Purpose: In this qualitative descriptive study, we aimed to explore the experiences of nurses providing end-of-life (EOL) care in an emergency department (ED) setting and identify the associated challenges and implications for clinical practice. Methods: Twelve nurses with over 1 year of EOL care experience in the ED were interviewed. The collected data were analyzed using thematic analysis, as outlined by Braun and Clarke. Results: Five main themes with corresponding subthemes were identified: (1) Inadequate Environment for EOL Care, including physical environment barriers for a dignified death and emotional restraint in a chaotic setting; (2) Impact of Life-Sustaining Treatment Decision Complexity, encompassing complicated dynamics of family decision-making and compromised care quality in the decision-making process; (3) Managing Care Relationships in Physician-Limited Settings, manifested as navigating limited physician communication and bearing the emotional weight of EOL care; (4) Challenges in Protecting Patients’ Rights, characterized by powerlessness in the face of silent patients and confusion from reversed decisions by families; and (5) Actualizing Compassionate EOL Care, ensuring dignity through purposeful actions and navigating environmental barriers to dignified care. Conclusion: We highlight the need for systematic changes in the ED to better support EOL care, including the development of culturally sensitive communication protocols, shared guidelines for decision-making, and improved collaboration between healthcare professionals. These findings provide valuable insights into enhancing EOL care in EDs. Future efforts should focus on policy changes, tailored education programs, and support systems that address the multifaceted needs of patients, families, and healthcare providers.

INTRODUCTION
METHODS
    1. Research Design
    2. Participants
    3. Data Collection
    4. Ethical Considerations
    5. Data Analysis
    6. Methodological Rigor
RESULTS
    1. General Characteristics of Participants
    2. Thematic Analysis of EOL Care in the ED
        Theme 1: Inadequate Environment for EOL Care
        Theme 2: Impact of Life-Sustaining TreatmentDecision Complexity
        Theme 3: Managing Care Relationships in Physician-Limited Settings
        Theme 4: Challenges in Protecting Patients' Rights
        Theme 5: Actualizing Compassionate EOL Care
DISCUSSION
CONCLUSION
REFERENCES

• Jang Yu Jin(Registered Nurse, Gyeongsang National University Hospital, Jinju, Korea)
• Chang Hee Kyung(Associate Professor, College of Nursing, Gyeongsang National University, Jinju, Korea) Corresponding author