Opening up awareness: Nurses' accounts of nursing the dying.

This thesis is primarily based upon unstructiared interviews with nurses about their experiences of and attitudes towards nursing the dying. The main focus of the thesis is upon nursing the long term dying within a general hospital as seen from the nurse's viewpoint. The research is based upon the work of Glaser and Strauss which identified patterns of communication between health care workers and dying patients as being crucial to the experiences of the dying, and is broadly supportive of their findings. Many of the nurses interviewed expressed a preference for nursing dying patients who were aware of their dying. However, despite this preference for 'openness' most nurses reported difficulty in achieving this situation. Nursing the dying in an open awareness context was associated with enotional involvonent with the dying, and with satisfaction from such nursing care. It is argued that open awareness and good nursing care of the terminally ill is more likely to occur under a system of individualized patient care which is coupled with team support of individual nurses. The other features which affect the likelihood of open awareness developing are patient characteristics, doctors' views about disclosure, and individual characteristics of nurses.