Abstract
Purpose/Problem Statement: Caring for patients with substance use disorder is a challenge for nurses, especially patients who use intravenous (IV) drugs and contract endocarditis. Infective endocarditis is a cardiac infection with a high mortality rate, and yet this disease receives little attention in the media or research. IVDU-IE has been referred to as the Cinderella of Cardiology. Nurses disposition young patients in the prime of their lives to hospice care, funeral homes, morgues, or home to die. The purpose of this modified photo elicitation phenomenological study was to explore the impact of caring for patients diagnosed with IVDU-IE at the end of life on nurses.
Background/Significance: IVDU-IE mortality rates are high, 40% at the one year mark. Recidivism is a reality, and surgeons struggle to justify operating on damaged heart valves. Nurses have conflicting feelings about repeat valve replacements. Notably absent from the IE conversation are the nurses’ views of caring for IVDU-IE patients at end of life.
Methods: A modified photo elicitation phenomenological investigation was conducted using photographic mediums, written reflections, and individual phenomenological unstructured interviews. Twenty-nine nurses, ages 22 to 65 years of age participated in the study. Nurses uploaded photographs via an electronic survey platform, ArcGIS and Qualtrics. Five phenomenological interviews were conducted by the researcher.
Findings: Photoelicitation and phenomenology combined to yield three themes that described the impact of caring for IVDU-IE patients at end of life on the nurse as 1) a “heartbreaking” experience to witness, (2) an “exhausting” experience to endure, and (3) a practice-altering experience that transforms.This study adds to the addiction science literature as there is a paucity of end-of-life studies exploring this phenomenon. This study will inform nursing practice, education, and health policy.
Discussion: End-of-life care education is needed to improve the care experience for nurses and patients. Trauma informed care of nurses following these challenging care experiences is needed, sucy as formal debriefing to mitigate turnover, as "the sadness has only ever been outweighed by COVID," as "that burnout is real". Future research is needed to explore the benefits of ecopsychology and ecotherapy as a method to process trauma.
Notes
Reference list included in attached slide deck.
Sigma Membership
Epsilon Sigma at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Phenomenology
Research Approach
Qualitative Research
Keywords:
Hospice, Palliative, or End-of-Life, Stress and Coping, Health Equity or Social Determinants of Health, Global Health Issues, Ethics, Substance Use Disorder, Intravenous Drugs, Endocarditis
Recommended Citation
Todt, Kendrea Lea, "Exploring the Impact of Caring for Patients Diagnosed with IV Drug Use Endocarditis at End of Life" (2025). Biennial Convention (CONV). 188.
https://www.sigmarepository.org/convention/2025/presentations_2025/188
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-12-05
Funder(s)
East Tennessee State University
Exploring the Impact of Caring for Patients Diagnosed with IV Drug Use Endocarditis at End of Life
Indianapolis, Indiana, USA
Purpose/Problem Statement: Caring for patients with substance use disorder is a challenge for nurses, especially patients who use intravenous (IV) drugs and contract endocarditis. Infective endocarditis is a cardiac infection with a high mortality rate, and yet this disease receives little attention in the media or research. IVDU-IE has been referred to as the Cinderella of Cardiology. Nurses disposition young patients in the prime of their lives to hospice care, funeral homes, morgues, or home to die. The purpose of this modified photo elicitation phenomenological study was to explore the impact of caring for patients diagnosed with IVDU-IE at the end of life on nurses.
Background/Significance: IVDU-IE mortality rates are high, 40% at the one year mark. Recidivism is a reality, and surgeons struggle to justify operating on damaged heart valves. Nurses have conflicting feelings about repeat valve replacements. Notably absent from the IE conversation are the nurses’ views of caring for IVDU-IE patients at end of life.
Methods: A modified photo elicitation phenomenological investigation was conducted using photographic mediums, written reflections, and individual phenomenological unstructured interviews. Twenty-nine nurses, ages 22 to 65 years of age participated in the study. Nurses uploaded photographs via an electronic survey platform, ArcGIS and Qualtrics. Five phenomenological interviews were conducted by the researcher.
Findings: Photoelicitation and phenomenology combined to yield three themes that described the impact of caring for IVDU-IE patients at end of life on the nurse as 1) a “heartbreaking” experience to witness, (2) an “exhausting” experience to endure, and (3) a practice-altering experience that transforms.This study adds to the addiction science literature as there is a paucity of end-of-life studies exploring this phenomenon. This study will inform nursing practice, education, and health policy.
Discussion: End-of-life care education is needed to improve the care experience for nurses and patients. Trauma informed care of nurses following these challenging care experiences is needed, sucy as formal debriefing to mitigate turnover, as "the sadness has only ever been outweighed by COVID," as "that burnout is real". Future research is needed to explore the benefits of ecopsychology and ecotherapy as a method to process trauma.
Description
A modified photo elicitation phenomenological investigation was conducted to explore the impact of caring for IVDU patients at end of life. Nurses endure trauma in these care experiences reporting these experiences as "excruciating" to witness and similar to watching a suicide. These care experiences are traumatic to nurses, who described them as "heartbreaking," and "exhausting" to endure, and left them changed, with scars and transformed, with a resolve to advocate for these patients.