Since hospice nurses are responsible for providing care to individuals during the final phases of life, they frequently must confront the profoundness of bereavement and grief, but they are not prepared for this through their nursing education programs. The purpose of this study is to explore how hospice nurses who repeatedly experience the deaths of patients effectively resolve their grief and to identify the implications for designing effective educational programs. The rationale for this study is the need to understand how hospice nurses resolve grief in order that educators can develop strategies to better prepare nurses to work with terminally ill patients.

This study uses a multi-subject case study approach to explore how hospice nurses effectively resolve grief associated with patients' deaths. In-depth, semi-structured interviews with five Registered Nurses functioning in home-bound hospice care settings provide the data base.

The principal themes which emerge regarding grief resolution strategies used among this sample of hospice nurses are: (1) The establishment of a collaborative nurse/patient relationship is central to the nurses' abilities to resolve grief. (2) Open and honest ventilation of feelings activated by the deaths of patients assists the nurses to work through these feelings. (3) The maintenance and use of a solid support system by the nurses is an important factor in grief resolution. (4) Cultivation of and participation in diversional activities is necessary in order for the nurses to maintain a balance between their personal and professional lives. (5) Achieving a sense of closure to the nurse/patient relationship assists the nurses to disengage from the lost relationship and prepares them to be able to reinvest in new relationships with terminal patients.

This dissertation argues that nurses need to be educated to deal effectively with the grief associated with deaths of patients. Further, educational efforts addressing the coping strategies identified in this study must be directed to those nurses already employed in the health/care delivery system as well as those receiving their basic nursing education preparation.