Nurses Coping with Personal Grief

Because nurses work so closely with dying patients....providing intimate care to the whole person...including physical, emotional, and spiritual care.....sharing in conversation the patient's fears and concerns...... we expose ourselves...our personal feelings. When patients die, we seldom allow ourselves to adequately acknowledge our own losses, or to fully comprehend the intimacy of our relationships with clients. Nurses Announcements Archive Article

How many of you have felt helpless or guilty when caring for a seriously ill or dying patient?

How many become overwhelmed with emotion after a particularly "bad death", or the death of a patient you have allowed yourself to become attached to?

What should nurses do to avoid the pain that such circumstances often cause?

Or are there appropriate ways to deal with these feelings?

Too often we think we are to be "pillars of strength" in times of crisis or death. While we provide supportive care to patients and families, we fail to recognize our personal need to process loss. We fail to see our need to grieve.

In order to offer compassionate care for the critically sick and for the dying, as nurses we must be able give of ourselves without being destroyed in the process. For self preservation, we may resort to ineffective coping mechanisms such as withdrawal, psychological numbing, and avoidance of personal involvement with patients. Failure to work through the grieving process leads to potential burnout.

As nurses, we strive to provide compassionate care, sharing in the grief, loss, and fear experienced by dying patients and their families. We want to do more than just go through the motions, becoming numb to the pain of others.

What are some of the ways you have found to cope with the repetitive emotional strain that you face on a daily basis as you care for people in physical, emotional, and spiritual pain?

It is important that we see ourselves as humans and recognize the emotional reactions that traumatic events evoke in us. Acknowledgment of our vulnerability to tragedy is a fundamental factor in the way each of us handles the senseless losses we are faced with every day in our professional lives.

Feel free to share your stories of situations that have been particularly difficult for you to deal with. We can learn from each other.

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Yes grief does hurt. But I find it helpful to talk about it. It helps to get the hurt out and also helps to know others feel the same way. It is good for us to share ways to cope with the pain as well.

0 Votes
our profession makes us most susceptible to trauma than we think.. every day, we face emotional and psychological challenges as we nurse our patients back to health. but what could be worse than having to play the "professional" nurse when it is your own mother who is lying on her deathbed? ..... do you think a person could go through this unscathed??

we nurses have been through all these and more. we have kept the profession alive despite all the trials. its only just to be each others' support system. feel free to comfort each other, we nurses need to heal to. how can we care for the sick when we, ourselves have been wounded deeply?

with this post, i am reaching out to all the nurses. i may be a stranger for some, but this stranger is willing to hear all your worries. i may not have all the answers but i do have the heart to share with you all.. feel free to contact me.

great post and intriguing questions. imho, no, you can't get through this unscathed unless you were without a heart or soul. not that it matters from a stranger, but as a nurse and a daughter, i have such a need to tell you that you did a great job for your mom that day. :redpinkhe this story must be hard to relive. thanks for sharing it.

talking is important and listening, really listening, is grand too. i guess that is one of the wonderful things about this site and your blog. thank you, tnbutterfly and kurisuchine08, too. :flwrhrts:

0 Votes
Specializes in N/A.

Hello everyone,

I am a new Nursing student at Kaplan College in the Registered Nurses Program. It is 20 months long and I am very excited about my new carreer change. I have an A.A. in Psychology, and a B.A. in Organizational Leadership from Chapman Univerisity in Orange Country California ,but most of my experience is in the hospitality industy. I love working with people and making them happy, but I do have a few concerns adapting to my new carreer.

I realize that I will be working with sick people. My goal is to work in the Emergency Room, because I like high energy and excitement. However, I am wondering how to deal and cope with the stress and slight possible depression of seeing people at their worst in critical conditions. I realize that I am there to assist in making them feel better, and put them on a path to recovery; but the idea of seeing small children critically injured concerns me. I know I will adapt and overcome my anxiety about this, but I would appreciate any tips, suggestions, techniques, or personal wisdom on how to deal with the stress and feelings associated with seeing people at their worst. Also, I would like some advice on dealing with grief of patients who have pasted that you have grown attached to.

In addition, I could use some advice on excelling at school; and how to deal with the stress of all of the information and assignments.

