Journal of Undergraduate Research


nursing perceptions, end life care obstacles, critical access hospitals




Death is an unavoidable occurrence. Nurses are on the front lines when it comes to caring for dying patients. When providing end of life (EOL) care for critically ill patients, nurses frequently come across obstacles (Beckstrand, Giles, Luthy, Callister & Heaston, 2012). The purpose of this study is to identify the largest and the most frequent obstacles when providing EOL care to rural critical care patients. Our intent is to use the data to improve EOL care for rural patients and their families.

One quarter of community hospitals in the United States are critical access hospitals (CAH) and 19 percent of the total population live in rural areas (Seright, & Winters, 2015). A CAH is a hospital that is located in a rural area, is at least 35 miles from the nearest hospital, and is state certified as a necessary provider of care to area residents (Beckstrand et al., 2012). Over half of people living in rural areas have at least one major chronic illness but often lack the proper resources to care (Seright, & Winters, 2015). CAH nurses are the first line health care providers for these patients and often provide EOL care for critically ill patients. Nurses in rural hospitals provide care for a wide variety of patients, often working on several different floors within the same shift. Because of the diversity seen in CAH, a unique health care environment develops.

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Nursing Commons