SURGEONS, NURSES AND BEREAVED FAMILIES ATTITUDES TOWARD DYING IN THE BURN CENTER

Because death of a patient is one of the most emotionally disruptive events in the health professionals' life as well as the bereaved, it was hypothesized that surgeons' and nurses' attitudes in the burn centre would interfere with their emotional support of the bereaved family. Consequently, we performed a psychometric assessment of the surgoens' nurses' and bereaved families' attitudes about death and dying in the burn centre. A psychometric instrument was developed and validated that assessed 13 surgical directors' of burn centres, 13 burn nurses' and nine bereaved family members' attitudes on death and dying in the burn centre. In the case of the bereaved family member, this instrument was complemented by interviews to ensure that the respondents understood each question. All surgeons and nurses were experienced health professionals working for an average of 12 +/- 8 years and 3 +/- 1 years respectively. The majority of burn surgeons (six) and the burn nurses (seven) found it to be emotionally difficult to support emotionally the bereaved family after the death of the patient. Over half the burn surgeons (seven) and nurses (seven) felt that the process of dealing with the bereaved family was different from that experienced in other hospital settings. The surgeons attributed this difference to the long duration of the patients' illness, while the nurses felt that it was due to the traumatic and painful qualities of burn injury. These emotional difficulties experience by the staff in dealing with the dying patients were associated with a relatively low frequency of contact with the bereaved families after the patients' death. While six burn surgeons and ten burn nurses contacted the bereaved families by telephone, only one surgeon and three nurses sent a sympathy card to the families. One burn surgeon notified the family about the autopsy results. Two burn nurses were the only health professionals to attend a patient's funeral.. All but one health professional felt that death and dying practices should be integrated into the medical school and nursing curricula. Despite the health professionals' perceived emotional difficulty in death-telling and low frequency of contact with bereaved families, all bereaved family members expressed considerable satisfaction with the care of the dying patient as well at their emotional support. Their high level of satisfaction was attributed to the perception of excellence of patient care as well as constant and supportive communications.