Advance Care Planning in Practice: Hospital Nurses’ Experiences with Known and Unknown Goals of Care
Other Titles
Rising Star Poster/Presentation
Abstract
Background: Hospital continues to be the place of death for the majority of Canadians, despite the common preference for a less aggressive comfort-focused plan of care at the end-of-life. Advance care planning (ACP) is recognized as a means to prevent unwanted care for patients. However, ACP is often not occurring in acute care settings before patients lose the capacity to participate. This means that a patient’s goals of care are frequently left unknown, which may not only lead to overtreatment and patient harm, but also to moral distress in nurses.
Purpose: The purpose of this thesis study is (1) to explore the perceptions of acute and critical care nurses toward ACP and (2) to understand their experience in providing care for patients whose goals of care are known and unknown. The conceptual work of Cynda Rushton (2018) on Moral Resilience provides the framework for this study.
Design: This study is utilizing a qualitative interpretive description methodology with thematic analysis.
Setting and Sample: Participants are being recruited from acute and critical care units from a large teaching hospital in Manitoba, Canada. Purposive sampling is being used to select nurses from both acute and critical care contexts, in addition to convenience and snowball sampling within both areas according to inclusion and exclusion criteria.
Methods: Semi-structured interviews are being conducted virtually via Zoom, where audio is recorded and transcribed verbatim. Transcripts are then analyzed thematically, aligning with an interpretative description approach, with organisational assistance from NVivo 15 software.
Preliminary Results: Although themes have not yet been established, early participants describe rarely knowing their patient’s own goals for their care, as the preference to ‘do everything’ is often presumed, and ACP discussions typically occur with families once the patient has deteriorated and cannot participate. Nurses state that knowing their patient’s preferences would provide them with ease in their work by feeling morally aligned with the care provided and would dispel confusion and guilt that often occurs when goals of care are unknown.
Significance: The findings of this study are important for adding to our knowledge on acute and critical care nurses’ perceptions toward ACP and understanding the moral and emotional impact of ACP on the experience of providing care, thus shedding light on ACP’s value in the hospital setting.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Interpretive Description
Research Approach
Qualitative Research
Keywords:
Advance Directives (Medical Care), Hospital Nursing Staff, Nurses' Attitudes, Patient Care
Recommended Citation
Hebert, Ashley; Thompson, Genevieve; McMillan, Diana; and Lee-Ameduri, Katarina, "Advance Care Planning in Practice: Hospital Nurses’ Experiences with Known and Unknown Goals of Care" (2026). International Nursing Research Congress (INRC). 91.
https://www.sigmarepository.org/inrc/2026/posters_2026/91
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
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
2026-09-04
Advance Care Planning in Practice: Hospital Nurses’ Experiences with Known and Unknown Goals of Care
Toronto, Ontario, Canada
Background: Hospital continues to be the place of death for the majority of Canadians, despite the common preference for a less aggressive comfort-focused plan of care at the end-of-life. Advance care planning (ACP) is recognized as a means to prevent unwanted care for patients. However, ACP is often not occurring in acute care settings before patients lose the capacity to participate. This means that a patient’s goals of care are frequently left unknown, which may not only lead to overtreatment and patient harm, but also to moral distress in nurses.
Purpose: The purpose of this thesis study is (1) to explore the perceptions of acute and critical care nurses toward ACP and (2) to understand their experience in providing care for patients whose goals of care are known and unknown. The conceptual work of Cynda Rushton (2018) on Moral Resilience provides the framework for this study.
Design: This study is utilizing a qualitative interpretive description methodology with thematic analysis.
Setting and Sample: Participants are being recruited from acute and critical care units from a large teaching hospital in Manitoba, Canada. Purposive sampling is being used to select nurses from both acute and critical care contexts, in addition to convenience and snowball sampling within both areas according to inclusion and exclusion criteria.
Methods: Semi-structured interviews are being conducted virtually via Zoom, where audio is recorded and transcribed verbatim. Transcripts are then analyzed thematically, aligning with an interpretative description approach, with organisational assistance from NVivo 15 software.
Preliminary Results: Although themes have not yet been established, early participants describe rarely knowing their patient’s own goals for their care, as the preference to ‘do everything’ is often presumed, and ACP discussions typically occur with families once the patient has deteriorated and cannot participate. Nurses state that knowing their patient’s preferences would provide them with ease in their work by feeling morally aligned with the care provided and would dispel confusion and guilt that often occurs when goals of care are unknown.
Significance: The findings of this study are important for adding to our knowledge on acute and critical care nurses’ perceptions toward ACP and understanding the moral and emotional impact of ACP on the experience of providing care, thus shedding light on ACP’s value in the hospital setting.
Description
This qualitative interpretative description study aims to explore hospital nurses’ perceptions toward advance care planning (ACP) and the experience of providing care to patients whose goals of care are known and unknown. Semi-structured interview data are being analyzed thematically to ultimately examine the impact ACP has on nurses. Preliminary results suggest the important impact ACP has on nurses and their workplace satisfaction, emphasizing ACP’s value in the hospital setting.