Hospice Nurses' Knowledge and Attitudes Toward the Near-Death Experience

I surveyed 60 hospice nurses regarding their knowledge and attitudes toward the near-death experience (NDE), using Thornburg's NearDeath Phenomena Knowledge and Attitudes Questionnaire. Most hospice nurses had previous work experience with an NDEr. Approximately half the nurses were knowledgeable about the NDE. All participants had a positive attitude toward near-death phenomena and toward caring for an NDEr. Recommendations include near-death phenomena inservice education for hospice nurses and inclusion of NDE content in nursing education programs. The near-death experience (NDE) is a topic of increasing controversial concern, especially among paraprofessionals and health care professionals providing holistic care to the terminally ill client. The NDE can be summarized as a close encounter with death having sequential components that culminate in a spiritual event. Thus this spiritual event encompasses physiological involvement, a mental metamorphosis, and an apparent encounter with a spiritual being (Moody, 1975; Ring, 1984; Moody and Perry, 1988). Advancements in medical technology have provided the means for a significant number of acute care and terminally ill clients to be resuscitated (Grosso, 1981). Thus the NDE is experienced by a variety of clients with acute health dysfunctions as well as by a majority of clients with terminal and chronic illnesses (K~ibler-Ross, 1975; Ring, Ms. Barnet t is a critical care staff nurse in the Baptist Medical Center Medical Intensive Care Uni t in San Antonio, TX. This paper was derived in par t from her Master of Science in Nurs ing thesis submit ted to Radford University. Reprint requests should be addressed to Ms. Barne t t a t 223 Harcourt, San Antonio, TX 78223. Journal of Near-Death Studies, 9(4) ,'~'ummer 1991 % 1991 Human Sciences Press, Inc. 2 2 5 226 JOURNAL OF NEAR-DEATH STUDIES 1984). Nurses providing care to such clients need adequate knowledge and attitudes in order to help clients deal with their emotional and spiritual feelings about the dying process and/or the NDE. Since hospital stays have shortened, many terminally and chronically ill clients have been ushered into the community where care is continued. Hospice nurses constitute a majority of home supportive caregivers, and it is these nurses who are present to provide the holistic care and spiritual support these clients require. The NDE is a spiritual event with significant implications for the terminally ill client, who may or may not have experienced near-death phenomena. Furthermore, the NDE needs to be recognized and understood by hospice nurses who care for terminally ill clients, as this phenomenon may be incorporated into the holistic approach of the hospice nurse by providing a positive counseling strategy for those clients who may be afraid of death or who may have questions regarding the dying process. This study was designed to assess the knowledge and attitudes of hospice nurses toward the near-death experience and toward caring for near-death experiencers. Th e or e t i c a l F r a m e w o r k a n d R e v i e w of the Li terature The theoretical framework for this study was based on Jean Watson's (1988) model of human care. According to Watson, the main goal of nursing is to help individuals attain and maintain a higher level of accord within their consciousness, physical being, and spiritual essence. Within Watson's theory, the actual caring occasion is a phenomenal field that identifies the role of both the hospice nurse and the hospice client. These two persons, the hospice nurse and the hospice client, with their unique pasts and spiritual personal histories, constitute an event within the phenomenal field. Thus the actual caring occasion is a phenomenal field that incorporates time and space in which life's experiences, knowledge, and attitudes take place, including near-death phenomena. Providing counseling to terminally ill clients regarding the dying process and the NDE is an actual caring occasion that provides a hospice nurse a positive interactional (transpersonal) linkage to the client and his or her family. The scientific literature has documented the existence of a neardeath phenomenal event composed of specific spiritual components. The client who has experienced a near-death phenomenal event reports a more positive attitude toward life, a sense of invulnerability, a