Summer 2005

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Name: Emily Moore
Hometown: Wooster, Ohio
Major: Communication
I.S. Title: More Than Just a Nurse: A Qualitative Study of the Communication Strategies That Pediatric Nurses Use With Family Members of Terminally Ill Patients and the Impact of These Interactions on Nurses’ Perceptions of Their Work
Advisor: Denise Bostdorff

Independent Study taught Emily Moore how to conduct ethnographic research, how to edit and revise and revise again, and how many hours it takes to transcribe tapes of one-hour conversations.

Most importantly, I.S. inspired and reinforced Moore’s decision to enter the nursing field. She sees the job of a nurse as "of utmost importance when attempting to develop high-quality care and improve relationships with patients and their families." Her study also convinced her of the crucial role of communication in health care.

Moore interviewed a number of nurses who care for terminally ill children at a hospice and a hospital in the Midwest. Ethnography involves studying a small group of subjects in their own environment. Rather than drawing conclusions from statistical data, the ethnographic researcher looks in detail at the circumstances and experiences of the few subjects being studied.

Moore found her subjects "enthusiastic about their jobs." They displayed genuine interest in the well-being of their patients and their patients’ families. "It takes a special person to work in the field of terminal illness," Moore says. The research opened her eyes to a nurse’s diverse communication roles: teacher, interpreter, intermediary, and comforter as well as caregiver. While some of the nurses she interviewed had trouble with the personal/professional emotional boundaries, they each found it rewarding to help a family through the death of a child.

Few studies deal with this particular mix of factors, says Denise Bostdorff (communication), Moore’s adviser. The off-campus setting was unique. "Emily put together theory and research and took it into the real world," Bostdorff explains.

Bostdorff watched Emily transform from an average student into a highly motivated scholar, eager and diligent. I’d suggest that she could try something — and she would follow up right away. She completed much of her research by the end of the fall semester."

A Wooster alumnus (who must remain anonymous) was happy to help Moore find nurses to interview. Those nurses now want to read Moore’s analysis, which Bostdorff says is well-written and makes their work come to life."

Working with dying children gave these nurses "glimpses of spiritual wisdom," according to Karen, one study participant. Children with a terminal illness often cope with their situation better than the adults around them and are wiser in some ways. They are not afraid of death, Karen said, and sometimes attempt to reassure their parents.

Karen offered the example of a young girl with a brain tumor who returned from Disney World and asked, "Karen, guess who I saw?"

The nurse was expecting Mickey Mouse, as she told Moore. Instead the girl said, "When I was on the airplane, I looked out the window and saw God." The child came home from Disney World on a Friday afternoon and died on Sunday, after telling her mom that she was okay.

"Such interactions influence nurses’ perceptions of their jobs in ways that can change their attitudes and values and remind them that their work is needed and important," Moore says.

Communication skills can be a low priority for medical professionals. Few medical or nursing schools offer classes in how to talk to patients or their families. To change the situation, health care advocates recommend that nurses and physicians employ certain communication strategies such as active listening. "Many nurses, like the ones I interviewed, are already using those strategies," Moore says. "They can serve as a model for working with all patients, not just the terminally ill."