outliers before further analysis using

appropriate descriptive statistics and plots. Descriptive statistics for demographic variables and survey

questions were calculated. Chi-square test of association was used to examine relationships of selected

categorical variables.

RESULTS

Descriptive statistics for demographic characteristics of the participants are reported in table form in Table 1.

Sample

A total of 2,804 individuals responded to the invitation to participate and started the survey. A total of 2,480 (88.4

percent) completed the survey. Most respondents (80 percent) were female, half were under age 27, and the

majority were white (67.6 percent). A majority of the respondents (60.7 percent) reported being single, and about

a quarter (26.8 percent) reported being married. Most (57.6 percent) of the students said they were in bachelor's

programs; about a quarter (25.9 percent) reported being in associates programs. Participants came from every

state in the United States as well as the District of Columbia with more populous states (e.g., CA, FL, NY, PA, and

TX) proportionally represented in the sample.

Descriptive statistics for questionnaire items are reported in Table 2. A majority (65.8 percent) of respondents

reported being present at a death outside of their nursing experience; almost 41 percent reported being present

at a death as a nursing student. The majority of those who experienced a patient death (62 percent) experienced

that death early in their nursing programs.

Responses for Students Who Experienced a Death

The remaining questions were directed specifically toward those who reported experiencing a patient death as a

student (n = 1,148). Slightly more than a quarter of those respondents (26.8 percent) said they needed help

coping. Only one third of these students received debriefing.

A chi-square test of association was used to examine the relationship between reporting the need for help

coping with a patient death and receiving debriefing. Of the 1,148 students respondents, 33 (2.6 percent) had

missing data and were excluded from the test. The test was not significant, x2(df = 1, n = 1,115) = 1.19, p = .275,

indicating that there did not seem to be an association between needing help coping and receiving debriefing

after experiencing a patient death as a student. A majority (194/306, 63.4 percent) of those who reported

needing help coping did not receive debriefing.

Participants were asked to rate their level of preparation on a scale of 1 to 4 (1 = prepared, 2 = somewhat

prepared, 3 = prepared, 4 = very prepared) in several areas related to death and dying: process of death and dying,

EOL care, and ways to cope with the death of a patient.

* Thirty-six percent of nursing students asked if they felt prepared with the process of death and dying reported

they were less than prepared (not prepared or somewhat prepared). >

6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest

https://search-proquest-com.ezproxy.brenau.edu:2040/docview/2132190303?accountid=9708 5/10

* Perceptions of being prepared to provide EOL care resulted in 45 percent feeling less than prepared (not

prepared or somewhat prepared) and 47 percent felt prepared or very prepared.

* Asked if they felt prepared to cope with the death of a patient, most nursing students (45 percent vs. 35

percent) felt less than prepared (unprepared or somewhat prepared).

Only 24 percent of the nursing students reported that their nursing curriculum (what they learned in class)

prepared them in general EOL care. Only 17 percent felt that the curriculum prepared them to cope with the death

of a patient. Participants were asked who helped them prepare to deal with issues surrounding patient death

(process of death and dying, EOL care, and ways to cope with death of a patient); options for each category were

as follows: no one, clinical instructor, clinical staff, other nursing students, friend or family member, and learned

in nursing class. Learned in nursing class and clinical instructor were among the top-ranked answers in most

categories. The top answer to who prepared respondents to cope with the death of a patient was "no one."

Clinical instructors were referred to as preparation resources for EOL care (19 percent), process of death and

dying (17 percent), and coping (17 percent) in these areas.

Participants were asked to rate their level of preparation on a scale of 1 to 4 (1 = unprepared, 2 = somewhat

prepared, 3 = prepared, 4 = very prepared) in several areas related to communication: communication with dying

patient, communication with patient's family, and communication with members of the health care team. The

majority (57 percent) of nursing students felt less than prepared (unprepared or somewhat prepared) to

communicate with a dying patient; only 23 percent reported feeling prepared or very prepared. Again, the majority

(64 percent) of participants felt unprepared or somewhat prepared to communicate with the dying patient's

family. However, participants felt more prepared to communicate with members of the health care team (45

percent vs. 35 percent).

