2019 Volume 7 Pages 44-51
In the nursing records of one acute care hospital, Juntendo University Hospital, the Japanese expression “mi-no-okidokoro-ga-nai” is often used to refer to patient-specific-distress at the end of life in the nursing records. It literally means feeling out of place, being so embarrassed one wants to disappear, or having a sense of restlessness. However, medical nurses at J Hospital seem to use this expression when patients have terminal restlessness.
In this paper, I report from the electronic medical records of patients nursed during their final moments of life at the hospital, and examine the circumstances of “mi-no-okidokoro-ga-nai”. The results show that whenever the nurses judged that the distress symptoms in terminally ill patients was not sufficiently alleviated, this Japanese expression was used to imply that the medical team should quickly diagnose the cause of the pain and expand the range of treatments. In such a context, we consider ways to broaden the treatment range of patients, with consideration of various ethical issues.
