The value of death: bringing death back to life: what does it mean for nurses?

This week’s blog is written by Dr Sarah Russell (@LearnPEOLC), Lead Palliative and End of Life Care Nurse, Portsmouth Hospitals University NHS Trust. Sarah can be an Alumni Champion for the Florence Nightingale Foundation (@FNightingaleF). She can be a member of the British Geriatrics Society, the End of Life Special Interest Group and co-author of the book The Lancet Commission on the Value of Death (#ValueofDeath).

On the first^street February 2022, at Lancet The commission published its report The value of death: bringing death back to life. Drawing on multidisciplinary perspectives from around the globe, an unbalanced and contradictory view of death and dying is on the core report. There is a have to rebalance relationships and partnerships between dying people, families, communities, health and social care systems and wider civil society. The Lancet The Commission proposes a brand new vision for death and dying, including greater community involvement and health and social services, in addition to increased support for bereaved people. The report identifies five realistic principles of utopia and concludes with recommendations.

Principles of a practical utopia:

1. Social determinants of death, dying and mourning were discussed,
2. Dying is known as a relational and spiritual process, not simply a physiological event,
3. Care networks provide support for people who find themselves dying, caring and bereaved
4. Conversations and stories about on a regular basis death, dying and mourning develop into common,
5. Death is taken into account to have value.

More information concerning the report could be present in this short material video. Basically, report is a call to arms for people and society to make sure balance throughout the system “AND A reductionist, linear approach that fails to take into account the complexity of the death system will not achieve the rebalancing needed.” (Sallnow et al. 2022:1).

As a palliative care nurse A Florence Nightingale Foundation Alumni Champion and co-author, in my view, the report has far-reaching consequences for nurses; specifically as to what our contribution through leadership, policy, strategy, research, education and practice is to restoring the balance between death in life. I consider within the argument that “Dying is understood as a relational and spiritual process, not simply a physiological event.” in addition to get well “death, dying and mourning as social problems” (Sallnow et al. 2022:1) is prime to the long run of dying and the worth we place on death. As nurses, we play a major role in assessing the worth of death.

Nurses, after all, experience death in most of the environments by which we work. However, the important thing message of the report is that: “Health care is now the context in which many people encounter death, and as families and communities have become marginalized, their familiarity and confidence in supporting death, dying and bereavement has declined. Relationships and networks are replaced by professionals and protocols.” (Sallnow et al. 2022:2). If we consider that not less than a part of this statement is valid, then what’s the nurse’s contribution to supporting relationships and networks reasonably than implementing protocols? Unfortunately, the COVID-19 pandemic has only highlighted the medicalized, transactional nature of death, with many conversations and decisions made within the absence of family and friends, following the rules that dominate the death experience.

I faced challenges in how I contributed report and in my response to it. Reading this book, at the same time as a co-author, makes me ask myself what my role is in valuing death as a nurse, a person and a former family caregiver. The concepts contained in two models helped me think: Pioneering palliative care nurses (PPCN) i Florence Nightingale Foundation (FNF) Alumni Champion (Box 1). Pioneering palliative care nurses is an idea developed by Heather Richardson and Marie Cooper of St. Patrick’s Hospice. Christopher in Sydenham. The Florence Nightingale Foundation Alumni Champion summary comes from one other FNF Alumni Champion, Rebecca Thomas, Senior Improvement Nurse at Cwm Taf Morgannwg University Health Board.

Box 1: Pioneering palliative care nurses and alumni champions of the Florence Nightingale Foundation (reprinted with permission)

Key characteristics of pioneering palliative care nurses	Being an Alumni Champion of the Florence Nightingale Foundation
1. Following the spirit of compassion 2. Activist for change 3. Super connector 4. Champion of public health 5. A natural visionary leader 6. Hero of excellence in care 7. Creative and significant thinker 8. Ambassador of the nursing occupation

When I take a look at these models, two things stand out to me: being a change activist (PPCN) and being brave (FNF). The Lancet Commission for The Value of Death: Bringing Death to Life she just emphasized to me that as nurses we needs to be brave, campaign for change and put ideas into motion.

I like to recommend reading: report and related information documents on death and dying. I consider it has something to say to us as individuals, practitioners, teams, services, organizations, nationally and globally.

The Royal College of Medicine is hosting an event dedicated to The Lancet Death Value Commission: Day 1 Bringing Death to Life Event^street March 2022. More information available Here.

Declaration:

Sarah Russell is co-author of The Lancet Commission on the Value of Death report and wrote an identical blog for the British Geriatrics Society on the importance of the Value of Death for Older People report.

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