Professional boundaries, part II: is it OK to go to patients' funerals?
Brian Booth, RGN
Attending a patient's funeral
I recently yattered on here about professional boundaries in nursing (http://issue 4 - https://pcnr.co.uk/articles/121/are-professional-boundaries-getting-blurred-or-are-nurses-finally-shedding-outdated-hierarchical-constraints). I’ve been giving it some thought since; there may be something more worth discussing, and I am genuinely interested in your answers, because it bothers me.
The original piece I submitted to this fine journal was meant to see if we could get a discussion going, with the intention of finding out what nurses thought about the difference between past practice - 'nurses must never get familiar with their patients' - and the present view, whatever that may be. But moving on...
To the chase: I would really like to know what differences exist in nursing attitudes to attending patients’ funerals. I work in a small community hospital; but you, gentle reader, are more likely to have much more of a one-to-one relationship with patients than I do.
Here are three examples, from my own recent experience, upon which I'd appreciate comments. In each case, staff attended the funeral in their own time; in the first, just me, in the others, colleagues came. (Note: I made excuses for staff and myself for not attending any of the post-funeral gatherings.)
A patient in his late 80s - let’s call him ‘Fred’ - had no living blood relations; his sister-in-law and her children, along with a local musical celebrity, were the only other people present. He had been a professional musician, I’m an amateur, so we never lacked something to talk about, and we formed one of those relationships which happen in nursing – close, but not unprofessional. Fred was scared of dying, but knew it was coming, and he explicitly asked if I’d be there to see him off. So I was.
‘Joe’, a widower, had recently married for the second time, and his mother and children disapproved. He was fit and active, until a stroke flattened him, in his early 60s. He was the kind of patient that every nurse loves looking after, witty, full of stories – then he died, very unexpectedly. He had jokingly asked me, more than once, to be there at his funeral, which I treated as a promise unlikely to need keeping (‘I’ll probably go before you’ was my usual response); but I felt I should. Several other staff came – also in their own time – and found we were the sole supporters of his widow, with his family making their feelings towards her very clear. Without us, that woman would have stood in a pew alone.
‘Tom’ was in his 40s, with an aggressive lung cancer. He came to our hospital with an unrelated medical problem, and chose to stay with us when the end suddenly loomed nearer, instead of having palliative care at home, or moving to a hospice. He and I had the kind of conversations about his impending death that non-professionals might find tasteless, even distressing, but we were both from the North-west of England, where the humour is decidedly black; and his dark joking manner struck a chord with some other staff. When he died, we felt that we, as his nurses, should attend his funeral; he had made us laugh, we could have a cry.
So: our patients sometimes die. Is that an end to it?
And is it unprofessional to attend the funeral of one, if we don't go to those of all the others?
..to see if we could get a discussion going, with the intention of finding out what nurses thought about the difference between past practice - 'nurses must never get familiar with their patients' - and the present view, whatever that may be.