Participants were asked who helped them prepare to deal with issues surrounding communication

(communication with dying patient, communication with patient's family, and communication with members of

health care team); options for each category were as follows: no one, clinical instructor, clinical staff, other

nursing students, friend or family member, and learned in nursing class. The top answer to who prepared

respondents for all the communication questions was "no one." Students responded that their curriculum

prepared them to communicate only 18 percent of the time when communicating with the dying patient, 20

percent of the time when communicating with the family of a dying patient, and 18 percent of the time when

communicating with the health care team. Clinical instructors helped prepare students to communicate with the

dying patient (15 percent), the family of the dying patient (14 percent), and the health care team (18 percent) of

the time.

Nursing students were asked specifically about what they would like to be taught about EOL care. The number

one answer from students was more education on how to communicate with the dying patient and family.

Students wanted more education on EOL care in general, including the actively dying process and supportive

resources for the family and the patient. Students also wanted education on postmortem care of the patient.

Students requested debriefing and education on how to cope with a patient death. They suggested more

education on EOL care earlier in the nursing curriculum with more educational activities involving death and

dying through simulation scenarios, faculty experiences, and even a hospice clinical.

DISCUSSION >

6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest

https://search-proquest-com.ezproxy.brenau.edu:2040/docview/2132190303?accountid=9708 6/10

It is significant to note that the sample was fairly representative of nurses in the United States, both in terms of

geography and in terms of race. Participants came from every state and the District of Columbia. Nearly one third

(31.9 percent) identified with racial groups other than Caucasian.

Nationally, nursing students (41 percent) reported being present at a patient death. This high percentage of

individuals who experience a patient death as a student highlights the importance of death education. Despite

the sensitive nature of the topic of death itself, nurses need to be prepared for the almost inevitable death

experiences they will encounter. Current recommendations strongly encourage nursing schools to educate

students about EOL care (Ferrell, Malloy, Mazanec, & Virani, 2016). Death education may be integrated into

nursing curricula, particularly for concept-based nursing programs.

More work needs to be done to help students cope with patient death. Asked who helped them cope with the

death of a patient, the top answer was "no one." Clinical instructors were reported to play a leading role in the

training of nursing students in all areas regarding death and dying. Given that clinical instructors are frequently

adjunct faculty who receive lower levels of professional development than regular faculty in the academic

setting, it is possible that many clinical instructors are insufficiently prepared to guide students in matters of

death and dying, communication with family and medical staff, and debriefing. Clinical instructors spend more

one-on-one time with students than almost any other instructor in nursing school. They are also uniquely

positioned to observe student interactions with patients and patients' families.

The Institute of Medicine (2015) publication Dying in America specifically identifies a lack of communication

skills, interprofessional education, and curricula focused on palliative and EOL care in nursing education. The

American Association of Colleges of Nursing (2016) recommends competencies and curricular guidelines

regarding EOL issues, including communication with dying patients and families and assisting the patient, family,

colleagues, and one's self to cope with the dying process, grief, and bereavement. Role modeling, simulation, and

debriefing may be the most efficacious ways to prepare students to deal with the challenges associated with

patient death (Keene, Hutton, Hall, & Rushton, 2010). In addition, introducing students to critical reflective

practice early in their academic endeavors may increase their resilience while creating cultural meaning for the

dying process (Hodges, Keely, & Grier, 2005). As Benner (1982) noted, novice nurses (and we would add prenovice

nurses) need mentoring, particularly in the advanced skills needed for EOL care.

LIMITATIONS

It may be noted that a sizeable proportion (11.6 percent) of those who began the survey did not complete it. It

may also be noted that many of the questions directed to those who experienced a patient death as a student (n

= 1,148) had high rates of missing data (around 20 percent). Patterns of missing data for those questions were

examined. Most individuals completed all of the questions (n = 902, 78.6 percent). It was found that a large

majority of missing answers were attributed to a consistent set of individuals (n = 224, 19.5 percent), who, it

seems, simply did not complete most of the questions. A small percentage of individuals (n = 22, 1.9 percent)

chose not to answer between one and six questions but completed the others.

