Communication in the management of the nursing care before the death and dying process

Abstract

Objective: To understand, from the perspective of complexity, the factors related to communication for the management of the nursing care before the death and dying of hospitalized people. Method: The Complex Thought and Grounded Theory were used as theoretical and methodological references, respectively. The data were collected through semi-structured interviews, from May 2015 to January 2016, with three sample groups, totaling 41 participants: Nurses, nursing technicians and members of the multidisciplinary team of a public hospital in Minas Gerais, Brazil. The data analysis followed the steps of open, axial and selective coding. Results: The management of the nursing care before the terminality and death involves a complex process of communication among patient, relatives and professionals, in which the interactions are permeated by the meanings of the end of life. Subjective, educational, sociocultural and institutional conditions influence nurses’ interactions, generating order/disorder in the management of care. Conclusion: Communication represents an important challenge for nursing management because it involves different actors, given the context of uncertainties and affectivities in the process of death and dying. It is important to emphasize the importance of the nurses being open to communication with these people, because this process requires complex actions regarding the demand for training and permanent education, as well as interdisciplinary action to guarantee humanization and comprehensive care.