The process of dying and imminent death may affect staff more adversely than the everyday pressures of looking after acutely ill patients. Staff have to come to terms with the realization that no amount of dedication or hard work is going to reverse the situation. Then there is a change in care from an aggressive and invasive approach to one of making the patient comfortable and ignoring adverse physiological changes.

Once the doctors have made the decision for terminal care to take place and appropriate analgesia has been prescribed, the nurses should take control of the patient's care, which becomes palliative rather than curative, thereby allowing nurses the opportunity to deal with the process more effectively.

Often, even before having time to come to terms with the death of one patient, nurses and doctors have to care for another acutely ill patient. This may cause emotional confusion at the sudden turnabout of dealing with death one minute and life the next. There may even be self-criticism at not dealing with the situation in the best possible way.

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