Gillan Pauline Catherine, Jeong Sarah, van der Riet Pamela
Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Qld 4059, Australia.
University of Newcastle, Australia.
Nurse Educ Today. 2021 Feb;97:104674. doi: 10.1016/j.nedt.2020.104674. Epub 2020 Nov 26.
The concept of "good and bad deaths" has been widely addressed in the literature. However, little is known of undergraduate nursing students' experiences with death in clinical practice or how they perceive good and bad deaths.
To explore undergraduate nursing students' personal and professional/clinical experiences of death and dying.
A qualitative narrative inquiry design.
Eighteen third year Bachelor of Nursing students participated in the study.
Data was collected through individual participant interviews and analysed using Clandinin and Connelly's three dimensions of narrative inquiry (temporality, sociality and place).
A key finding of the study revealed that students' death experiences are shaped by the role of others, especially experienced nurses in clinical practice. Embodied good death experiences were influenced by the presence of nurses who guided students through the experience. Disembodied bad death experiences were influenced by undignified care, ritualistic post-mortem care and the physical coldness of the deceased and the environment.
Nursing students need meaningful preparation to undertake end of life care in clinical practice, including post-mortem care and the possibility of bad deaths. End of life care education and end of life care simulation play a role in preparing students for end of life care in clinical practice. End of life care education needs to be commenced early in the undergraduate degree. Furthermore, nursing clinicians need to be aware of the impact that they have in shaping good and bad death experiences for undergraduate nursing students, the Registered Nurses of the future.
“善终与恶终”的概念在文献中已得到广泛探讨。然而，对于本科护理专业学生在临床实践中面对死亡的经历，以及他们如何看待善终与恶终，我们却知之甚少。
探讨本科护理专业学生在死亡与临终方面的个人经历以及专业/临床经历。
定性叙事探究设计。
18名护理学本科三年级学生参与了本研究。
通过对参与者进行个人访谈收集数据，并运用克兰迪宁和康奈利的叙事探究三个维度（时间性、社会性和地点）进行分析。
该研究的一项关键发现表明，学生的死亡经历受到他人的影响，尤其是临床实践中经验丰富的护士。具体而言，有护士引导学生经历死亡过程，这对学生体验到善终有积极影响；而不体面的护理、程序化的尸体护理以及死者和环境的冰冷，则会给学生带来恶终的体验。
护理专业学生在临床实践中进行临终护理，包括尸体护理以及应对可能出现的恶终情况时，需要得到有意义的准备。临终护理教育和临终护理模拟在帮助学生为临床实践中的临终护理做好准备方面发挥着作用。临终护理教育应在本科阶段尽早开展。此外，护理临床医生需要意识到，他们对于塑造本科护理专业学生（未来的注册护士）的善终与恶终体验有着重要影响。
