Nurses' Experience in Providing End-of-Life Care in Intensive Care Unit: A Scoping Review.

Abstract

<b>Background:</b> Most ICU patients are in the terminal phase and require complex palliative care support and End-of-Life Care (EoLC). Nurses play a central role in symptom management, emotional support, and shared decision-making. However, evidence on nurses' experiences in providing EoLC remains fragmented and lacks a comprehensive synthesis. <b>Objective:</b> This review aimed to identify, map, and synthesize global evidence on ICU nurses' experiences in delivering EoLC, including challenges, coping strategies, and implications for critical care nursing practice. <b>Methods:</b> A scoping review was conducted following Arksey and O'Malley's framework and PRISMA-ScR guidelines. Systematic searches were performed in the PubMed, Scopus, and EBSCOhost databases for studies published between 2015 and 2025. Thematic analysis was applied to the qualitative studies to identify patterns and key issues. <b>Results:</b> Twelve qualitative studies conducted in diverse countries met the inclusion criteria. Five major themes emerged: (1) emotional and moral challenges; (2) cultural and spiritual influences; (3) communication and interprofessional collaboration; (4) professional development and organizational support; and (5) resource constraints. These findings indicate that ICU nurses' experiences with EoLC are multidimensional and shaped by the cultural context and institutional policies. <b>Conclusions:</b> ICU nurses' experiences with EoLC reflect complex ethical, emotional, and organizational dimensions. Improving care quality requires structured training, organizational support, and culturally sensitive policies to strengthen critical care nursing practice.