How physicians see nurses’ role in decision-making about life-prolonging treatments in patients with a short life expectancy: An interview study

Objective: Exploring physicians’ views on hospital nurses’ role in decision-making about potentially life-prolonging treatments in patients with a short life expectancy. Methods: A qualitative study using semi-structured interviews with hospital physicians. Data were collected from May to September 2019 and analyzed following principles of thematic analysis. Results: Fifteen physicians working in different hospitals and specialisms participated. Physicians stated that they are responsible for the final decision about potentially life-prolonging treatments. They considered nurses’ role in decision-making to be complementary to the roles of both patients and the physicians themselves, especially when there are doubts or complex situations. Physicians varied in how important they found nurses’ involvement in the decision-making process: some physicians saw the involvement of nurses as “situation-dependent”, while others viewed nurses’ involvement as standard practice. Furthermore, physicians mentioned practical obstacles to involving nurses, like the limited time available to both nurses and physicians themselves. Conclusion: Physicians recognize a complementary role for nurses in decision-making about potentially life-prolonging treatment, especially in cases with doubts or complex situations. Practice implications: Physicians and nurses should engage with each other to make nurses’ involvement less situation-dependent. This inter-professional collaboration regarding decision-making about life-prolonging treatments should be stimulated, supported and maintained.