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Crit Care Nurse 2002 Jun; 22(3): 18
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Letters to the Editor

Acceptance of death and dying

After reading the Guest Editorial, "Lessons for Critical Care Nurses on Caring for the Dying? (February 2002:11), something clicked inside my head. Zara Brenner said, "Deaths are interpreted as failures, and people don’t take pride in what they could not accomplish. In the hospice/palliative care unit, success is defined by the quality of the process, not by the outcome." With all the technological advances in the critical care setting, it is unsettling when we are not able to save someone. I asked myself throughout the article if this was a cultural phenomenon. Is it so hard to accept because we, as a country, have so many treatment options and, often, a seemingly endless resource pit?

Hospice has provided an alternative to dying in the hospital hooked up to every tube possible. I believe the concept of hospice has paved the way for pain management across the spectrum. However, hospice continues to have barriers. Healthcare practitioners hesitate to refer patients to hospice for fear of losing control of the patient’s healthcare or missing a treatment that could delay the inevitable. I was attracted to the hospice concept early on in nursing school because of its leadership role in interdisciplinary care, patient- and family-centered approach to care, and acceptance of what is meant to be. Hospice continues to make impressive progress across the world.

While attending an international research conference, our group discussed cross-cultural beliefs such as the circle-of-life phenomenon, family commitments, and how third world countries can be more advanced in their acceptance of death and dying. Our society tends to be "outcome" driven when it comes to effective therapies, whereas other countries view the "process" with equal importance. Fortunately, many clinicians and researchers are identifying the need for interventions leading to "a good death." I hope more educators will see the importance of closing the knowledge and comfort gap in individual nurses, and include death and dying as an integral part of school curriculum and job orientation.

Connie Jaenicke, RN, BSN
 Minneapolis, Minn





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