Nurses Coping with Personal Grief

by tnbutterfly, BSN, RN Admin | 19,374 Views | 56 Comments

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    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?

    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. 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.
    Last edit by Joe V on May 15, '09
    Blanca R, jennybean14, nurse_tin, and 14 others like this.
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    About tnbutterfly, BSN, RN

    tnbutterfly has 'More than 35 years' year(s) of experience and specializes in 'Parish Nsg, Disaster Nsg, Peds, Med-Surg'. From 'TN'; Joined Jun '06; Posts: 22,141; Likes: 12,692.

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    56 Comments so far...

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    Has anyone out there had a patient overdose to medication due to a defective PCA pump? I programed the pump correctly but something went wrong and the pump released too much medication. After a Narcan drip and overnight in SICU... the patient is OK but I am having a terrible time. I have been a nurse for 29 years and never had anything like this happen before. Any words of comfort out there?
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    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? i was put in that role last summer, i was on duty when my dad brought my mother to the hospital where i was working. i was the one who saw the signs of congestive heart failure at its worst stage. my mother's lungs were drowning, and i asssisted the doctor intubate my mom while she was conscious. i could not afford to be worried or anxious for it may cloud my judgment and make me commit a grave error that would jeopardize her life more. i was the one who suctioned the secretions out of her lungs, and all the while i have to maintain a straight face to assure my family who had been watching all the time. 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.
    lindykid, TrueAngelofMercy, liebling5, and 10 others like this.
  5. 11
    I worked in the primary care setting as a MA for years. My perspective is a little different, because I was with patients for years at a time. I've had older patients pass, and been with patients from diagnosis to death.

    I had a patient in my age range who had a type of osteosarcoma. My age - it was my "that is not fair moment". We were quite close, as was his family. I was with this man as he fought with every fibre of his being. He was amazing! But he didn't succeed and he did eventually go to hospice and died. I worked very hard with his physician to make sure that he was adequately medicated for pain, that he got the referrals to specialists that he needed, and eventually that he and his family got the hospice care he needed. I went to his funeral, and I cried. I had been with this family for several years. I knew about his work, his life, his girlfriend. He knew about nursing school and prereqs while I worked. His family came to thank the doctor and I for the care that all of them received. Before he went into hospice in his last office visit he told me that he thought I would be a wonderful nurse. That's a recommendation that I will never forget.

    I think that sometimes to protect ourselves we distance ourselves from patients, and yes sometimes you need to keep perspective. These are not your best friends. But they are human beings, with lives and hopes and dreams, and sometimes those are cut short early. As they are in our own families, with our own friends.

    I'm "only" a nursing student, but it seems to me a good cry once in a while never hurt anyone. We also are human beings, not just human DOINGS - we are more than the sum of our nursing interventions. We need to give ourselves permission to be, to feel, and to accept.

    Sorry that's so long - but I obviously have some strong feelings on this one.
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    Quote from madnurse2b

    I think that sometimes to protect ourselves we distance ourselves from patients, and yes sometimes you need to keep perspective. These are not your best friends. But they are human beings, with lives and hopes and dreams, and sometimes those are cut short early. As they are in our own families, with our own friends.

    I'm "only" a nursing student, but it seems to me a good cry once in a while never hurt anyone. We also are human beings, not just human DOINGS - we are more than the sum of our nursing interventions. We need to give ourselves permission to be, to feel, and to accept.
    You make some very excellent points. Yes, our patients are human beings as are their families. When we forget this...the humanness...the emotions..the hopes and dreams....of our patients AND ourselves....we lose sight of why we are doing what we do.

    You may be "only a nursing student", but I believe you are going to be a very compassionate nurse.
    Hosserdawg, CandyGyrl1985, and nitenite like this.
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    The ones that drive me crazy are the ones where the pt is dying -- cancer that's mets'd or a dying liver, etc. One doc at our hospital would tell a 3 day dead corpse they are going to be fine. It's wrong, and it's immoral for the doc to not tell a patient they are dying. I mean, if the person's A/O, give them time to face end time issues, don't make their final days filled with a sense of betrayal. If it happens to me, I'd rather the doc told me so I could make my arrangements, say what needs saying, do what needs doing.

