Changes that occur in nursing when a patient is categorized as terminally ill

Abstract

Death work is different from ordinary nursing care and demands the nurse’s full attention (Field, 1984; May, 1991, 1995; Wakefield, 1996a,b). This article examines the way in which nurses change the normal operational rules of the ward when a patient is dying, to create an aura of domesticity, and with it a notion of tenderness. The study adopted an ethnomethodological approach, which allows everyday taken-for-granted behaviours to be afforded an overtly observable status (Garfinkel, 1967). Although the sample size was small, consisting of 22 surgical nursing staff and 4 student nurses on one ward, it has been possible to identify some trends in clinical practice. For example, when relatives normally entered the ward they were ‘excluded’ from participating in care. Conversely, when patients were dying, the notion of mutual participation was introduced (Szaz and Hollander, 1956) enabling relatives to assist nurses in the administration of rudimentary nursing interventions.