Conectar
To explore and gain a deeper understanding of how registered nurses in palliative care develop personal and professional approaches in confidential conversations with patients.
A qualitative study using focus groups.
Between March and May 2024, 22 registered nurses working in specialised palliative care in the northern region of Sweden participated in five focus groups. The discussions were recorded, transcribed verbatim and analysed using interpretive description.
Registered nurses pursued meaningful, supportive interactions during confidential conversations. Their reflections revealed vulnerabilities and the importance of continuous self-reflection, fostering growth, resilience and professional development. They sought ways to process emotional challenges, from individual reflection to peer discussions and structured supervision, refining their approaches. Four themes emerged: balancing external demands with inner motivation, recognising personal limitations, managing compassion with professional responsibility and gradually building trust.
Reflection and continuous professional development are essential for navigating confidential conversations in palliative care. These practices help registered nurses balance empathy with boundaries whilst managing emotional and professional challenges. Peer support and shared learning, as well as fostering self-awareness and emotional resilience can enhance care quality and promote sustained professional growth across healthcare settings.
This study highlights the emotional challenges registered nurses face in confidential conversations with patients at the end of life. Reflection and support help them handle these challenges and promote person-centred care by enabling patients to express their inner thoughts and wishes. The findings apply to palliative care and other settings caring for patients at the end of life.
Findings were reported following the Consolidated Criteria for Reporting Qualitative Research guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
To explore aspects of interpersonal relationships in palliative care nursing, focusing on confidential conversations between patients and registered nurses (RN).
A qualitative study employing focused ethnography.
Data were collected through unstructured participant observations, field notes and interviews with patients and RN in specialist palliative care. Data were analysed using reflective thematic analysis.
Confidential conversations in palliative care are founded on trust that is fragile and develops dynamically through consistent interactions. Small talk, presence and silence are essential for initiating and maintaining trust and the interpersonal relationship. The environment, patient condition and RN emotional presence and competence shape these conversations. As the relationship evolves, conversations adapt to the patient's changing needs. Missed signals or interruptions can disrupt flow, but the potential for repair remains, allowing for restoration and strengthening of trust and connection.
Confidential conversations in palliative care are grounded in fragile, dynamic trust, necessitating ongoing presence, sensitivity and adaptability from RN. To support these interactions, healthcare environments must prioritise privacy, relational continuity and communication training. Future research should investigate how organisational structures and clinical settings influence confidential conversations.
Healthcare environments should facilitate confidential conversations by ensuring relational continuity and minimising distractions. Communication training that emphasises presence and management of silence can strengthen nurse–patient relationships, enhancing patient care and emotional support.
This study explores key aspects of confidential conversations in palliative care, emphasising trust and emotional sensitivity. It addresses a research gap in palliative care using rare observational methods to deepen understanding of nursing relational aspects. The findings offer practical guidance for enhancing communication and relational skills, informing training and policy development and ultimately, improving emotional support and care.
Findings are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.
This study did not involve patient or public participation in its design, conduct or reporting.
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