Perceptions and attitudes of nursing students toward end-of-life care: A qualitative study at a tertiary hospital in Uganda

Background: Clinical practice is an important part of nursing education as it helps nursing students transition into competent health professionals capable of providing quality services. However, research studies convey their significant role as a stressor for nursing students when they encounter end-of-life situations during clinical practice. Furthermore, the perceptions of nursing students regarding end-of-life care (EOLC) have not been exhaustively studied in the Ugandan context. Objective: This study was conducted to understand nursing students’ perceptions about EOLC during clinical practice at Mulago National Referral Hospital. Design: This qualitative study employed a phenomenological approach and was conducted among fifteen nursing students from Makerere University who were assigned to clinical practice at Mulago National Referral Hospital, Kampala, Uganda in 2023. Method: Participants were purposively selected for the study from third- and fourth-year undergraduate nursing students. Data were gathered through semi-structured in-depth interviews which were audio-recorded, transcribed, and thematically analyzed using Atlas.ti version 6 software. Results: Three main themes emerged from the data: (i) reactions to the physical process of EOLC; (ii) changes in ideas about dying patients; and (iii) student attitudes toward dying patients. Participants described their reactions as chaotic, devastated, and scared during their first encounter with care for dying patients. They also highlighted how their attitudes evolved from unfavorable impressions to positive perceptions as they gained experience. Conclusion: In this study, nursing students exhibited divisive attitudes toward EOLC starting with uncertainty and fear, then often growing into confidence and compassion. These powerful experiences show how much EOCL can shape students personally and professionally, highlighting the need for greater support in their educational journey. Further research could help understand how this process unfolds in different settings.