Barriers and facilitators in the provision of palliative care in critical care: A qualitative descriptive study of nurses’ perspectives

Intensive care units are providing increasing amounts of palliative care. Accordingly, integrating palliative care as a component of comprehensive critical care has been identified as a necessity. The purpose of this study was to explore what critical care nurses perceive as barriers and facilitators in the provision of palliative care in the critical care setting. We conducted a qualitative descriptive study between 2016 and 2017. Eleven critical care nurses working within an intensive care unit in a tertiary care western Canadian hospital participated in this study. Semi-structured individual interviews were conducted with each participant and data was interpreted using thematic analysis. Key barriers and facilitators identified were related to communication, end-of-life decision making, the life- saving mentality of the ICU, exposure to palliative care education, and the strengths and perils of the critical care environment. The results of this study provide insight into the initiatives and resources that are required to enhance the provision of palliative care in the critical care setting.