Dying: Changing Culture and Care in the Acute Sector

While the focus of acute care delivery, generally, is helping patients to recover and maintain health and well-being with a view to returning home and back to normal living for them, not all patients recover and go home. Some... [ view full abstract ]

While the focus of acute care delivery, generally, is helping patients to recover and maintain health and well-being with a view to returning home and back to normal living for them, not all patients recover and go home. Some patients die in hospital. Medicine has undergone monumental change in recent decades and has made tremendous advances in its capacity to prolong life. However, despite the greatest medical interventions, death cannot be avoided forever. With such huge emphasis on preventing death and prolonging life, it arguably raises the question, is sufficient attention and focus afforded to the death experience in the acute care sector? Are we doing it as well as we could/should? Bearing in mind that there are no ‘practice runs’ available for staff in this area, there is only one opportunity to do this right for each dying patient and their family. Nursing care should be based on the best available evidence whether caring for the living or the dying. So what does contemporary evidence suggest? End of life care must ensure that the dying patient receives optimal care in an environment sensitive to their needs and those of their family members. Dignity and respect should be foremost in care priorities. There are a number of intricate skills that are required by different healthcare professionals that contribute to the overall experience of a ‘good death’. All members of hospital staff have the potential to impact on this either positively or negatively. This paper will discuss key areas of focus that can be addressed including desired strategies to ensure that staff develop an awareness of end of life issues and nurture the personal communication techniques, knowledge and skills to manage these issues in a sensitive and culturally appropriate manner.