DEATH PROCESS: NURSING RECORD EXPERIENCE AS A SUPPORT OF THE PROFESSIONAL IN THE PALLIATIVE CARE UNIT

Abstract

Cancer patients' last days’ condition has been described as multiple, multi-faceted and changing symptoms that mean high emotional, social and spiritual impact and requires specific attention from palliative care professionals. Since the starting period of the Palliative Care Unit at the Institut Català of Oncology (ICO) in Barcelona, the necessity of a record sheet was discovered, in order to record the whole process of the agony condition. The study has a double objective; on one hand to describe the complexity of last days’ condition that is recorded in the nursing records and how these records are useful for the following-up of the mourning period and the intervention of other professionals. On the other hand, it asses, from a qualitative point of view, its validity for the professionals themselves. This descriptive study was designed in three stages following a different methodology in each. During the first stage, records were analyzed of the condition of the last days of 150 patients that died in the unit over a year, so as to detect the need of following-up on mourning. In the second stage, by consensus in a meeting, the points that should be contained in the record sheet that were going to be used were defined and the modifications were written In the third stage, filling out, satisfaction and utility as an instrument of a specific record were assessed. As a result, it was discovered that one of every four conditions of death registered in our sample were "complex processes” with a high emotional impact for the team. A percentage of 27 % required mourning tracking by the social worker or a professional from the Psychiatry Department for pathologic cases. Regarding the satisfaction of the record itself, nursing professionals stated it was useful, particularly for this condition and that it could be improved. Being involved in the practice of these results allows us to better approach the process of the last days, to dictate complex conditions, and to prepare future actions for the mourning period.