How do doctors and nurses respond to deathbed phenomena?

PhD student working as Healthcare Assistant on St Christopher’s wards to study clinicians’ reaction to patients’ experiences

“You matter because you are you,” St Christopher’s founder Dame Cicely Saunders famously said as she urged her fellow palliative care clinicians to look after the whole person – to take into account all aspects of their care, physical, mental and spiritual.

It’s in that vein that Rachel Cummings is exploring a fascinating subject that touches on the last two of those aspects of care – mental and spiritual.

Rachel, a nurse with previous hospice experience, is spending at least six months in the in-patient unit at St Christopher’s as part of the research for her PhD.

“I’m looking at what’s sometimes called ‘deathbed phenomena’,” Rachel explains. “A classic example would be when someone who is dying sees a relative who is already dead, perhaps calls out their name and might have a conversation with them. Another example could be someone reporting seeing beautiful lights in the corner of the room or perhaps getting ready for a journey, checking they’ve got their tickets.”

She also lists meaningful coincidences, such as clocks stopping at the time of death, animals sitting on the bed and birds perching on a windowsill at that poignant moment, as further examples.

Rachel’s task is not to investigate the truth or otherwise of these phenomena and coincidences, but to examine clinicians’ response to them.

To do that she is working two or three days a week as a Healthcare Assistant, performing all the usual tasks anyone in that role would, like taking breakfast orders, toileting and washing patients as well as sitting in on the handovers and briefings her nurse and doctor colleagues have at the beginning and end of shifts.

Rachel adds: “What do we as healthcare professionals want to do with these stories? I’m not here to judge the truth of these experiences but see how they affect care and how we circulate these stories and talk to each other about them. It’s in these handovers when I can often observe how clinicians discuss patients’ experiences.”

Patients and professionals are left in no doubt about Rachel’s role as she wears a large ‘Researcher’ badge on her HCA uniform and there are posters and information sheets available around the wards.

In a healthcare environment often dominated by clinical decision making, Rachel says these occurrences require clinicians to look at them through a different lens.

“It is beyond the day to day practice of modern medicine and this project does engage with the important debate around the art and science of nursing and how artistry is an important part of care. These experiences can be really significant. So what do we as clinicians do with them and how do we respond to them both with the patient and amongst ourselves, that’s the question?”

Rachel is nearing the end of the second year of six on her PhD. Following her time at St Christopher’s, she will the conduct a series of formal interviews with clinicians about their responses to these experiences. She will then write her thesis which will publicly available online.

Patients, family members, or professionals who have thoughts, stories and comments or would like to discuss the project with Rachel, are very welcome to contact her via email Rcumm002@gold.ac.uk.