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Nursing the dying: essential elements in the care of terminally ill patients


Maria Júlia Paes da Silva, Associate Professor of the Medical-Surgical Nursing Department, Nursing School, Universidade de São Paulo, São Paulo, Brazil
Tel: 55 11 3066-7558


Aim:  To verify those aspects of care that nurses view as important when assisting patients beyond therapeutic possibilities and who are not under intensive care.

Objectives:  (1) To find out how nurses cope with daily confrontation with the death and suffering of dying patients, (2) To identify whether nurses feel it is important to have communication skills in order to assist the terminally ill patient, (3) To estimate nurses’ degree of work satisfaction, and (4) To explore the humane aspects of nursing assistance to the dying.

Method:  Data were collected in January and February of 2002 by means of individual semistructured interviews with 14 nurses from the unit of haematology at a general hospital in the city of Sao Paulo, Brazil. Interviews were recorded, transcribed, and further analysed according to the qualitative method proposed by Bardin (1977).

Results:  We found that Brazilian nurses caring for dying patients should be receiving psychological and emotional support. Results also highlighted different individual approaches in the endeavour to communicate with terminally ill patients, as well as the avoidance patterns developed by some nurses. The latter appeared to be as a result of personal difficulties in coping with the reality of human suffering and death. Finally, there is a need for better preparation in communication skills for nurses caring for terminally ill patients.

Conclusion:  Although the number of interviewed nurses in our study was small, the results corroborated the findings of other studies on the subject.