David Kenneth Wright

David Kenneth Wright
University of Ottawa · School of Nursing

PhD, RN, CHPCN(C)

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61
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Publications

Publications (61)
Article
Full-text available
Background Intolerable suffering is a common eligibility requirement for persons requesting assisted death, and although suffering has received philosophic attention for millennia, only recently has it been the focus of empirical inquiry. Robust theoretical knowledge about suffering is critically important as modern healthcare provides persons with...
Article
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Background Even as healthcare providers and systems were settling into the processes required for Medical Assistance in Dying (MAID) under Bill C-14, new legislation was introduced (Bill C-7) that extended assisted death to persons whose natural death is not reasonably foreseeable. The purpose of this paper is to describe the experiences of nurses...
Presentation
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Moral experiences are part of nursing practice and moral distress not uncommon, as nurses deal with ethically difficult situations in their practice. The devastation caused by the COVID-19 pandemic has exacerbated existing issues and given rise to unique ethical challenges. Social distancing measures that keep people who are dying, and their famili...
Article
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Efforts to curb spread of COVID-19 has led to restrictive visitor policies in healthcare, which disrupt social connection between patients and their families at end of life. We interviewed 17 Canadian nurses providing palliative care, to solicit their descriptions of, and responses to, ethical issues experienced as a result of COVID-19 related circ...
Article
Authorities within the field of palliative care frequently espouse that assisted death is – and must remain – separate from palliative care. This fault line, between palliative care and assisted death, has important implications for how we enact end-of-life care, particularly in jurisdictions where assisted death is legal. And yet little is known a...
Article
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Background and Rationale The Compassionate Communities movement emphasizes the importance of illness, disability, dying, caregiving, and grief across the lifespan and highlights the communal responsibility of caring for one another. There is a need to recognize and incorporate the needs of diverse communities within this movement and research on dy...
Article
Background Contemporary healthcare exists within a cisnormative landscape, where the expected (and ideal) patient is white, straight, and male. As a result, we see the erasure of trans persons in healthcare, health research, and health education, which results in negative experiences and poorer outcomes. Further, nurses report feeling inadequately...
Article
Background In the last few decades, research and clinical care have attempted to identify and meet the palliative care needs, concerns and challenges of patients of all ages with neurologic disease, under the newly defined subspecialty of neuropalliative care. However, the role of nurses in care organization and provision, as well as nursing priori...
Article
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Healthy End of Life Project (HELP) Ottawa is a community-based participatory research initiative which is based in four community sites in Ottawa, Ontario (Canada) (2 community health centers, and 2 faith communities). Focused on the needs of people who are frail, living with advanced illness, and their caregivers, including the needs of people who...
Article
Background Moral distress, the phenomenon in which an agent is constrained in acting on their ethical choice, is a reoccurring theme in the literature on nurses' experiences of end-of-life care (EOLC). Understanding moral engagement solely through a lens of moral distress can be limiting—as such, we sought to explore the diverse experiences nurses...
Article
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There is a called-for shift to an upstream provision of palliative care as an overall care approach within a health equity perspective. Our research explored how nurses in psychiatry engage with aging patients and mortality to discern enactment of ethical dimensions of care. Drawing from tenets of interpretative phenomenological analysis, forensic...
Article
Due to the criminalization of marginalized people, many markers of social disadvantage are overrepresented among prisoners. With an aging population, end of life in prison thus becomes a social justice issue that nurses must contend with, engaging with the dual suffering of dying and of incarceration. However, prison palliative care is constrained...
Article
Background In the last two decades, nursing authors have published ethical analyses of palliative sedation—an end-of-life care practice that also receives significant attention in the broader medical and bioethics literature. This nursing literature is important, because it contributes to disciplinary understandings about nursing values and respons...
Article
Background The intensive care unit (ICU) is a care context that is sometimes described as being unconducive to the values and ideals of a good death in end-of-life care. Such assumptions render the ICU emblematic of a troubling discourse about end-of-life care in this clinical context. Aim To stimulate a reflective examination of intensive care nu...
Article
Background: Over the last three decades, there has been a growing body of literature that has described moral distress as a prominent issue that negatively affects intensive care nurses. Yet, little focus has been given to how intensive care nurses cope and continue in their practice despite being exposed to moral distress. Objective: To describ...
Article
Objectives: The purpose of this study was to provide a comprehensive exploration of nurses' meaningful experiences of providing end-of-life care to patients and families in the intensive care unit (ICU). The objectives of this research were: (1) To explore what is meaningful practice for nurses regarding end-of-life care; (2) To describe how nurse...
