Departmental Bulletin Paper がん患者遺族との関わりを通して生成する中堅看護師たちの卓越・固有感覚―がん認定看護師たちの語りから―
Working with Bereaved Families of Cancer Patients: Work Identity Narratives of Senior Certified Nurse Specialists

横田(有田), 恵子(恵子)

With the proliferation of palliative care in Japan, the area of nursing for bereaved families of cancer patients has become increasingly active around the turn of the century. This means that even after the patient has died, the bereaved family continues to be under the care of nurses. One of the main reasons for this is to "prevent bereaved families from developing forms of pathological grieving." This also leads to increased demand for the psychological care of nurses who engage in this care work because in the process of establishing relationships with these bereaved families, the nurses themselves come to feel deep senses of loss and sadness as well. It is fairly common for family members to talk about themes of "regret" in their recollection narratives, and these stories often include things the families were unable to do for the patient while he or she were still alive. Nurses, too, understand and empathize with these feelings or regret.In this paper, I will first review the philosophy of palliative care and its actual practice based on the literature. Then, based on in-depth interviews of two certified nurse specialists in cancer nursing, I will illuminate the process in which nurses share the deceased patient's memories with the bereaved family, acknowledge each other's anxieties and loneliness from the loss, and become a presence in the life of these bereaved families as a result.Finally, I will offer a critical perspective on how the trend toward medicalization of the bereaved family after the patient's death is not necessarily a unilaterally positive development, and that such movement can lead to the undermining of the lived-life as a holistic entity underfined by terms of medicalization.

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