Nursing care at the time of death

We're expected to be able to cope with anything really. Sometimes you just have to pretend to be OK. 'Cos - you know - it's expected of you. You are it - the one who copes - while everyone else falls about' (Mary, staff nurse). This quote from Mary (whose name has been changed), a nurse in a care home for older people, is representative of the type of response that I commonly heard during the fieldwork on a project into the management of death and dying in these settings in the UK (Sidell et al, 1997). Indeed, nurses, as frontline workers, have to cope with death in a variety of settings - hospitals, hospices, domestic homes as well as residential care homes. In this chapter, I explore what happens at and around the time of death from a sociological point of view and how this impacts upon nursing care. I begin with a discussion of the importance of being able to predict when death will occur and go on to ask what is is about death that makes it such a special event. I follow this discussion with an exploration of different ways in which death is constructed and how this impacts upon the moment of death. I challenge the assumptions that underpin the notion of a 'good' death, both from the point of view of the possibility of being able to define what this means as well as its achievement. I conclude with a discussion of the body after death and its immediate impact upon any family and friends of the deceased