Article
The number of people aging and dying behind bars is growing, bringing greater attention to the need for prison palliative care. While this trend has rightly led to increased scholarship, a focus on understanding the most effective way to deliver prison palliative care has overshadowed thinking about why the need itself has arisen, as well as deeper...
Article
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Background Living donor kidney transplantation (LDKT) has several advantages over deceased donor kidney transplantation. Yet rates of living donation are declining in Canada and there exists significant interprovincial variability. Efforts to improve living donation tend to focus on the patient and barriers identified at their level, such as not kn...
Data
Supplementary_Appendix_1_Codebook-LDKT – Supplemental material for Health Professional–Identified Barriers to Living Donor Kidney Transplantation: A Qualitative Study
Article
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Context: Based on the clinical care pathway of delirium in palliative care (PC), a published analytic framework (AF) formulated research questions in key domains and recommended a scoping review to identify evidence gaps. Objectives: To produce a literature map for key domains of the published AF: screening, prognosis and diagnosis, management,...
Article
Objectives In 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia (VAE). Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec positi...
Article
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1 Background The purpose of this concept analysis was to examine how the concept of personhood has been used in the nursing literature. The person is central to nursing, as the object of nursing work, or care, and a key element of theory. Health and illness confront conventional notions of personhood based on the Western philosophy, in delineating...
Article
The practice of operating room (OR) clinicians – nurses, surgeons, and anesthetists – is fundamentally about preserving life. Some patients, however, die in the OR. Clinicians are therefore vulnerable to moral and emotional trauma. In this paper, we discuss three forces that shape clinicians’ moral and emotional experiences in OR care: biomedical v...
Article
Delirium, a common syndrome in terminally ill people, presents specific challenges to a good death in end‐of‐life care. This paper examines the relational engagement between hospice nurses and their patients in a context of end‐of‐life delirium. Ethnographic fieldwork spanning 15 months was conducted at a freestanding residential hospice in eastern...
Article
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Abstract Background: Health research is conducted with the expectation that it advances knowledge and eventually translates into improved health systems and population health. However, research findings are often caught in the know-do gap: they are not acted upon in a timely way or not applied at all. Integrated knowledge translation (IKT) is advan...
Article
Background: A movement is underway to promote a palliative approach to care in all contexts where people age and live with life-limiting conditions, including psychiatric settings. Forensic psychiatry nursing-a subfield of mental health nursing- focuses on individuals who are in conflict with the criminal justice system. We know little about the v...
Article
Background: Rules and regulations represent an aspect of psychiatric hospitalization about which little is known. Study purpose: To explore the perceptions of rules from the perspective of youth receiving hospital-based psychiatric services. Design: Qualitative descriptive. Methods: Perceptions of rules were elicited through semi-structured...
Article
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Canadian end-of-life care is changing. Given recent legislative changes concerning assisted death (euthanasia and assisted suicide), it is vital to examine the perspectives of nurses regarding their care of patients who want to die. This qualitative descriptive study reports findings from interviews with 11 oncology nurses about their experiences o...
Article
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Les soins de fin de vie changent au Canada. À la lumière des récentes modifications législatives sur l’aide à mourir (euthanasie et suicide assisté), il y a lieu d’examiner le point de vue des infirmières sur les soins à donner aux patients qui veulent mourir. Cette étude descriptive et qualitative rapporte les résultats d’entrevues réalisées auprè...
Article
Background: Legislative changes are resulting in assisted death as an option for people at the end of life. Although nurses' experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses' experiences of caring for people who request thi...
Article
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‘Suffering’ is a central discursive trope for the right-to-die movement. In this article, we ask how proponents of physician-assisted dying (PAD) articulate suffering with the role of medicine at the end of life within the context of a decriminalization and legalization debate. We draw upon empirical data from our study of Carter v. Canada, the lan...
Article
Since the 1990s, there has been a growing global movement to legalise the controversial practice of physician-assisted dying (PAD). In the last twenty years, 13 jurisdictions have decriminalised or legalised PAD which, in turn, have produced new knowledge on the practice. The recent case of Carter v. Canada, which decriminalised PAD in Canada in 20...
Article
Delirium is extremely common in dying patients and appears to be a major threat to the family's moral experience of a good death in end-of-life care. To illustrate one of the ways in which hospice caregivers conceptualize end-of-life delirium and the significance of this conceptualization for the relationships that they form with patients' families...
Article
Background: Recent events in Canada have mobilized public debate concerning the controversial issue of euthanasia. Physicians represent an essential stakeholder group with respect to the ethics and practice of euthanasia. Further, their opinions can hold sway with the public, and their public views about this issue may further reflect back upon th...