Thank you in advance,

Dave

0 Votes
Specializes in Psych, LTC, M/S, Supervisor, MRDD,.

Great posts guys!!! Ive been a nurse for about 13+ years. I've always cried like a baby!! I just learn when to release it and when not to release it. I participate in dark humor at times! More calloused nurses make a habit of this. But, I hope to never be a consistant purveyor of morbid humor to cope with my emotions..:yawn:

The first time I had a patient die....I was an LPN in LTC the cna came up to me and said "Mrs so n so is c/o chest pain." (which she had some somatic c/o every minute!) I blew it off, went on with mealtime meds, and thought I'd take her Mylanta a little later. Two minutes later the cna came to me and said "mrs so n so in unconsious". Actually Mrs so and so was DEAD!! Most likely acute MI?? I felt HORRIBLE!! I cried and cried. My charge nurse (who was an old heartless battleaxe, I thought!) told me "get it together, this isn't about u it's about her right now! Dont u dare let that family see u cry! This is their time to grieve!"

I went into the little chapel area and bawled like a baby! Partly for feeling responsible, partly because I felt like a failure, and partly because the battleaxe yelled at me. I disobeyed a golden rule in nursing school....I ignored a c/o chest pain!! After I pulled myself together, the family had left, the post-mort care was done. I went down the hall to find the battleaxe. She was in the dead womans room, before the funeral home people arrived, at mrs so n so's bedside. I silently entered the room and witnessed one of the most beautiful images in my career. That old, snippy, charge nurse was kneeling at the head of the patients bed, holding the lifeless hand of Mrs so n so, bowing her head, praying and grieving in her own way!!!!

I started crying again, of course!! But, it taught me really important things on emotional maturity. That 65 year old nurse was not uncaring--she just had priorities and saw to them before her own feelings or grief. My 20 year old self did not have a grasp on that yet.....My 33 year old self still works on it daily- my anger, my frustration, my grief, etc......I feel in time when I'm 65 or so I will get there!!

0 Votes
Specializes in ICU.
Amen, feeling is a good thing. It gives us a conscience. I like this thread. It's so hard to talk about sometimes, though. Grief hurts. We are all humans :redpinkhe:redbeathe:heartbeat before nurses, aren't we?

Some caregivers deal with pain & hurt by "raising shields". This may keep them from feeling pain after a patient suffers or dies, but it can also keep them from feeling at all. It's a careful balancing act - caring/feeling enough, without caring/feeling too much. If you raise your shields, you run the risk of being an insensitive (purely technical) caregiver, which I think will impair your ability to give your patient all that they need, including a true connection with their caregivers. If you don't protect yourself (emotionally), you run the risk of being hurt too deeply by a patient's suffering or death. It can be a hard balance to maintain.

Just my opinion....

0 Votes
Specializes in tele, oncology.

I work on the oncology/tele floor at my hospital, so we tend to see a lot of oncology readmits, from diagnosis to hospice.

It took me a long time to adjust to the different mode of caring that is needed between say an acute MI or CHF and a cancer patient. I honestly wasn't sure at first that I'd be able to handle it, but I think that I've managed to get it straightened out in my head somewhat.

I've learned a lot in the last several years, working with our oncology patients....

I've learned how to compassionately tell patients and family members "It's just not going to get any better, no matter how had we all fight it." Or "I'm so sorry, but the pain is not going to get any better, to be more aggressive with pain management, we really need to sit down and talk about code status."

I've learned that finding out which family member is on your side can be of great importance...as in, the one who has accepted the patient's wishes and will support you in your quest to provide the best care for the patient within those parameters, regardless of if it's to fight it all the way or to go hospice.

I've learned that it's okay to cry a little in front of families when their loved one passes, and to offer hugs to them in addition to kleenexes.

I've learned that sometimes I'll be the one to hold their hand when they pass, so that the family knows that their loved one did not die alone.

I've learned that being able to recognize family members in the halls or on the elevators and asking about their loved one goes a long way to building up rapport and trust with them...they'll remember that you remembered, and the next time you care for the patient you'll usually get "You're the nurse that asked about Richard's surgery while we were on the elevator, we were hoping you'd get to take care of him."

I've learned how my coworkers respond to deaths, and how to treat them individually when it happens to one of their patients.

