Education, empowerment and the dying patient

Abstract

Nurse education has focused, in recent years, on the need for students to translate theory into improvements m practice. This thesis has used this idea to examine the concept of empowerment and the dying patient. Nurses involved in post-registration education have been asked to examine their practice and produce written reflections on critical incidents related to empowerment. These have then formed a basis for the examination of the strategies and barriers which effect the care of dying patients and their right to self-determination. A new paradigm approach to the research has been adopted in an effort to involve the subjects of the study (the nurses) in defining and controlling the outcomes. The data has been analysed, in the main, by employing 'thick description’ advocated by Geertz to attempt to discover intentions and meaning which organise actions. The thesis has examined five areas of concern:1. The need to change the culture of care surrounding the dying patient.2. The role that ritual action takes in limiting the options open to patients.3. Strategies and barriers, linked to the communication process, which effect patient empowerment and come to fight by an examination of the data.4. The value of the nurse as patients' advocate and its effect on the process of empowerment.5. Examination of the concept of reflection in practice and within the educational process as a way forward. The conclusion highlights the difficulties that nurses have with ideas of change and attempts to emphasis positive aspects around nurse/patient communications, which may point the way forward for greater autonomy for patients. The need for further research is highlighted, which would examine the effect on practice of reflection on critical incidents and enquire into ways of ensuring that change results which moves towards the reduction of disempowerment for vulnerable dying patients.