National Nurses United

Dame Cicely Saunders 9/1/06 12:11 PM Page 12 Saunders' interest in the needs of the dying and her dynamic personality were already evident to her nursing colleagues. They recall her being upset as a student nurse at the medical establishment's lack of attention to the needs of the dying, both in providing pain relief and psychological comfort. Bold for the time, she often questioned the decisions of the doctors she worked with. Sadly though, like many nurses, Saunders developed a severe back problem, which forced her to give up full-time nursing shortly after qualifying. She was determined, however, to stay in the caring field, so she next trained as a "Lady Almoner" (medical social worker). While working as a medical social worker, Saunders still found the energy to spend one evening a week acting as a ward sister at St. Luke's Hospital in Bayswater, London, where she focused on pain relief and comfort. World War II heavily influenced her life in a different way, too, when, while working at London's St Thomas' hospital several years later, Saunders met David Tasma, a Polish man who had escaped the Warsaw Ghetto and fled to England. He was dying of cancer and suffering great pain. Despite his scant knowledge of English and hers of Polish, they struck up a close relationship, which strengthened her ongoing interest in relieving the suffering of the dying. It was in their many and lengthy conversations that the idea of a "place to die peacefully" was formed. Both thought that a busy hospital ward was not a suitable environment to spend the last days of life. Saunders fell in love with Tasma and stayed with him through his dying process. He left her all he had in the world, £500.00 (about $28,000 in today's U.S. dollars), and encouraged her to use it to help start the type of caring environment to die in that they had both discussed so much. He told her: "I'll be a window in your home". Saunders would eventually have three loves in her life, all Polish, and she helped all of them through the process of dying. They in turn strengthened her resolve to change the way that the dying are cared for. No stranger to grieving herself, she found, like many others, that the process ultimately gave her creativity, energy, and strength to achieve her vision. Frustrated by the medical establishment's lack of a scientific approach to the study and treatment of pain and its relief, Saunders came to realize that she needed to become a doctor in order to make the changes she was so passionate about. At age 33, she began to train as a doctor and qualified in 1957. Having trained as a nurse, almoner, and doctor, she has since been described as "a complete multi-professional team in one person." For the next seven years she dedicated herself to research into pain control. She had not lost sight of her vision of opening her own hospice ONE NURSE'S LEGACY 12 REGISTERED NURSE DEAN AND CHAPTER OF WESTMINSTER OPPOSITE: FRANK BARRATT/KEYSTONE/GETTY IMAGES The hospice movement is one of the United Kingdom's great success stories. From the 1967 opening of the first modern hospice, St. Christopher's, the hospice movement, both within the U.K. and around the world, has dramatically changed over the past 40 years the way people are treated when faced with terminal illness through rapid medical and social advances. St. Christopher's Hospice cares for 2,000 patients and their families a year and, in training more than 60,000 health professionals, has spread its standards of caring for the dying throughout the world. It is regarded by some as one of the greatest social innovations of the last 100 years. There are now more than 220 hospices in the U.K. and 8,000 hospices in 110 countries around the world. Every year, hospice care touches the lives of millions of people throughout the U.K. Around 250,000 patients were cared for by hospices in 2004, either in a hospice facility or by hospice workers in their own home. But this care also extends to families and loved ones, which means hospices support many more people than just patients. More than 100,000 people volunteer in local hospices in the U.K. and, without them, hospices could not continue the work that they do. By 1980, the principles of pain relief Saunders set out in such works as Care of the Dying (1960), The Management of Terminal Disease (1978), and Living with Dying (1983) have became standard practice in the health service. And in 1987, palliative medicine was recognized as a speciality in its own right. W W W. C A L N U R S E S . O R G SEPTEMBER 2006

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