    I've seen people with liver CA, lung CA sent home without ever being told they found a malignancy -- and sadly, the ones they usually send home with a kiss and a shove out the door are the ones without insurance. It breaks my mean old heart.
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    Quote from nerdtonurse?
    The ones that drive me crazy are the ones where the pt is dying -- cancer that's mets'd or a dying liver, etc. One doc at our hospital would tell a 3 day dead corpse they are going to be fine. It's wrong, and it's immoral for the doc to not tell a patient they are dying. I mean, if the person's A/O, give them time to face end time issues, don't make their final days filled with a sense of betrayal. If it happens to me, I'd rather the doc told me so I could make my arrangements, say what needs saying, do what needs doing.

    I've seen people with liver CA, lung CA sent home without ever being told they found a malignancy -- and sadly, the ones they usually send home with a kiss and a shove out the door are the ones without insurance. It breaks my mean old heart.
    What are some ways the nurse, as the patient advocate, can use to approach the physician in situations like this? Don't we have a responsibility to speak up?
    LockportRN likes this.
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    It is very hard to control my tears in front of the patients. I am too emotional. When I first time watching the newborn baby delivered, my happy tears came out, not the mother's. The doctor gave me a strange glance, made me think whether am I professional or not.
    I worked in Fetal Assessment Unit/complicated OB clinic. Most pregnant women had more or less issues to visit us. I hate to see anything wrong happened to those innocent, immature fetus. They are so LIVE to me when I watch them thru the ultrasound. I feel what mother's feel. Hide my heart become extremely difficult to me. I don't know how to handle this problem. I know I should treat them professionally, emotional support, but not personally involved, but how could I control my tears when a newborn baby just passed away in my arm after several hrs living, or I had to tell a happy young pregnant mother that her baby didn't develope the brain?
    Anyone can tell me the way or any resource that offer solution?
    liebling5 and tnbutterfly like this.
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    Hello, I found this to be a very interesting blog. My main reason for wanting to become a registered nurse is because I went through a devastating experience seven years ago. My son's father (which was my husband at the time) was in a terrible car accident.
    For the first 3 months me and my son spent day after day in the ICU. Watching and waiting for any answer, a miracle ...something. It was the most painful time in my life. He remained on a ventilator..and was unresponsive. What made all the difference was the attitude of some of the nurses. He had nurses that did their job and went about their day, and then there were nurses that gave care with love in their hearts. They were not only there as a caregiver, but as a friend and a support system. They took time to explain procedures, medications, etc. some even took time to pray with us. It made a huge difference. It made our situation bearable.
    I think those are the best kind of nurses~the ones that put their heart into their work~.I feel their is no limit to how much you can put into a patient both emotionally and physically. At the end of the day, if you know that you gave all you could to your work, that is the most important thing. I do believe that all the good you do for others will come back to you. Once you have become a calloused nurse you have lost your purpose. Nursing is about giving of yourself, and putting your whole heart into your work.
    liebling5, Hosserdawg, *LadyJane*, and 4 others like this.
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    Hi, I too found this blog to be interesting because I at first believed that we were supposed to be always the pillar of strength, But now after working 30 years I think it is the good nurse who lets her feelings out, but I did it with the patients. I learned to be emphathatic rather that sympathatic. Empathetic means you can relate to their pain by putting yourself in their shoes for a time, but knowing that you will be taking them off when you leave and go home. But when you are sympathetic you tend to wear the shoes home, and keep them on much longer than you intended to.I always took my cues from the patients own reaction and allowed my emotions to match theirs. I also tried to stay out of myself and focus on the patient or and what their needs were. And how important to them that I could experience and reflect the feelings they may have been haveing..... That how I would want to be treated and its how I try to treat others..The old golden rule...I have found that nurses either handle things that way, or they become hardened and cynical...GOOD LUCK.
    *LadyJane*, AnnieWotton RN, wondern, and 1 other like this.


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