RESUMO
Grief is examined in this article as spiritual chaos, rather than stages to be worked through. Major characteristics of grief and spirituality are identified as well as ways in which chaos theory can help us understand grief. Indigenous approaches to death, dying and grief are explored, and the role of the ritual elder, particularly in terms of creating a safe space in which grief can be safely sampled. Guidance from experienced helpers such as ritual elders assists persons experiencing grief to deal with issues in a more conscious way. It is argued that holistic health care teams require spiritual carers as full members, and that the role of spiritual carer may at times need to be undertaken by various members of the health care team.
RESUMO
This exploratory study using a survey design sought to investigate nurses' perceptions of palliative care nursing before and after participating in a 60-hour continuing education programme. The 26 participants, from various nursing backgrounds, were enrolled on a joint university/hospital course which used a problem-based learning approach. During the course introduction, demographic data, together with descriptions of the students' perception/understanding of palliative care nursing, were obtained. Students' perceptions became the sole focus of the post-course study. Qualitative responses were analysed thematically and the remainder were analysed descriptively. The results suggest that those who undertook the course were beginning to move from a focus on carrying out nursing care to a deeper awareness of the possibilities of simply being with a patient. Other implications of the study were that palliative care educational programmes should be structured and taught in ways which help students reconceptualize the human person more holistically. Other factors emerged that were related to the physical environment of care and the wellbeing of staff in the practice setting.