Background A diagnosis of cancer can mean that the ‘taken for granted’ future is disrupted which impacts on self-image and social roles. People may strive to contribute to a meaningful life (Armstrong-Coster, 2004) and develop contingencies to preserve their sense of self-identity so remain within their social worlds (Becker, 1997). In their everyday work, hospice staff face tensions and conflicts within families as well as the loss of anticipated social roles for their patients. In the case presented, the anticipated social role of wife in a young dying women brought into focus personal and professional unity and conflict for hospice staff.
Aims To explore the challenges of a hospice responding to a families wishes by organising a wedding for a dying woman: whose needs are we meeting?
Methods Through the medium of a Schwartz Centre Round 4 members of hospice staff presented their contrasting experiences and feelings evoked by hospice weddings. In keeping with the SCR, a multidisciplinary discussion was then opened up to staff.
Results The juxtaposition of different professional and personal beliefs and values was explored and the challenge of how to manage complex social dynamics of meeting the patient’s and family’s needs when death is a spectre at the wedding celebration. The discussion focused on opposing views of whose needs are the most pressing: the dying woman or the needs of a caring family anticipating bereavement.
Conclusion Resolution is not the aim of the SCR but open, honest conflict and discussion in a confidential environment allowed the ‘unspeakable’ to be spoken. In dealing with such complex issues in a hospice setting, the SCR allows an effective means of exploration not necessarily resolution.
Application to hospice practice Schwartz Centre Rounds are protected time to allow hospice staff the space to explore socially and emotionally difficult situations.
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