Reflection Activity After Patient Death to Reduce Anxiety in Intensive Care Nurses

Abstract

BACKGROUND: Many nurses, particularly those working in intensive care units, experience anxiety and burnout as a result of caring for patients with complex conditions and high mortality rates. This situation often leads to employee dissatisfaction and high turnover. LOCAL PROBLEM: The purpose of this project was to reduce anxiety related to patient death among nurses in a 17-bed medical intensive care unit through the implementation of a previously developed evidence-based postdeath reflection activity called "The Pause." METHODS: Unit leaders received training in the Pause. Staff nurses anonymously and voluntarily completed preintervention and postintervention surveys collecting self-reported demographic data and scores on the revised Collett-Lester Fear of Death Scale, which measures fear and anxiety about death. The intervention was performed by a trained staff member when a patient died. Quantitative data were evaluated using descriptive statistics and measures of effect size. RESULTS: A total of 38 nurses (54% of nursing staff members) completed the preintervention survey, and 22 nurses (31% of nursing staff members) completed the postintervention survey. The mean total score on the revised Collett-Lester Fear of Death Scale decreased by 15% (Cohen d = 0.53) from before to after the intervention, indicating reduced overall anxiety related to patient death among participating nurses. CONCLUSION: Implementation of the Pause was associated with a decrease in anxiety among bedside nurses. Given the minimal cost and workload for staff members, along with the positive outcome, continuation of this intervention is recommended.