Essence of caring for a person dying

The present paper aims to illustrate the essence of caring through the philosophical lens of palliative care gained from one family's experience within a home environment. The narrative used provided a vehicle through which a family member recalled the experience of caring for her mother, who was dying. The essence of caring is portrayed by the use of exemplars gained from the narrative situated within a palliative context depicting both the person dying and the carer's perspective. The narrative offers the opportunity to better understand cultural knowledge, history and social practices from the perspective of the family unit, and to understand how families might be best supported by health professionals engaged in care delivery. The commitment demonstrated by family members in caring for a family member dying is significant and needs to be more valued as a contribution to our understanding of this life event. From the analysis of this family's experience, health professionals are afforded an insight into the diversity of needs that encompass the essence of care being provided in the home. This opportunity allows health professionals to gain further insight into this significant life event, leading to an enhancement of their practice and enabling them to be better equipped to meet the individual needs of family units.     

The experiences of the registered nurse caring for the person dying of cancer in a nursing home

This paper reports on research that set out to identify and describe the experiences of the registered nurse caring for the resident dying of cancer in a nursing home. The research method used was a qualitative single case study involving five registered nurses in one nursing home. Thematic analysis of data from unstructured interviews and reflective journals was used to explicate the nurses' experiences. Four major themes were extracted from the data. These themes were the exclusivity of the relationships, difficulties in the management of pain, the expectations of the registered nurse and the impact of caring. The nurses' experiences were loving, fascinating, compelling and rich. The overarching experience of the nurses came from the relationship they formed with the residents. A crucial finding in this study was that these registered nurses valued the elderly resident and developed meaningful relationships with them. All aspects of the relationships were unique and profound. However, the emotional involvement with the resident, multiple death losses, confrontation of personal losses, limited workplace support such as counselling, potentially places these registered nurses at emotional risk from burnout and complicated bereavement. The implications of these findings for nursing practice, education and research are discussed.     

Frances's story of nursing art: The most wonderful person in the world.

This story is the second in a series constructed from a study designed to describe how the art of nursing was perceived and understood by patients during a critical illness. Two in-depth interviews were conducted during the recovery phase of this person's illness to answer the question "When is nursing (considered) art?" The initial lead-in to the discussion was, "Tell me a story about a nursing situation that really stood out in your mind-one that was significant and meaningful," and, "What was the experience like for you?" The interviews were tape recorded, transcribed, condensed into a short story, and shared with the participant. The researcher also composed a "response" to the person's story that personally expressed what the story triggered for her. Undergraduate students were invited to reflect and respond to the "aesthetic face" of nursing from the perspective of a person who was nursed while critically ill. Two examples of student response are included.     

The final story: events at the bedside of dying patients as told by survivors

Events at the bedside of a dying patient form lasting memories for families and friends. What is said, who is there, and how care is delivered prevail when individuals are recalling the dying event. The La Crosse Advance Directive Study (LADS) (Hammes & Rooney, 1998) was conducted to examine end-of-life planning in a Midwestern community where an extensive advance directive education program exists. The results indicated that families and friends wanted to be present at death; wanted to give their loved one permission to die; and wanted to have consistent, thorough, and honest communications with their providers. Families also felt compelled to keep the promises they made to their dying loved ones. This study provides an opportunity for families and friends to tell their stories of the events at the bedside of dying patients. Their stories identify a need for more medical, nursing, patient, and family education in end-of-life care.     

Mutual suffering: a nurse's story of caring for the living as they are dying

The aim of this study was to uncover the meaning of the lived experience of mutual suffering in relation to the care of a dying patient. The study took place within an acute medical ward in a district general hospital on the south coast of England as part of a reflective practice development programme. Parse's human becoming theory provided a framework for the study and Parse's research methodology was adopted. Understanding the nature of human relationships within nursing practice is central to nursing work, enabling patients and their health-professional carers to live and work healthily in the context of human becoming. Illuminating mutual suffering through reflection enables nursing and health-care professionals to acknowledge the paradoxes of practice and, thus, create new strategies for the provision of care and the improvement of practice, so that quality of life is maximized for the patient and for themselves.     

Exploring the concept of quality care for the person who is dying

The concept of good quality care for the patient who is dying is diverse and complex. Many of the actions that are being taken to increase the quality of care of the dying patient are based around outcome, uniformity of service and standardization of process. There are two main areas that are referred to when dealing with care of the dying patient; end-of-life care and palliative care. High quality end-of-life care is increasingly recognized as an ethical obligation of health-care providers, clinicians and organizations, and yet there appears little evidence from the patients' perspective. There are many national and local initiatives taking place to improve the quality of care people receive towards the end of their life. This being said initiatives alone will not achieve good quality care and deliver good patient experiences. Only clinicians working at the front line can truly influence the way in which quality is improved and good experiences delivered.     

The case for a sociology of dying,death, and bereavement

Dying, death, and bereavement do not occur in a social vacuum. How individuals and groups experience these phenomena will be largely influenced by the social context in which they occur. To develop an adequate understanding of dying, death, and bereavement we therefore need to incorporate a sociological perspective into our analysis. This article examines why a sociological perspective is necessary and explores various ways in which sociology can be of practical value in both intellectual and professional contexts. A case study comparing psychological and sociological perspectives is offered by way of illustration.