attitudes to death, end-of-life care, grief, narrative



  1. Mitchell, Ann M. PhD, RN
  2. Sakraida, Teresa J. DNSc, RN
  3. Dysart-Gale, Deborah PhD
  4. Gadmer, Nina MHA


RNs and other healthcare professionals engage in helping relationships that involve objective therapeutic exchange and intervention for the dying and bereavement support for the survivors. Nurses must possess good communication skills to give the attuned empathic responses upon which humane, complete, and comprehensive end-of-life care is based. These empathic responses are conditioned by nurses' emotional and cognitive attitudes toward death and dying. This article will examine the ways in which nurses, through discussions on death, use three cognitive methods-knowing, explaining, and understanding-in their attempts to come to terms with dying and the death process. A greater understanding of how RNs currently think and talk about the end of life promises several opportunities to improve in care of the dying.