But I haven't learned yet how to leave it at work all of the time, or how to stop asking "Why?", or how to stop worrying about the family. I wonder sometimes if I ever will, and if I do, if that will be a good thing or a bad thing. The part of me that allows me to be a compassionate care giver seems tied up with that part of me that worries and questions, so I'm afraid that if it goes away it will affect my abilities to connect.

0 Votes

,

Please what is A/O ??

I am finding this posting very interesting because I am too a very sensitive caring person. At times I may be too sensitive. What I keep in mind at all times, there but for the grace of God go I. I put myself in the patients shoes and I do bond. Grief comes in many forms. Since I had from 27 to 17 residents day to day for six months I became attached to them. In LTC I took

care of them in their home. So, when I was let go I did not grieve for the loss of one but for the loss of ALL my residents that I loved, bonded with and cared about. I still miss the dear people and it truly hurts to be cut off suddenly and not prepared. Not the same as a dying loved patient but none the less a terrible loss I deal with. It has been a few weeks now and I am healing. But, during the day I think of them often. Thank you for letting me bare my heart. The whole reason I became a nurse was to "care" for others and to do that I give emotionally too.

0 Votes
Specializes in ICU.
,

Please what is A/O ??

Alert & Oriented.

0 Votes

Hi, I found this site by seraching for nurses grieve. I have spent the last 2 hours trying to find something to help in my current situation, its a long shot, but hey, I'll try anything.

2 days ago we were told my father has terminal hepatocarcinoma, he has been given weeks (this isn't a relatives support page, I hear you say), I'm a nurse, been nursing for 22 years, one subject that hasn't had a lot of research done or papers written on is how nurses begin to grieve about a family member... when my Mum died 3 years ago, I went into nurse mode throughout her 13 month battle with Motor Neurone Disease & fell apart 5 months after her death.

My family are very concerned I am going to do the same thing with Dad, my Dad said to me yesterday "Please don't get as involved as you did with your mother, I don't want you to make yourself ill again" As I said to him, there is very little I can do about it & anyway, me not being involved is not an option, I have always been Daddy's little girl.

How do I take my nurses head off & become the daughter of a dying man??? I've had a few tears, but they are due to a feeling of hopelessness about not being able to help with their grief.

Any suggestions would be gratefully received

Sian

0 Votes
Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Sian.........First let me welcome you to allnurses. I am so glad you found the site and especially am glad that you found my blog.

I feel your pain.....I really do. Part of the inspiration for writing this entry in my blog was the loss of my father a little of a year ago. Like you, I was Daddy's little girl, as well as "his nurse". He always looked to me for medical advice. But it became more emotionally difficult for me as his condition progressed.

Let me just share a few personal opinions and heart-felt advice.....from my experience.

As his daughter (who just happens to be a nurse), I could not just stand by and take off my nursing hat, so to speak. This was my most important patient......my Dad. I used my heart and my nursing knowledge to be the best advocate I could. I was able to do for him what no one else could...... He trusted me.

I know it is a difficult position for you to be in. You are a nurse who not only knows the implications of his tests, his condition, the doctor's words. But you are also his daughter. All of this affects you deeply. But your family looks to you to help them understand the doctor's words. They look to you for guidance in this most difficult time.

One thing that I did......rather than try to explain everything to my dad and the family......I helped him explore the questions he had and helped him direct these questions to the doctor. I let the doctor address these issues and made sure he explained things in a way that Dad and my sister could understand. Many times I would meet with the doctor before he entered the room and share my concerns. I felt this method allowed my dad to still have some sense of control. Plus, it placed the responsibility back on the doctor to do his job.

Of course I was at Dad's side as much as possible, which I would do even if I wasn't a nurse. But, I tried to take as many breaks as I could. It is important to eat. I didn't feel like eating much, but I made sure I left the room, even if it was just to walk down to the cafeteria to get a drink. You need to give yourself time to be alone......to regroup......to cry........to phone a friend......to pray. This is really important. I hope you have a good friend that you can talk to. You need to make sure to take care of yourself.

