"They Stay With You": Nursing Home Staff's Emotional Experiences of Being in a Close Relationship With a Resident in Long-Term Care who Died.

Anne Kristine Ådland,Ellen Ramvi,Marta H Lavik,Birgitta H Gripsrud

doi:10.1177/08980101211017766

Abstract

Aim: To explore and develop understanding of nursing home staff's emotional experiences of being in a close relationship with a resident in long-term care who later died. Design: Ethnographic fieldwork. Methods: As part of fieldwork, narrative interviews were conducted with nursing home staff (n = 6) in two nursing homes in Norway and analyzed using interpretative phenomenological analysis. Findings: Through data analysis, we identified three superordinate themes: (1) wanting to be something good for the resident and their families, (2) striving to make sense of the resident's death, and (3) struggling to balance being personal and professional. Implications for holistic nursing and conclusion: Nursing home staff experience tensions between ideals of distanced professionalism and the emotional experience of proximity, evidenced by personal commitment and mutual recognition in relationships with “special residents” in long-term care. To support holistic practice, awareness is needed of the emotional impact of relationships on health professionals. Suppressing feelings puts staff at risk of moral distress, compassion fatigue, and burnout, as well as higher turnover and absenteeism. Managers should facilitate discussions on professionals’ ideals of relationship-based practice, including processing of, and reflection on, emotional experiences in long-term care. Rituals to mark a resident's death can provide further emotional containment.

Highlights

This article concerns nursing home (NH) staff’s emotional experiences of being in a close relationship with a resident who later died
By which we mean registered nurses and regulated health care workers who work in NHs, regularly encounter dying and death
To understand how our findings touch on Candrian (2014), and Simard (2020), we suggest the following line of interpretation: the accumulated intensity of feelings produced by close relationships in long-term care can be said to reflect a certain level of intimacy for some participants, for others it may be an underlying contributor to their desire or need to distance themselves from becoming emotionally involved

Summary

Introduction

This article concerns nursing home (NH) staff’s emotional experiences of being in a close relationship with a resident who later died. The present study evolved as part of an ethnographic fieldwork (Ådland et al, 2019) on how health professionals in multicultural staff communities encounter death in NHs, and how institutional procedures, structures, and rituals support or undermine communication about their personal and existential experiences. One of the residents has been asking for health care worker ‘Timmy’ several times today and when Timmy enters the living room, the resident clearly becomes happy. His face lights up and he immediately asks Timmy to follow him to his room. The resident is very frail, and Timmy finds the resident’s walker and helps him up from the couch. Previous studies have identified how NH staff can form strong bonds with residents and their families. McCallin (2011, p. 2331) found that nurses caring for patients at the end of life went beyond the “efficiency-effectiveness rhetoric to engage in meaningful ‘being with’ relationships” with patients,

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