[Caring for dying patients--and if they refuse?]

Caring for dying patients...and if they say no? Caring for dying patients is a difficult and demanding task for nurses. One aspect of this theme, namely the question how nurses react to and feel about the desire of dying patients to omit nursing actions with the goal of improving their well-being, was studied in an clinic for internal medicine of a university hospital. The care of 4 dying patients was observed and 8 involved nurses were interviewed. A grounded theory approach was chosen for analysing the data. The results show under which circumstances dying patients expressed their wish to omit certain nursing actions and what actions were not wanted. Furthermore the paper describes: (1) factors which influenced the nurses activities, (2) nurses strategies and (3) the emotional consequences nurses activities had on themselves. From the results several conclusions could be drawn for the care of dying patients. The study shows that nurses can become aware of and reflect upon their dealing with patients' wish to omit nursing actions.