I don't know if you are a religious person or not, but there is a peace and a strength that passes all understanding that comes from the Lord at times like this. When he was able, my dad was at church every time the doors were opened. He had a very strong faith. We both found great comfort in the daily visits from the pastor. I would stay in the room for a short time, and then step out to let Dad and the pastor have some private time. I knew Dad had concerns and questions that he wouldn't address in front of me......... wanted to remain strong for his little girl. And the pastor and I had private time as well to address my own concerns. For me, this was instrumental. Spiritual needs are so great during these rough times. Even if you or your father are not religious, you still have spiritual needs. I would request a visit from the chaplain. He/she can address your needs, even if you are a non-believer.

For me it was impossible to not be a nurse. Any loving daughter would want the best care for her father in his dying days. As a nurse, you are able to provide things that others can't. Yes it is a difficult position to be in. But, you are going to grieve......whether you are a nurse or not. It will be painful now and in the days, weeks, months.......and years to come. For me, looking back........I am glad I had the special knowledge to insure that Dad got the treatment he needed and his questions answered. But more importantly...... this was my special gift to him.....My love. Yes it was and still is painful. It will affect you. You can't really stop the pain.....during or after. But you will know that you were there for him just as he was always there for you when you were his little girl.

I don't know if this has helped or not. I know you are going through a terrible time. Please let me know how things are going for you. You and your family are in my thoughts and prayers.

0 Votes

Okay, I'm crying now...Thank you for sharing this. It takes me back, too. If I had a redo, I would try to laugh more during the year and 3 months I had with my Daddy after his RAEB dx. It's like Leukemia. In the end it was. He worked so hard and didn't even really get to retire. Anyhoo, if, only if... I would try to listen to more music with him and find out more about him and our family history maybe if its not too painful. One of my best memories was remebering him laugh. After reading evrything the final line, is so fitting, something about a day without laughter is wasted.

I know there is such sadness but if you can rent a funny movie and just escape for a while and laugh your ever luvin' butts off together. Adam Sadler's 'Happy Gilmore', praise Jesus, came out during this time. Damn, that made us laugh. We all laughed together as a family. It was so healing. It really helped us just go on.

That reminds me of how I saw an Ellen rerun yesterday where the young guy said while he was in a coma the nurses put Ellen on his tv everyday and he said her funniness and laughter helped him heal, while it also helped his family who was there most often too for over a year. If only it was a coma...

I also remeber telling my Dad how I will always think of him and his spirit will go on even though his body won't be and that will really, really suck because he 's been your go to for advice, unconditional love and acceptance guy in your life forever. Let him know you will carry on his memory and hopefully most the time you can remeber the laughter not the sad times with the docs and hospitals in the end. Let him know you will be okay. You will still be talking to him and asking his advice throughout your life and there will be times you can feel the answer more than others. It will be hard but you will make it through this as sometimes life gives us no choices. Maybe you can share an artistic pursuit of some type?

It is strange watching yourself and your family going through Elizabeth Kubler Ross's stages that we all learned about in school. Help him with the medical questions like tnbutterfly said but also help him get his personal affairs in order if he hasn't, and wants help. Assure him that you want to help him as a daughter first, nurse last. Will you be able to be with him in his final days? I saw your Mom has already passed.So sorry. Does he have a significant other now?

If I had a redo, I would try even harder to find out and focus on the things Daddy really loved and do all of them I could. We were so busy with transfusions, etc, and trying to find a bone marrow match, that it was naturally going to be stressful at times. I wish we had taken a trip to someplace fun together as a family, along with his girlfriend, while he was still up to it. We could've made it fun. Is it too late for this already? Is he already in terrible pain? If so you can reassure him that you will make sure he gets his pain meds and antianxiety meds as needed if that's what he wants. Most anything to help the overwhelming anxiety right now is a really, really good thing for all involved. Just sit together if you can. Be still. Hold hands and sit in the sun together. Let it shine on your faces together and try to remember no one can take these moments from you. Even though it may be the hardest thing you've ever done try to make the most out of each and every moment. Try to get through the sadness and let as many laughs in as you can possibly find right now. When 'Waterboy' came out all I could remember was how Daddy had laughed so heartily at "Happy Gilmore" and how hard we would laugh together at this. I could almost feel him there laughing with me. Try and capture these moments and tell him that's how you want him to remember you and you him. God bless you, sian, and know thoughts and prayers are with you all. :redpinkhe

0 Votes
Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Thanks wondern for the wonderful suggestions.

0 Votes