Birth and death are the two things that a single person can never avoid in this life. It is possible to avoid illnesses, financial challenges, hunger, psychological disorders, etc. Still, human birth and death remain to be unchangeable: one day, a person appears in the world, another day, a person leaves this world. However, such simple understanding of the notions cannot be applicable to nurses with their experience of death and dying.
Nurses know that dying and death are, probably, the two most painful and challenging periods for all people including those, who are dying, and their beloved ones and families, who have to accept the truth as it is, take care for dying people, and observe how one life is ending. Still, despite all those challenges, tears, and emotional disorders, nurses have to demonstrate their readiness to take care of dying people, help relatives of such patients to accept the facts, and explain the peculiarities of the situations when death and dying occur.
Nowadays, many Americans are provided with an opportunity to decide where they can spend the last days of their lives: at home, in specialized nursing care centers or nursing homes, or in hospitals (Teno et al., 2013). Anyway, in the majority of cases, nurses turn out to be direct participants or observant of human death and dying periods. They know a lot about such situations and demonstrate rather different approaches on how to cope with the challenges of human death and help other people to deal with it.
If a person is in the condition of dying and prefers to stay at home, many families find it normal to hire a nurse and help the patient. In such situations, nurses face a number of personal concerns and the necessity to complete their functions as caregiver, concerns about patients and their readiness to understand how serious the whole situation can be, and the concerns about the patient’s families, who may be not ready for such change of event (Peterson et al., 2010a).
Long-Sutehall et al. (2011) admit that critical care environments require additional ethical and moral explanations in order to avoid the dilemmas that occur with the necessity to withdraw treatment. The point is that treatment for dying people may have a number of trajectories, and nurses have to be aware of all of them. As a rule, nurses, as well as other participants of this process including doctors and family members, have to understand their roles clearly, fulfill their duties, and stay motivated.
In such situations, the role of nurses remains to be crucial because they connect patients with their doctors, provide families with clear explanations, and take of dying people even if being aware of the outcomes. On the one hand, nurses are challenged about the impossibility to change something. On the other hand, nurses are the only people, who can offer some changes and improvements on the basis of the already given situation, e.g. talk to the patient, create the best conditions, organize contact with family members, etc.
Unfortunately, such inabilities to influence the development of the events and the necessity to accept death and dying as something normal and usual create a number of ethical dilemmas and concerns. Not many nurses are ready for such work; therefore, the nurse shortage remains to be a serious problem in the USA and other countries (Peterson et al., 2010b). Such factors as stress and burnout are the main reasons for why nurses cannot work for a long period of time at the same place.
They have to provide high-quality care for their dying patients and, in most cases, observe their deaths. It is not an easy task for ordinary people. Many nurse students face a serious challenge when they start learning the issues of death and dying at their working places. Some students are even ready to change their minds because of the impossibility to get ready for such situations. Nurses have to manage their emotional labor and know how to recognize and regulate any kinds of emotions with the help of professional tears (Bailey, Murphy, & Porock, 2010).
Besides, nurses have to understand that there are many patients, who are not ready to accept the fact that they are dying. Nurses should develop personal and professional attitudes to such patients and to the fact that death is coming. The acceptance of death should not be personal, but the recognition of such issues as culture or religion should stay important for the nurses, who want to help their patients and their families (Braun, Gordon, Uziely, 2010).
Nurses may be frustrated with their inabilities to help, challenged by the necessity to cooperate with dying people and their families, and obliged to follow the prescriptions given by doctors. Such responsibilities influence the psychological state of nurses. They have to know whom to address for help and explanations.
In general, death and dying from a nursing point of view may gain a new character and importance to accept these concepts not only as something ordinary that cannot be avoided. Nursing experience helps to realize that death and dying is a serious challenge that cannot be understood and accepted. It has to be overcome by any possible means.
References
Bailey, C., Murphy, R., & Porock, D. (2011). Professional tears: developing emotional intelligence around death and dying in emergency work. Journal of clinical nursing, 20(23‐24), 3364-3372.
Braun, M., Gordon, D., & Uziely, B. (2010). Associations between oncology nurses’ attitudes toward death and caring for dying patients. Oncology nursing forum 37(1), 43-49.
Long-Sutehall, T., Willis, H., Palmer, R., Ugboma, D., Addington-Hall, J., & Coombs, M. (2011). Negotiated dying: A grounded theory of how nurses shape withdrawal of treatment in hospital critical care units. International journal of nursing studies, 48(12), 1466-1474.
Peterson, J., Johnson, M., Halvorsen, B., Apmann, L., Chang, P. C., Kershek, S.,… & Pincon, D. (2010a). What is it so stressful about caring for a dying patient? A qualitative study of nurses’ experiences. International Journal of Palliative Nursing, 16(4), 181-187.
Peterson, J., Johnson, M., Halvorsen, B., Apmann, L., Chang, P. C., Kershek, S.,… & Pincon, D. (2010b). Where do nurses go for help? A qualitative study of coping with death and dying. International journal of palliative nursing, 16(9), 432-438.
Teno, J. M., Gozalo, P. L., Bynum, J. P., Leland, N. E., Miller, S. C., Morden, N. E.,… & Mor, V. (2013). Change in end-of-life care for Medicare beneficiaries: Site of death, place of care, and health care transitions in 2000, 2005, and 2009. The Journal of the American Medical Association, 309(5), 470-477.