LAUSR

AIMS The aims of this study were to develop an understanding of the lived experience of the Post Anaesthetic Recovery Unit Nurse facilitating Advanced Directives and implications for patient centred care. DESIGN Interpretive Phenomenological Analysis. METHODS Homogenised purposive sampling of six registered nurses using in-depth semi-structured interviews. Interviews were conducted between June and July 2018. Analysis was performed using Interpretive Phenomenology Analysis. RESULTS Post Anaesthetic Recovery Nurses experienced a "Grey Zone" when facilitating Advanced Directives post anaesthetic. The "Grey Zone" is defined through four themes; The 'Trigger' of the anaesthetic characterised by physiological instability; 'Confusion and Frustration' featuring balancing of roles as a clinician and advocate during patient decline; 'Consistent Paternalism' by medical staff in the consideration of Advanced Directives; and 'Disempowerment' where nurses faced issues of advocacy, personal distress, a lack of literature or protocols and handover of information. CONCLUSION The lived experience of nurses facilitating Advanced Directives post anaesthetic may be distressing. Further research is required to understand implications of Advanced Directives following an anaesthetic. Education and development of protocols are recommended to optimise patient centred care.