Preface
Acknowledgments
Introduction
Nurses as Actors
Comparison of Terminal and Acute Care
The Role of the Registered Nurse
The Problem
Method
Definition of Terms
Guiding Questions
Data Collection
Data Analysis
Symbolic Interactionism
Symbolic Interactionism and Nursing Care
Literature Cited
Four South
the "Hospice Unit"
The Unit
The Patients
A Typical Day
Five Days in the World of Four South
Monday
Tuesday
Wednesday
Thursday
Friday
Beliefs and Behaviors of Four South Nurses
Beliefs About Nursing
Philosophies of Nursing
Holistic Care
Spiritual Care
Nurses Are Human
And the Show Must Go On
Nursing the Dying
Beliefs About Life and Death
A "Good Death"
Accompanying the Dying
Relationship of Beliefs to Observed Behavior
Expressive and Instrumental Behaviors
Expressive Behaviors
Instrumental Behaviors
Relation of Expressive and Instrumental Behaviors
Interactive Behavioral Models
Are These Nurses Different?
Philosophies of Life and Death
The "Good Nurse"
Distancing
Philosophical Similarities of Four South Nurses
Nursing Priorities
Conclusion
Literature Cited
Nursing the Living and the Dying
Acute and Terminal Labels
Biological and Psychospiritual Care
Dimensions of Care with Acutely Ill Patients
Dimensions of Care with Terminally Ill Patients
Unit Dynamics
Inconsistencies
"Busyness"
Focus of Care in Hospice
Differences among Individual Nurses
Responsiveness versus Unresponsiveness
or Do They Need Me?
Interactions with Responsive Patients
Interactions with Unresponsive Patients
Interactions with Disoriented Patients
Interactions with the Dying
Symbolic Interactionism: An Explanatory Framework
Conclusion
Literature Cited
Role Transition: How Do the Nurses "Change Gears"?
Role Theory
Disparate Ideologies of Care
Role Insufficiency
Role Conflict
Nursing as Caring
Caring Strategies
Caring as an Explanation of Findings
Symbolic Interactionism and Caring
The Effect of Busyness on Caring Behaviors
Conclusion
Literature Cited
Conclusion
Summary
Role Transition
Caring
Patient Responsiveness and Orientation
Symbolic Interactionism
Specialized Preparation and Time
Discussion
Literature Cited
APPENDIX A: Method
The Design
The Setting
Protection of Human Subjects
Techniques of Data Collection
Data Analysis
Literature Cited
APPENDIX B: The Fieldwork
My Background
Gaining Entrance
Getting Started
Doing the Fieldwork
APPENDIX C: Review of the Literature Relevant to the Study
Hospice
Origin of Hospice Care
A Model Hospice
Caring
Caring Defined
Caring in Nursing
Caring in Hospice
Literature Cited
Bibliography
Index
