Carers need support

BMJ 1994;309:1017-1018 (15 October)

Letters

Carers need support

EDITOR, - Mina Mills strikingly illustrates the isolation ofpatients dying in hospital, particularly their minimal contactwith both medical and nursing staff as death approaches; thiscontact was so short that on occasion it could be measured inseconds.¹

Greater thought needs to be given to what keeps caring professionalsaway. In my experience as an observer on a palliative care unit,helplessness in the face of death provokes such anxiety thatprofessional carers develop defences against it.² Resortingto technology and disease "labelling," busyness, performingroutine procedures such as taking pulse and blood pressure mayall be seen as defences that are attempts to distance professionalsfrom recognising their own horror at death's challenge to theirprofessional omnipotence. In her classic paper Menzies noteshow the ward environment and its procedures may be set up toreinforce defences that protect the staff working there from. . . [Full text of this article]