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Sammanfattning

Ideals of «the good death» have profound implications for newly qualified nurses’ ability to cope with emotional and physical stress when working with dying patients; this ideal can be difficult to address in medical units in patient-safe hospitals. The study employs institutional ethnography to gather data via participant observations in medical units, interviews and analysis of newly qualified nurses’ and colleagues’ speech and behavior, complementary to analysis of texts in documents related to the ideology of the patients’ safety program. The majority of work activities in medical units are related to survival of patients because doctors inspect unintended deaths of patients and identification of critical illness in patients, which could be essential for the survival of patients. However, doctors disclaim responsibility for survival if patients are incurably ill, and entrust nurses to define palliative care, because health, survival and productivity are no longer possible. The ideology of patient safety programs are control and development; therefore, death may appear as a mistake, for which new nurses blame themselves in a society with increasing individual responsibility for failure and success; at worst, they consider themselves failed nurses if patients die.

MeSH