Nursing care at the time of death
'We're expected to be able to cope with anything really. Sometimes you just have to pretend to be OK. 'Cos – you know – it's expected of you. You are it – the one who copes – while everyone else falls about' (Mary, staff nurse). This quote from Mary (whose name has been changed), a nurse in a care home for older people, is representative of the type of response that I commonly heard during the fieldwork on a project into the management of death and dying in these settings in the UK (Sidell et al. 1997). Indeed, nurses, as frontline workers, have to cope with death in a variety of settings – hospitals, hospices, domestic homes as well as residential care homes. In this chapter, I explore what happens at and around the time of death from a sociological point of view and how this impacts upon nursing care.
I begin with a discussion of the importance of being able to predict when death will occur and go on to ask what it is about death that makes it such a special event. I follow this discussion with an exploration of the different ways in which death is constructed and how this impacts upon the moment of death. I challenge the assumptions that underpin the notion of a 'good' death, both from the point of view of the possibility of being able to define what this means as well as its achievement. I conclude with a discussion of the body after death and its immediate impact upon any family and friends of the deceased.
The time, setting and place of death all have the potential to impact upon the way that professionals are able to provide care at the time of death. One of the key factors in being able to provide care is knowing that someone is dying and when his or her death is likely to occur. The importance of being able to predict death and dying was something that Glaser and Strauss