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Understanding the differences between a good and bad death

Retelling past experiences of death in the workplace can help students gain the understanding between a good and bad death, writes Debbie Crickmore.

Many nurses will recall stories of past times as told to them by nursing assistants and mentors. In turn, they will recall and pass onto nursing students their experiences. This oral tradition runs counter to any claim that people living in long-stay hospitals have been forgotten. 


Picture: Alamy

As I enter the final years of my career I know this to be personally true when I speak of Jackie and Brenda (not their real names), the child and adult whose lives formed the basis of my intermediate examination care study and nursing care assessment respectively.

As the youngest child of older parents, death was not unknown to me. Yet it was in a long-stay learning disability – then ‘subnormality’ – hospital in the late 1970s and early 1980s that I learned fundamentals of a ‘good’ death. Invariably, this involved a move for an individual to the ‘sick’ ward. 

While it might have been more sensitive to nurse them in their usual environment, a parallel could be drawn with people living in the community being admitted to an acute hospital. Though this might have meant access to more advanced technological and pharmacological care, it was possibly considered a failure if a hospital resident died away from home. 

What could be different

Individuals would be ‘specialed’, receiving one-to-one care in the absence of the contemporary requirement for additional funding, so they would never be alone. They would be visited by staff from their own ward, the hospital chaplain and the local GP. I have no recollection of anyone dying in pain or distress. Porters respectfully removed the deceased to the mortuary, with a nurse escort, where freshly cut flowers from the gardens would be placed. 

A significant failing, with the benefit of hindsight, was the abject lack of explanation to surviving members of the hospital community and the offer of support to understand and mark the loss of their peer.

Staff efforts 

I recall efforts by hospital staff to contact next of kin, including joint visits with the administrator to deliver news of a relative’s anticipated or actual death. Where funeral arrangements were made by the hospital, it was with the greatest of care, and senior representatives of the ward and hospital-led mourners. Full uniform was worn, even when no longer an everyday feature; hat, white dress, silver buckled belt, red lined cross strapped cape or ‘tippet’ (short navy shoulder cape for the ward sisters). Male nurses left their white coats and epaulettes behind and donned their hospital suit jackets. Negotiation took place to allow those who wished to pay their respects, while maintaining safety for those remaining. Staff would also attend off-duty.

Remembering

It was at one funeral that my otherwise kind and supportive nursing officer betrayed his military background, where emotion might be perceived as weakness, and gently rebuked me for shedding silent tears as a shaft of sunlight settled in the local church on the coffin of a man, Phineas, who in life spent much of every day propelling himself down the ramp at the centre of the ward to feel warmth and a breeze on his face. I use this expression of an emotional connection to demonstrate that, rather than being forgotten, people who died in long-stay hospitals mattered and live on in my practice and teaching.


About the author

Debbie Crickmore is programme director pre-registration learning disability nursing, link lecturer and academic support tutor at the University of Hull

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