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Research ArticleOriginal Research

The Lived Experience of Respiratory Therapists During Withdrawal of Advanced Life-Sustaining Therapies at End of Life in the ICU

Kristiana GH Cullum, Catherina A Madani, Eloisa R Cutler and Karen J Reavis
Respiratory Care December 2022, 67 (12) 1568-1577; DOI: https://doi.org/10.4187/respcare.09249
Kristiana GH Cullum
San Diego State University, School of Nursing, San Diego, California.
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  • For correspondence: [email protected]
Catherina A Madani
San Diego State University, School of Nursing, San Diego, California.
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Eloisa R Cutler
University of California, San Diego Medical Center, San Diego, California.
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Karen J Reavis
San Diego State University, School of Nursing, San Diego, California.
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Abstract

BACKGROUND: The act of withdrawing advanced life-sustaining therapies, more specifically mechanical ventilation, is performed in hospitals all over the world. Success involves coordination of several members of the patient care team, including nurses, providers (physicians nurse practitioners, or physician assistants), and respiratory therapists (RTs). The experiences of RTs surrounding this procedure are not well documented. The aim of this study was to explore the lived experience of RTs who have participated in withdrawal of advanced life-sustaining therapies, utilizing a hermeneutical phenomenological approach.

METHODS: Individual interviews were conducted with experienced RTs that were audio recorded and transcribed. The data were analyzed by 4 health professionals, and data were triangulated.

RESULTS: Three themes emerged from the study: (1) impact of power relations surrounding the process, (2) needing tools to provide quality withdrawal of advanced life-sustaining therapies, and (3) emotional involvement/exposure. It was clear from the analysis that RTs desire more education, to be part of the decision-making, and to be appreciated for their role in this emotional process.

CONCLUSIONS: Through this study, the role of RT in withdrawal of advanced life-sustaining therapies is better understood, which can only lead to improvement in the overall process for health care team, patient, and families.

  • withdrawal of advanced life-sustaining therapies
  • palliative extubation
  • respiratory therapist
  • mechanical ventilation withdrawal
  • end of life
  • terminal care
  • phenomenology

Footnotes

  • Correspondence: Kristiana GH Cullum PhD, San Diego State University, School of Nursing, 5500 Campanile Drive, San Diego, CA 92182–4158. E-mail: kcullum{at}sdsu.edu
  • The authors have disclosed no conflicts of interest.

  • Copyright © 2022 by Daedalus Enterprises
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Respiratory Care: 67 (12)
Respiratory Care
Vol. 67, Issue 12
1 Dec 2022
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The Lived Experience of Respiratory Therapists During Withdrawal of Advanced Life-Sustaining Therapies at End of Life in the ICU
Kristiana GH Cullum, Catherina A Madani, Eloisa R Cutler, Karen J Reavis
Respiratory Care Dec 2022, 67 (12) 1568-1577; DOI: 10.4187/respcare.09249

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The Lived Experience of Respiratory Therapists During Withdrawal of Advanced Life-Sustaining Therapies at End of Life in the ICU
Kristiana GH Cullum, Catherina A Madani, Eloisa R Cutler, Karen J Reavis
Respiratory Care Dec 2022, 67 (12) 1568-1577; DOI: 10.4187/respcare.09249
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Keywords

  • withdrawal of advanced life-sustaining therapies
  • palliative extubation
  • respiratory therapist
  • mechanical ventilation withdrawal
  • end of life
  • terminal care
  • phenomenology

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