Although it is not possible to determine specific reasons for noncompletion, it may be possible to speculate. The

topic of experiencing a patient death during schooling has the potential to be emotionally difficult to think about

and discuss. It may be that the emotionally difficult nature of the topic led some individuals to not complete the

questions. This survey also asked several open-ended questions in the format of typed responses. It may be that

additional time required to think about and formulate responses led some individuals to give up rather than

complete the entire survey. >

6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest

https://search-proquest-com.ezproxy.brenau.edu:2040/docview/2132190303?accountid=9708 7/10

IMPLICATIONS FOR NURSING EDUCATION

Students need and want more education on EOL nursing care as well as how to communicate with dying patients

and their families and postmortem care. Most nurses, at some point in their careers, will encounter a patient who

is dying. Although death is often not discussed in many societies, it is a conversation that needs to be held in

order to ensure that the dying patient's wishes are known.

The Conversation Project (http://theconversationproject.org), which is dedicated to helping individuals talk

about their EOL issues, gives individuals the words to say to family members and to health care providers to start

the conversation on what they would like at EOL. Nurses provide the majority of care and are uniquely positioned

to help start the conversation of patient preferences and assist the patient and family through the dying process.

Dying is a deeply personal experience. For nursing students, the death of a patient, at the very beginning of their

career path, is often a stressful and overwhelming experience. Although debriefing and mentoring take place

routinely in simulation, they do not happen most of the time in real life. It is a double-edged sword to tell novice

nurses to care about their patients while asking those same nursing students to turn off caring when the patient

is dying or has died. Experienced nurses do a disservice to novice nurses when they tell them to "toughen up,"

rather than discuss their views of the dying experience. This lack of discussion and acknowledgement of salient

issues during the dying process may lead to nurse burnout and compassion fatigue.

In the clinical setting, nurse educators, particularly adjunct clinical faculty, need to be trained in debriefing

techniques, critical reflection, and mentoring nursing students as they provide care for those in the last phase of

life. Students need to be exposed to the dying experience, but with expert nurse mentors to role model and guide

them through an often challenging situation (Österlind et al., 2016).

For nursing students, as suggested by the respondents to this study, more simulation experiences with patient

demise and debriefing need to be part of the nursing curriculum. Allen (2018) points out that, even in an EOL

simulation setting, nursing students caring for dying patients experience increased stress. In our study, students

requested more EOL experiences through simulation and through clinical experiences, such as hospice and

palliative care with mentoring from their nursing faculty.

Sidebar

The authors have declared no conflict of interest.

Copyright © 2018 National League for Nursing

doi: 10.1097/01.NEP.0000000000000335

References

REFERENCES

Allchin, L. (2006). Caring for the dying: Nursing student perspectives. Journal of Hospice & Palliative Nursing, 8,

112-117.

Allen, M. (2018). Examining nursing students' stress in an end-of-life care simulation. Clinical Simulation in

Nursing, 14, 21-28.

>

6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest

https://search-proquest-com.ezproxy.brenau.edu:2040/docview/2132190303?accountid=9708 8/10

American Association of Colleges of Nursing. (2016). Peaceful death: Recommended competencies and

curricular guidelines for end of life nursing care. Retrieved from

www.aacn.nche.edu/elnec/publications/peaceful-death

Anderson, N., Kent, B., & Owens, R. (2015). Experiencing patient death in clinical practice: Nurses' recollections of

their earliest memorable patient death. International Journal of Nursing Studies, 52(3), 695-704.

Benner, P. (1982). From novice to expert. American Journal of Nursing, 82(3), 402-407.

Bryant, H. (2008). Maintaining patient dignity and offering support after miscarriage. Emergency Nurse, 15(9), 26-

29.

Carson, S. (2010). Do student nurses within an undergraduate child health programme feel that the curriculum

prepares them to deal with the death of a child? Journal of Child Health Care: For Professionals Working With

Children in the Hospital and Community, 14, 367.

Cavaye, J., & Watts, J. (2012). End-of-life education in the pre-registration nursing curriculum: Patient, carer, nurse

and student perspectives. Journal of Research in Nursing, 17(4), 317-326.

Dos Santos, J. L., & Bueno, S. M. (2011). Death education for nursing professors and students: A document

review of the scientific literature. Revista da Escola de Enfermagem da USP, 45(1), 272-276.

