title: Relatives' matched with staff's experience of the moment of death in a tertiary referral hospital.
abstract: BACKGROUND
  Although the majority of deaths occur in hospital it has been suggested that dying in hospital is largely a negative experience.
  
  
  OBJECTIVE
  To explore the experience of relatives and staff of patients dying in hospital using qualitative grounded theory.
  
  
  METHODS
  Patients receiving palliative care were identified who were likely to die in hospital. Family members were met by the researcher prior to the patient's death. The ward nurse and doctor (excluding palliative care team) most involved at that time were interviewed within 48 h of the death. The family were interviewed 2 weeks later. Interviewees described their experience of the patient's dying and death. Recruitment and thematic analysis of interviews occurred concurrently.
  
  
  RESULTS
  Twelve triads over 6 months (relative, nurse and doctor) were interviewed in relation to 12 patients. Dying patients and families need a guide to attend to their needs. Every detail is remembered by the family who take up residence in the hospital. Families value acts of kindness by staff. Hospital may offer benefits for the dying patient and family. However, there are gaps in care identified by families and staff. After death is critical time for the family. Junior doctors are often uncertain of their role, expressing grief and guilt. Young nurses inexperienced in care of dying patients value support and guidance by senior colleagues.
  
  
  CONCLUSIONS
  Leadership from nursing and medical staff is required for seamless provision of competent and compassionate care at this life changing time for grieving families.
authors.affiliation: Palliative Medicine Department, Wellington Public Hospital, Private Bag 7902, Wellington 6242, New Zealand. sinead.donnelly@ccdhb.org.nz
authors.forename: S
authors.initials: S
authors.lastname: Donnelly
authors.forename: M
authors.initials: M
authors.lastname: Dickson
mesh_terms: D001293:Attitude to Death; D004645:Empathy; D005190:Family / Q000523:psychology*; D017051:Hospice Care / Q000523:psychology / Q000592:standards*; D006801:Humans; D007857:Leadership; D008505:Medical Staff, Hospital / Q000193:education / Q000523:psychology* / Q000592:standards; D033262:Narration; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology* / Q000592:standards; D011361:Professional Competence; D062606:Tertiary Care Centers / Q000592:standards