Article
Context Delirium occurs in patients across a wide array of health care settings. The extent to which formal management guidelines exist or are adaptable to palliative care is unclear. Objectives This review aims to 1) source published delirium management guidelines with potential relevance to palliative care settings, 2) discuss the process of gu...
Article
Context: In end-of-life care, delirium is often not recognized and poses unique management challenges, especially in the case of refractory delirium in the terminal phase. Objectives: To review delirium in the terminal phase context, specifically in relation to recognition issues; the decision-making processes and management strategies regarding...
Article
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Context Delirium often presents difficult management challenges in the context of goals of care in palliative care settings. Objectives The aim was to formulate an analytical framework for further research on delirium in palliative care settings, prioritize the associated research questions, discuss the inherent methodological challenges associat...
Article
Delirium is a condition of acute onset and fluctuating course in which a person's level of consciousness and cognition become disturbed. Delirium is a common and distressing phenomenon in end-of-life care, yet it is underrecognized and undertreated. In this article, we review qualitative descriptions of the delirium experience in end-of-life care,...
Article
This qualitative study explores "helpful" nursing care from the perspective of adolescents at risk for suicide. While hospital-based nurses have a high level of direct and continuous contact with suicidal teens, little is known about the nursing care offered to this population. The purpose of this research is to explore the perceptions of suicidal...
Article
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Nursing theories provide inspiration for practice by describing how to meet needs, enhance wellness, and respond to clients as whole persons. This paper discusses the McGill Model of Nursing with reference to how its ideas can support nursing practice for patients with cancer during the end-of-life phase. We suggest this model provides for a relati...
Article
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Les théories infirmières inspirent les praticiens en décrivant comment répondre aux besoins, rehausser le bien-être et interagir avec les clients en tant que personnes considérées dans leur globalité. Cet article examine le modèle de soins infirmiers McGill relativement à la façon dont ses principes peuvent appuyer la pratique infirmière à l’intent...
Article
Symptom distress with end-of-life delirium (EOLD) is complex and multidimensional, and interprofessional (IP) teams require knowledge and skill to effectively care for these patients and their families. The purpose of this pilot study was to test an educational intervention about EOLD for IP teams at a long-term care facility and a hospice. The int...
Article
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Cette recherche identifie les interventions infirmières bénéfiques selon la perspective des adolescents à risque pour suicide. Quoique les infirmières du milieu hospitalier aient un niveau de contact direct, élevé et continu auprès du patient, il n’existe aucune recherche sur les interventions thérapeutiques offertes par ces dernières. Cette étude...
Article
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Delirium at the end of life is common and can have serious consequences on an older person's quality of life and death. In spite of the importance of detecting, diagnosing, and managing delirium at the end of life, comprehensive clinical practice guidelines (CPG) are lacking. Our objective was to develop CPG for the assessment and treatment of deli...
Article
This qualitative study explored new nurses' experience of their role within interprofessional health care teams in a mental health organization in Canada. Semistructured interviews were conducted with 10 nurses. Content analysis revealed two main themes, namely, adopting a passive role to learn how to fit in and engaging in an active role to impact...
Article
This study investigated the key aspects of a successful integration experience into mental health nursing from the perspectives of new nurses working in a psychiatric institution. Analysis of 10 semistructured interviews revealed that the relational atmosphere in which new nurses find themselves is determinant of their satisfaction with their integ...
Article
In this article we attempt to situate nursing within the interprofessional care team with respect to processes of ethical practice and ethical decision making. After briefly reviewing the concept of interprofessionalism, the idea of a nursing ethic as 'unique' within the context of an interprofessional team will be explored. We suggest that nursing...
Article
The purpose of this study was to develop and assess a staff development intervention seeking to promote dialogue about client sexuality in a mental health setting. Fifteen staff and two nurse managers from a single psychiatric inpatient unit participated. Major themes influencing practice regarding client sexuality were explored, and nursing strate...
Article
The daily work of palliative care nurses, who strive to respond to suffering at the end of life, is emblematic of the moral dimension of nursing practice. Traditional "mainstream" bioethics can fall short in addressing the complex and contextual nature of experience-as-lived in palliative care. This article proposes relational ethics as an underlyi...
Article
To examine dimensions of the psychosocial work environment that influence the psychological health of new-generation nurses. While much work has been done concerning the health of nurses in general, research on the relationship between the nursing work environment and the psychological well-being of new-generation nurses at the start of their caree...