ONCOLOGY NURSING FORUM – VOL 32, NO 1, 200597Death is inevitable for all living beings (Haisfield-Wolfe, 1996) and, as healthcare providers, nurses play a principle role in the care of dying individuals and their families. Consequently, the care that nurses provide to terminal or dying patients may be affected by their own attitudes toward death (Rooda, Clements, & Jordan, 1999). According to Rooda et al., “Determinants of attitudes toward death and dying encompass not only cultural, societal, philo-sophical, and religious belief systems, but also personal and cognitive frameworks from which individual attitudes toward death and dying are formulated and interpreted” (p. 1683). Therefore, nurses’ personal feelings also may infl uence how they cope with dying patients.The average life expectancy of Americans has increased dramatically since the early 1900s, from 49 years of age to Karen S. Dunn, PhD, RN, is an assistant professor, and Cecilia Otten, BSN, RN, and Elizabeth Stephens, BSN, RN, are graduate stu-dents in the Family Nurse Practitioner Program, all in the School of Nursing at Oakland University in Rochester, MI. (Submitted August 2003. Accepted for publication April 7, 2004.)Digital Object Identifi er: 10.1188/05.ONF.97-104Nursing Experience and the Care of Dying PatientsKaren S. Dunn, PhD, RN, Cecilia Otten, BSN, RN, and Elizabeth Stephens, BSN, RNPurpose/Objectives: To examine relationships among demographic variables and nurses’ attitudes toward death and caring for dying patients.Design: Descriptive and correlational.Setting: Two metropolitan hospitals in Detroit, MI.Sample: 58 RNs practicing in oncology and medical/surgical nursing. The majority was female and white, with a mean age of 41 years.Methods: Completed survey of three measurement tools: a demo-graphic survey, Frommelt Attitudes Toward Care of the Dying (FATCOD) Scale, and Death Attitude Profi le–Revised (DAP-R) Scale. Of 60 surveys distributed, 58 were completed and returned.Main Research Variables: Past experiences (level of education and death training), personal experiences (age, race, religion, and attitudes toward death), professional experiences (months or years of nursing experience and the percentage of time spent in contact with terminally ill or dying patients), and attitudes toward caring for dying patients.Findings: Most respondents demonstrated a positive attitude about caring for dying patients. Nurses who reported spending a higher per-centage of time in contact with terminally ill or dying patients reported more positive attitudes. No signifi cant relationship was found between nurses’ attitudes toward death and nurses’ attitudes about caring for dying patients. Statistically signifi cant relationships were found among certain demographic variables, DAP-R subscales, and FATCOD Scale.Conclusions: Regardless of how the nurses felt about death, provid-ing professional and quality care to dying patients and their families was salient. Implications for Nursing: Developing continuing education programs that teach effective coping strategies to prevent death anxiety and identifying barriers that can make caring for dying patients diffi cult may make the journey from novice to expert nurse a gratifying and reward-ing experience. Key Points . . .➤ The more experience that nurses have with dying patients, the more positive the care experience becomes.➤ Regardless of how nurses felt about death, providing profes- sional and quality care to dying patients and families was salient.➤ Findings from this study support Benner’s (1984) proposition that practical knowledge learned from professional experience may infl uence how nurses care for patients.79 and 74 years of age for women and men, respectively. Census bureau projections for the United States estimate that by the year 2030, the older than 65 age group will double to approximately 70 million, with the fastest growth rate to oc-cur in the older than 85 age group (e.g., nine million) (Federal Interagency Forum on Aging Related Statistics, 2000). Ac-cording to the National Cancer Institute (n.d.) Surveillance, Epidemiology and End Results (SEER) Cancer Statistics Review 1975–2001, more than half (57%) of the reported cases of cancer in the United States are among older adults, with the median age of death from cancer occurring at age 72. These statistics suggest that nurses will be responsible for the care of a larger population of dying patients in the future and, therefore, the need to be educated about death is warranted. Thus, the aim of this pilot study was to replicate the fi ndings from Rooda et al. (1999) to provide rationale for the develop-ment of proactive educational programs designed to improve the quality of care of dying patients and their families. Literature Review A review of the research literature to determine what effect death education may have on working nurses’ attitudes toward care of dying patients revealed very few recently publishedONCOLOGY NURSING FORUM – VOL 32, NO 1, 200598studies. Hainsworth (1996) examined the effects of an edu-cational program on nurses’ attitudes, subjective norms, and behavioral intentions toward care of dying people and their families using an experimental pretest/post-test design. The focus of the intervention was to improve nurses’ personal death awareness, communication with dying patients and families, and care provided to caregivers. The educational in-tervention was found to signifi cantly improve the experimen-tal groups’ subjective norms (e.g., nurses’ perceptions of their supervisors’ approval or disapproval of a specifi c behavior) directly after implementation. This signifi cant effect, however, disappeared over time. No statistically signifi cant effect was found between the experimental group and the control groups’ attitudes and their intentions to perform specifi c behaviors related to the care of dying patients and their families. These researchers identifi ed that the small sample size could have been the reason for the effect of the intervention not reaching signifi cance.In a convenience sample of 403 working nurses, Rooda et al. (1999) found that nurses who cared for a greater per-centage of terminally ill patients had more positive attitudes toward caring for dying patients than nurses who cared for a lesser percentage of terminally ill patients. Nurses with a greater fear of death had less positive attitudes