Threats to the good death: the cultural context of stress and coping among hospice nurses

Abstract

This study uses Australian data based on interviews with nurses and participant observation in an in-patient hospice and a community based hospice service to demonstrate how hospice nurses perceive stress in their work environment and cope with caring for dying patients. Stressors are discussed within a cultural context and are viewed as threats to the nurses' shared system of values which centres on the Good Death. The Good Death is conceptualised as a series of social events that involve the dying person as well as the other interactants who may include family, friends and health professionals. The death is defined as 'good' if there is an awareness, acceptance and preparation for death by all those concemed. The nurses' coping strategies and social supports are negotiated within the context of the hospice environment, and relate directly to the protection and affirmation of the nurses' shared value system.

Palliative care at home: Stress for nurses in urban and rural New South Wales, Australia

“…It was not the suddenness of death or the number of deaths that had been cited as a stressor, but the fact that the patient's and/or family's perception of death was ‘not right’ according to the urban nurses in our study 17 . Other studies have also cited this conflict of values 18,19 . On the contrary, the rural nurses in our study were more like those nurses in Munley’s study who felt stressed if other health professionals tried to impose their own values and beliefs on the patient/family 9 .…”

Changes in Emotion Work at Interdisciplinary Conferences Following Clinical Supervision in a Palliative Outpatient Ward

“…They appear to increase moral thinking and ethical reflections on care and treatment and, therefore, support previous findings of research into CS (Berggren & Severinsson, 2006;Severinsson & Kamaker, 1999). This recognition captures one of the great challenges in palliative care, namely, to separate the carer's own needs from those of patients in wanting to achieve the palliative ideal of a death that is "good" for patients and for their relatives (McNamara et al, 1995). The changed perspective on problems from existing practice seems also to have affected not only decisions about care and treatments of patients, when to be active, and when to withdraw but also the interpersonal dynamics and relations between team members.…”

How patients spend their time in a hospice and in an oncological unit

“…The PAC may, however, skew the results towards ‘doing’ by only covering the main activity, and thereby not revealing whether the nurses intended to or addressed the patients’ emotional and spiritual needs while providing physical care. Yet, a few studies indicate that nurses find it difficult to relate to patients’ spiritual and emotional needs when they have to concentrate on performing a task (McNamara et al . 1995, Rasmussen et al .…”