This is my first blog as a Florence Nightingale Foundation Professor. I started my new post 6 months ago at The University of Glasgow in partnership with NHS Greater Glasgow and Clyde, and currently I am the only FNF chair in Scotland. It’s good to be here and I am settling into the new role; I knew the University already as I did my PhD here, but there have been many changes since then, so I have still felt it has taken time to orientate.
The topic for this blog came to me when I spent some time last week with a visiting nurse academic, Aileen Collier, from Australia. We had a few days in Glasgow, ostensibly to write (we are writing a paper on implementation science and palliative care) but we found the time to discuss many other topics as well – ranging from coffee and good cake, to more erudite issues including how we ‘label’ patients and how this diminishes personhood, and even to the terms we use to talk about death and dying. A further twitter discussion on this topic (@BridgetJohnst) led me to consider further how we use language, particularly in serious illness.
There are many terms people use to refer to death and dying. ‘Passed away’ is one of my personal bug bears, but others include ‘lost his/her life’, ‘resting in peace’, ‘slipped away’, ‘sleeps’, ‘expired’, ‘departed this life’, or even ‘kicked the bucket’. We know that these terms are called ‘euphemisms’, but what are euphemisms and are they ever a good thing? A euphemism is generally an innocuous word or expression used in place of one that suggests something unpleasant, offensive or insensitively explicit. Therefore, because the reality of death and dying make us feel uncomfortable we often resort to euphemisms in order to reference indirectly the inevitable end of human condition.
So does this matter in nursing and healthcare? Is it helpful for the family of the person who has died? Some argue that using ‘passed away’ seems gentler, that it is not as harsh, and less cold than ‘died.’ Yet the use of ‘passed away’ instead of ‘died’ is an indication of the times we live in, an era when people in general tend to put off facing up to the hard facts of difficult situations for as long as possible. We try to avoid tough subjects, like death and dying. However, as nurses, we cannot avoid death and dying. It is part of our role and an important aspect of caring: denying the finality of death is not only unhelpful but can also lead to poor care. When breaking the bad news that a relative has died, if we say ‘lost’ or ‘passed away’ there may be circumstances when the person doesn’t understand and, therefore reaches the wrong conclusion. Neither ‘passed away’ nor ‘passed’ implies a complete and absolute finality, and being indirect about death may complicate the grief response and cause unnecessary worry. The key is honest, open communication in language that all parties understand.