Practical care work and existential issues in palliative care: experiences of nursing assistants

Background Despite increasing international interest in palliative care, little focus has been given to the role of nursing assistants, nor to research on existential issues. Aims and objectives To investigate nursing assistants' experiences of existential issues in palliative care. Design An explorative study using focus group discussions as data. Seven nursing assistants working in a palliative care unit and a nursing home participated on three occasions. Method Data were analysed using a content analysis approach. Results Two overlapping domains were extracted: practical care, interpreted in themes as meeting others, the patient's body and organisational boundaries; and existential issues, interpreted as the difficult part, the valuable part and death and dying. Communication seemed to be a theme central to both domains. Conclusions The results indicate that nursing assistants may give existential support in addition to practical aspects of care. The intimate interactions inherent in practical aspects of personal care create opportunities for meaningful conversations. Such conversations may constitute existential support for patients and a meaningful task for staff. Implications for practice It is important that nursing assistants are given an opportunity for further education and time for reflection. The simple intervention in the present study, that is, focus group discussions, gave them an opportunity to reflect upon their work. Education in gentle massage, for example, can also be suggested as it may improve non‐verbal contact and be beneficial for dying patients.