Mader-e-Milat International Journal of Nursing and Allied Sciences

Nurses’ Perception of Futile Care: A Systematic Review

2026-01-11T19:03:01+00:00

Background: Advances in medical technology have improved patient survival; however, the continuation of treatment at the end of life often raises ethical and professional concerns, particularly when such care is perceived as futile. Nurses, due to their continuous bedside presence, are frequently involved in and affected by decisions related to futile care.

Methods: This review aimed to synthesize existing literature on nurses’ perceptions of futile care, including how futility is defined, factors influencing these perceptions, and the professional outcomes associated with providing such care. A systematized systematic review was conducted in accordance with PRISMA guidance. PubMed, Medline, ProQuest, and Google Scholar were searched for relevant English-language studies published between 1980 and 2020. Qualitative, quantitative, and mixed-methods studies focusing on nurses’ perceptions of futile care were included. Due to methodological diversity among studies, findings were synthesized narratively.

Results: Twenty-two studies met the inclusion criteria. Across settings, nurses’ perceptions of futile care ranged from moderate to high. Futile care was commonly described as treatment lacking physiological benefit, prolonging the dying process, or failing to improve quality of life. Factors influencing perception included family insistence on continued treatment, cultural and religious values, interprofessional conflict, and organizational constraints. Perceived futile care was consistently associated with moral distress, emotional exhaustion, burnout, and reduced job satisfaction among nurses.

Conclusion: In conclusion, nurses frequently encounter and perceive futile care in critical care environments, with notable ethical and occupational consequences. Interventions focusing on education, communication, multidisciplinary decision-making, and institutional support may help reduce moral distress and improve the quality of end-of-life care.

Perceived Barriers in Implementation of Nursing Process in Public Sectors of South Punjab-Pakistan

2025-09-14T17:02:47+00:00

Background: The nursing process is a universal system that is essential to the nursing profession and is absolutely vital in the provision of the high quality and patient centered care. Its practical use elevates the level of patient care, whereas the inability to implement it effectively might harm the patient care outcomes. It is also important that the perceived barriers be understood individually and organizationally among nurses to facilitate the practical application of the nursing process.

Methods: A descriptive cross sectional study was used to establish the barriers in the implementation of the nursing process within the institutions of the public sector in South Punjab, Pakistan. The nurses working in Intensive Care Unit (ICU) and High Dependency Unit (HDU) of four tertiary care teaching hospitals as Nishtar Hospital Multan, Bahawal Victoria Hospital Bahawalpur, Sheikh Zayed Hospital Rahim Yar Khan and Teaching Hospital Dera Ghazi Khan were sampled to collect the data. There was also an application of a structured questionnaire to measure individual and organizational barriers.

Findings: Two hundred and thirty nurses took part in the research. In terms of the individual-level barriers, 60 percent of the nurses said they were highly hindered, and 40 percent had low perceptions. On the same note, 57% of respondents indicated that they are high of organizational barriers, and 43% of respondents indicated that they are low. These findings demonstrate that the adoption of nursing process entails major challenges in the provision of healthcare services in the general population.

Conclusions: The research points to the significant personal and institutional barriers to the implementation of the nursing process in the hospital of the South Punjab in the public sector. It is essential to mitigate these obstacles using specific interventions to enhance the nursing care and patient care outcomes.