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Supporting the relatives when giving a farewell to the deceased
BELLOVÁ, Daniela
Our research dealt with the support for the relatives in their final goodbyes to the deceased. We set ourselves two goals for our work upon the information obtained. The first one was to find out to what extent relatives are enabled to stay at the bed of a dying and deceased person in a hospital. The other goal was to make clear in what manners the final goodbyes are arranged in a hospital. Six research questions were then set: To what extent are relatives enabled to stay at the bed of a dying and deceased person in a hospital? In what setting are relatives given the information on the death? How are patient's belongings handed over to the survivors? How are the final goodbyes to the deceased arranged? How does the hospital staff care about the bereaved? And to what extent are the relatives enabled to speak to a priest or a psychologist? We chose a qualitative research method based on a semi structured interview for the research. The research was held in the České Budějovice Hospital and in the Písek Hospital at the LTC and Anaesthetic departments. 16 nurses participated on the interviews altogether. We found from the performed interviews that nurses allow relatives to stay at the bed of a dying person. They stressed the importance of an agreement and the respect to the run of the department. We also found out that the message of a client's death is usually communicated on the phone. A subsequent talk between a physician and the relatives is only held upon request of the relatives, mostly in the privacy of an office or a surgery. The handover of the belongings by a nurse is not so often held in privacy. The nurse first expresses her sympathy to the relatives after their arrival, then the handover of the belongings against an ID follows, they are checked and formalities are arranged. The only support provided at the handover of the belongings was in the form of reference to a priest or a physician. The handover of the belongings thus resembles a routine where only a minimum of the nurses care of sensitive communication and empathy. The replies of the nurses from the LTC and the Anaesthetic departments differed in the issue of the final goodbyes. At the Anaesthetic department the relatives always have the possibility of the final goodbyes. The final goodbyes are automatically allowed to the family of an organ donor. At the LTC, on the other hand, the bereaved must show active interest in the last goodbyes, which are allowed to them at a room or in a department bathroom. Although there is a final goodbye room at the pathology department of the Písek Hospital, most of the nurses did not know about this possibility or just were not sure. Another situation is in the case of death at presence of the family. In such an instance the relatives may stay at the bed how long they need. Nevertheless, the care focused directly on the client's family was what we missed about the nurses. A rare opinion was that some nurses mentioned a direct form of support, some do realize its absence and would appreciate an improvement, however the rest of the nurses do not consider a direct support for the family necessary or they do not perceive its absence. A priest was the most frequently mentioned profession. Nurses actively offer his services to clients and their families. Cooperation with a hospital priest and the possibility to visit the Space of Silence are very popular in Písek. Contracted priests, who were also praised by most of the nurses, visit the hospital in České Budějovice. There were however two remarks in this relation, that the hospital should have its priest and also a chapel. Cooperation with a hospital psychologist was only mentioned in two cases. A feedback for the head nurses of the named hospitals will be the output of the thesis. The purpose of the work is to offer and to the strengthen support to families and give them the opportunity to say their final goodbyes.
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Ensuring patient´s privacy during re-bandaging
BELLOVÁ, Daniela
This bachelor thesis investigates the way nurses ensure patient´s privacy in surgery departments during re-bandage. Beginning of the thesis´ theoretical part is focused on theoretical knowledge necessary for wounded patients care, the basic knowledge of anatomy and skin physiology. Next, what are a wound and what the healing process itself looks like. Which factors, either local or general, can negatively affect healing and how the care of particular nurse can contribute to it. Further, the process of wound treatment followed by post-surgery care and theoretical procedure of the bandaging itself, focusing on ensuring patient´s intimacy during the procedure. The entire knowledge of aseptic bandage procedures and good general patient care allows fast and uncomplicated healing. The number of re-bandages is decreased as well as the risk of violating the patients´ intimacy. Therefore, following chapters are focused on patient´s needs, his/her dignity and holistic approach of man. Patient´s needs are centered around self-concept and self-respect. Dignity and an emphasis on its compliance is the core of this thesis. The perception of intimacy, shame and nudity brings us to this issue. It is the reason this thesis was written and why it is so important to ensure such things as intimacy. Theoretical part of the thesis then brings information about legislative protection of privacy and highlights Patient´s rights and Code of Ethics for Nurses that should be remembered and followed by every nurse. Research in this thesis was conducted by the method of quantitative investigation in surgery departments in České Budějovice hospital, specifically in its surgical, orthopedic, traumatology, gynecology, urology, neurosurgery and cardiac surgery departments. Two kinds of survey were held. First was intended for patients hospitalized in surgery departments who underwent re-bandage and second one was given to the nurses working there. The aim of the thesis was to find out the way patient´s intimacy is ensured during re-bandaging. According to the highest number of positive answers from both clients and nurses, it was shown that nurses, when preparing to bandage patients, always ensure that the door is closed. When exposing a client, they make sure not to uncover his body more and longer than necessary. Despite this finding, we didn´t confirm the hypothesis number one: Surgery department nurses ensure patients intimacy during bandaging. The cause of the low number of achieved points was the failure to ensure patients intimacy in front of the other patients in the room, where majority of the bandaging were held. This finding contributed in the confirmation of the second hypothesis: Surgery department nurses do not use the equipment for ensuring patient´s intimacy during bandaging. Results from patient´s answers positively showed that nurses do not use either the curtain or the bandaging room. Therefore, clients are bandaged in front of other patients in the room. The kind of bandaging wasn´t taken into account in the survey. However, the intimacy is perceived differently by each individual and even its slightest disruption might be taken negatively. The third hypothesis: Intimacy violation occurs more frequently among long-term hospitalized patients, was confirmed. The results was not contributed by the majority of answers as with the previous hypothesis, but even small number of respondents confirming the decrease in quality during their hospitalization, could not be left unnoticed and was considered sufficient for confirming the hypothesis. The results of this bachelor thesis will serve as feedback for nurses and if it increases their interest in ensuring patients´ intimacy, then this work has fulfilled its purpose.
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