La signification des rites associés au décès de la personne soignée, pour des infirmières œuvrant en milieu hospitalier

Death has been and will always be a present phenomenon within society.  Although a sad and difficult stage, it remains an unavoidable and very real event.  The practices of certain rituals are known to ease the suffering caused by death.  However, it is not unusual to see very little or no time devoted to rituals for deaths occurring in hospitals (O’Gorman, 1998; Lemieux, 1991; Leonetti, 2004; Hamonet, 1992; Piquet, 1999; Hanus, 1999; Vachon, 2007; Hasendhal, 1998).  The possible reasons might originate from the fact that progress in medicine and technology lead us to think that human beings are impervious to death and that death represents a failure in the face of disease.  Lack of training in nurses on the subject of death is also to be considered (Leonetti, 2004; Goopy, 2005; Blum, 2006).  Finally, another possibility is the tendency in some western societies to hide and deny death (O’Gorman, 1998; Piquet, 1999; Matzo et al., 2001; MSSS, 2004; Leonetti, 2004; SFAP, 2005; Goopy, 2005).  Therefore, offering families the possibility of practicing their rituals as a sign of love for their departed is an element of the spiritual care included in nursing care.  To our knowledge, few studies have explored death rituals in a hospital environment, hence the relevance of this subject.  The purpose of this study is to describe and understand the meaning of rituals associated to the death of a cared-for person, for nurses working in a hospital environment.  To achieve this, the student-researcher conducted a phenomenological qualitative study, with nine nurses, with Watson’s caring philosophy as the disciplinary perspective of the study (1979, 1988, 2006, 2008).  The analysis of verbatim reports using Giorgi’s methodology (1997) has allowed us to uncover 28 sub-themes emerging from the following six themes:  a) being-with the person cared-for charged with the responsibility of caring; b) undisputed respect for human dignity and the sacred nature of rites; c) spiritual solace for cared-for persons, their families and staff; d) reconciliation of cultural and religious beliefs; e) death as an existential phenomenon; f) barriers against rituals.  Subsequently, the essence of the meaning of rituals associated to the death of the cared-for person, for nurses working within a hospital environment, emerged from these themes. Thus, the essence of the meaning is an essential tribute to the deceased and their family, despite the numerous barriers that refrain their practice.  Many themes and subthemes confirm the results of various studies and the view of different authors.  Nevertheless, the fact that some of our conclusions have never been published is a sign of the innovative nature of this study.  Consequently, the results of the present research can raise nurses’ awareness to understanding the rituals in a hospital environment and open some new avenues for interventions that could contribute to the renewal of end-of-life care.  Finally, being-with families in their practice of rituals certainly contributes to promote a more humane way of care.

Keyphrases: Rites, Caring, Respect, Rituals, Death, Phenomenology, Spirituality, Being-with, Beliefs, Barriers