A phenomenological study exploring ED nurses' experiences of older people's dignity

  • Bhupinder Pawar

Student thesis: Doctoral ThesisDoctor of Philosophy


Introduction: Following a number of high profile reports into health care delivery in the NHS, such as the Mid Staffordshire NHS Trust inquiry (Francis 2013), emphasis on maintaining older people’s dignity in health care is of paramount importance. Demographic shifts and an increase in the proportion of older people in the general population mean that the emergency department (ED) is, and will be, the entry portal to acute health care services for many older people. In line with all care settings, nurses are, and will continue to be, the main providers of care in ED. Dignified care of older people should start at the ‘portal’ entry through which older people start their health care journey. There is lack of evidence investigating the experiences of ED nurses in relation to older people’s dignity in the emergency department. The aim of this study was to explore ED nurses’ experiences of caring for older people in one ED, to describe their perceptions of dignity and factors that can facilitate or hinder dignified care.

Study Design: This was an exploratory qualitative study, guided by a descriptive phenomenology methodology. Ten experienced emergency care nurses were recruited in one emergency department using purposive sampling. Data were collected through semi-structured interviews, which were audio recorded and transcribed verbatim. Data were analysed using Colaizzi’s (1978) data analysis approach.

Findings: The findings indicated that nurses perceived older patients’ dignity in the ED as actions inherent to autonomy. Dignity was conceptualised as seeing and treating the older person as an individual human being. Participants described respecting the older person, maintaining privacy and giving information and choice as attributes of older person’s dignity. The ED was described as a complex care environment that included a number of factors that hindered nurses from providing dignified care. Lack of privacy was one of the main factors that compromised patient dignity in ED. Other factors identified as
hindering delivery of dignified care related to poor staffing levels, and pressures
of meeting specific government targets imposed on the emergency care service
provision. Nursing patients in corridors was described as the worst area for
maintaining older people s dignity.

Conclusion: The research revealed that nurses understood what constituted
dignified care and were capable of delivering this care. However, the complex
ED environment prevented them from delivering this care.
Date of Award2016
Original languageEnglish
Awarding Institution
  • Coventry University
SupervisorChris Carpenter (Supervisor), Andy Turner (Supervisor) & Simon Igo (Supervisor)

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