Edo-Gual, M., Tomás-Sábado, J., Bardallo-Porras, D., & Monforte-Royo, C. (2014). The impact of death and dying

on nursing students: An explanatory model. Journal of Clinical Nursing, 23(23-24), 3501-3512. Retrieved from

http:// onlinelibrary.wiley.com.erl.lib.byu.edu/doi/10.1111/jocn.126602/abstract

Ferrell, B., Malloy, P., Mazanec, P., & Virani, R. (2016). CARES: AACN's new competencies and recommendations

for educating undergraduate nursing students to improve palliative care. JournalofProfessionalNursing, 32(5),

327-333.

Gallagher, O., Saunders, R., Tambree, K., Alliex, S., Monterosso, L., & Naglazas, Y. (2014). Nursing student

experiences of death and dying during a palliative care clinical placement: Teaching and learning implications. In

In Transformative, Innovative and Engaging: Proceedings of the 23rd Annual Teaching Learning Forum, 30-31

January 2014. Perth, Australia: University of Western Australia.

Gillan, P., van der Riet, P., & Jeong, S. (2014). End of life care education past and present: A review of the

literature. Nurse Education Today, 34,331 -342.

Hodges, H. F., Keeley, A. C., & Grier, E. C. (2005). Professional resilience, practice longevity, and Parse's theory for

baccalaureate education. Journal of Nursing Education, 44(12), 548-554.

Huang, X. Y., Chang, J. Y., Sun, F. K., & Ma, W. F. (2010). Nursing students' experiences of their first encounter with

death during clinical practice in Taiwan. Journal of Clinical Nursing, 19(15-16), 2280-2290.

IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.

Institute of Medicine. (2015). Dying in America: Improving quality and honoring individual preference near the

end of life. Washington, DC: National Academies Press. >

6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest

https://search-proquest-com.ezproxy.brenau.edu:2040/docview/2132190303?accountid=9708 9/10

Keene, E. A., Hutton, N., Hall, B., &Rushton, C. (2010). Bereavement debriefing sessions: an intervention to

support health care professionals in managing their grief after the death of a patient. Pediatric Nursing, 36(4),

185-189, quiz 190.

Kent, B., Anderson, N. E., & Owens, R. G. (2012). Nurses' early experiences with patient death: The results of an

on-line survey of registered nurses in New Zealand. International Journal of Nursing, 49(10), 1255-1265.

Leighton, K., & Dubas, J. (2009). Simulated death: An innovative approach to teaching end-of-life care. Clinical

Simulation in Nursing, 5, e223-e230.

Neiderriter, J. (2009). Student nurses' perceptions of death and dying (Doctoral dissertation). Cleveland State

University, Cleveland, OH. ISBN:9781109278040.

Österlind, J., Prahl, C., Westin, L., Strang, S., Bergh, I., Henoch, I., & Ek, K. (2016). Nursing students' perceptions of

caring for dying people, after one year in nursing school. Nursing Education Today, 41, 12-16.

Parry, M. (2011). Student nurses' experience of their first death in clinical practice. International Journal of

Palllative Nursing, 17(9), 446-451.

Poultney, S., Berridge, P., & Malkin, B. (2014). Supporting pre-registration nursing students in their exploration of

death and dying. Nurse Education in Practice, 14, 345-349.

Schlairet, M. C. (2009). End-of-life nursing care: statewide survey of nurses' education needs and effects of

education. Journal of Professional Nursing, 25(3), 170-177.

Thompson, G. T. (2005). Effects of end-of-life education on baccalaureate nursing students. AORN Journal, 82(3),

434-440.

Wallace, M., Grossman, S., Campbell, S., Robert, T., Lange, J., & Shea, J. (2009). Integration of end-of-life care

content in undergraduate nursing curricula: student knowledge and perceptions. Journal of Professional Nursing,

25(1), 50-56.

Zheng, R., Lee, S. F., & Bloomer, M. J. (2016). How new graduate nurses experience patient death: Asystematic

review and qualitative meta-synthesis. International Journal of Nursing Studies, 53, 320-330.

Copyright Wolters Kluwer Health, Inc. Nov/Dec 2018

>

Brenau LibGuides

Return to GALILEO

6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest

https://search-proquest-com.ezproxy.brenau.edu:2040/docview/2132190303?accountid=9708 10/10

>

Copyright © 2019 ProQuest LLC.