• Kate White, Lesley Wilkes, Karen Cooper, and Michael Barbato.
• School of Nursing and Public Health, Edith Cowan University, Pearson Street, Churchlands WA 6018 Australia. k.white@ecu.edu.au
• Int J Palliat Nurs. 2004 Sep 1;10(9):438-44.

Aimto describe the impact of unrelieved patient suffering on nurses working with palliative care patients.DesignThis was a qualitative descriptive design using semi-structured interviews.Samplenine experienced palliative care nurses were interviewed.Resultsnurses acknowledged that the term 'suffering' generally was not used in the workplace. The nurses identified that only a small group of patients died with suffering that could be classified as 'unrelieved' but that the impact of these patients' suffering on themselves was enormous. Nurses describe the impact in terms of perceptions of suffering (difficult situation), feelings (helplessness, distress, feelings of failure), bearing the burden (alcohol consumption, headaches) and effects on their relationship with family. The nurses identified several factors that increased the personal impact of unrelieved patient suffering. The most important strategy for ameliorating the impact of unrelieved patient suffering was informal support from work colleagues.Conclusionthe nurses' stories indicate that the personal impact of unrelieved patient suffering could be reduced through acknowledgement of this suffering and better formal and informal support mechanisms.

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