How do we reconcile our human responsibilities and our need to grieve with those of working in a professional role: An audit of practice?

Abstract

Aims The decision about whether or not to attend the funeral of a patient is one that many professionals have to make and yet little attention is given to the moral, emotional and ethical dilemmas associated with attendance, both in practice and in the research literature. Anecdotal accounts can be found but very few research studies on this topic have been published. This study aimed to highlight and address this gap by carrying out an audit of practice, staff support and opinion regarding funeral attendance. Method Opportunistic sampling was used to recruit professionals who were attending an International Paediatric Palliative Care Conference. Participants (N=20) were asked to complete a questionnaire comprising 7 questions requiring ‘tick-box’ or free text comments. Results The results suggest that those working in palliative care do see a role for professionals attending a patient’s funeral, reflecting both the need of professionals themselves (“need to say goodbye”) and the families they care for (“‘want to support family by attending”). However not everyone viewed this as a professional responsibility and caution was raised about potential difficulties, coupled with strong opinion about the need to train and support professionals, and the need to implement clear and appropriate boundaries. Only 20% felt their training was good with 35% saying they had little or no training on how to manage the death of a child they had cared for. Only 30% respondents had written guidelines/policies and yet there was a strong view about the need for this. 100% felt that attendance at a funeral should be an individual’s choice, 95% felt attendance should be supported by management and 65% felt attendance should be paid for as part of working hours. Conclusion When professionals are faced with the decision about funeral attendance there is little research, guidance or information available to aid this process. Those surveyed had a strong opinion about the need to acknowledge and address this issue, particularly through policy development, training and support.