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.

Thank you for posting that touching poem.

Specializes in ICU, Telemetry.

You know, there's a Catholic custom of mourning those that have died in the prior year (all soul's day). I've often thought that we need to have a "staff only" day where we can mourn those we've lost. I mean, if we've got a heart, we're going to have patients that "get to us" but I know I'd feel weird going to a patient's funeral or a wake, and I'm not sure if it would help/hurt the family to see us there, especially if we were there when the pt died. But if we had a "dia de los muertos" at our facilities, where we could mourn and remember those we've lost, it might help a lot of people.

Specializes in Peds Critical Care, Dialysis, General.

Sian-

I know how you feel. My mother died Aug 8 of metastatic breast cancer. She went into the hospital in July 21 with cellulitis of the left leg, UTI and altered mental status. During her stay, ascites really kicked in - she looked 10 months pregnant - she had lost so much weight and had much muscle wasting. My husband cried when he saw her. My sisters and I cared for her, along with my precious Daddy, in the hospital and at home. We were told she had less than 3 months and when she and daddy heard from the doctor that this was it, she decided it was time to go. She began slipping away from us on the Tuesday night before her death. She died on her owns terms and in her own home with her family and other close friends around.

I don't think you take off the "nursing hat". I had skills I could use in caring for her, to make her last days and daddy's last days with her better. She loved it when I bathed her - I was the only one who could that like she liked and I also did her hair (I can do a mean roller set). Did I cry?? Yes, buckets. I still cry buckets. But I can also smile. I did what I could for her.

On the day after her death, my sisters and I went shopping to find something for her to wear. It was 4pm on Sunday, we thought we only had 2 hrs, but it was tax free weekend, monster sales and stores were open til 8pm. We were able to laugh and talk about how much she would have enjoyed us getting all this stuff together for her, then getting outfits coordinated for ourselves and our daughters.

The last earthly thing I did for my mother (at daddy's request) was go with my sister-in-law and do mother's hair and make-up. She was very particular about it - I knew how do both liked she preferred and my sister-in-law is a licensed cosmetologist and was able to help me. We weren't sure at first if we could make her look good, but we pulled it off - she was so beautiful.

Do I cry at work when a patient dies? Yes, most certainly - I work Peds ICU. I can cry with anybody, anytime and I'm okay with that. Some of our intensivists have been known to get misty-eyed. If I can get to the point where I cannot cry, I'll be turning in my notice.

When I'm home, I do things for me - nails, hair, shopping, internet surfing, allnurses, reading, etc. I pray alot, too.

Hope this helps,

Cindy

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.
You know, there's a Catholic custom of mourning those that have died in the prior year (all soul's day). I've often thought that we need to have a "staff only" day where we can mourn those we've lost. I mean, if we've got a heart, we're going to have patients that "get to us" but I know I'd feel weird going to a patient's funeral or a wake, and I'm not sure if it would help/hurt the family to see us there, especially if we were there when the pt died. But if we had a "dia de los muertos" at our facilities, where we could mourn and remember those we've lost, it might help a lot of people.

What a great idea! You might want to mention that to the chaplain at your facility.

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

Cindy.......So sorry to hear about your mom. That loss is so very fresh. You should take comfort in the fact that you were able to be there with her and provide that special care for her in a way like no other person could. Thanks for sharing your story. Feel free to come back to share as often as you like.

I hope this blog will serve as a support group for those with losses....whether they be recent or not.....family or patients. Grief is a thing that each person experiences differently. And there is no one-size-fits-all formula to deal with it or to make it go away.

As nurses we are affected by our patients' suffering and deaths. I totally agree with you....."If I can get to the point where I cannot cry, I'll be turning in my notice."

You know, there's a Catholic custom of mourning those that have died in the prior year (all soul's day). I've often thought that we need to have a "staff only" day where we can mourn those we've lost. I mean, if we've got a heart, we're going to have patients that "get to us" but I know I'd feel weird going to a patient's funeral or a wake, and I'm not sure if it would help/hurt the family to see us there, especially if we were there when the pt died. But if we had a "dia de los muertos" at our facilities, where we could mourn and remember those we've lost, it might help a lot of people.

I do agree. For nurses week I used to have a local pastor come and administer the 'Blessing of the Hands' but one year he became ill and at the last minute cancelled. At that time, we lost several residents and there were several staff members that lost close relatives. Yes we were close and supported each other but sadness still lingered. So on this day, I got a bunch of balloons (helium) and all the nurses (and any other staff that cared to join) went outside. I asked for their permission to pray and told those that do not wish to pray to stay and be of comfort to the others. After the prayer we said to all those that we had lost and gave to God's hands, and to our patients and to all the staff that worked in our little facility, we released the balloons to the air, thus releasing our grief. After many tears and hugs, the tension seemed to lesson. The sheer number of staff (and even some residents and family members) that were outside that day and grieving seemed to open us up that we are all one. That we all have hurt and pain. It helped us out of ourselves to look around when others were in need. It was something that touched me then and something that I will never forget.:redpinkhe

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

Lockport.......Thanks for sharing that. It sounds like it was a very touching and meaningful experience for all.

I like the analogy of releasing the grief as you release the balloons.

Too often Nurses think of themselves as the "pillar of strength." Yes, I believe that nurses are there not only to care for their patients on a medical level, but to provide support on an emotional one. Nurses are known to tend to take care of everyone but themselves. (Which tends to attribute to "Nurse Burnout.) When faced with a particularly difficult situation it is in our best interest to think clinically and dis-connect ourselves from the situation in a way that allows us to do our jobs proficiently without breaking us down. But once that situation is over, too few nurses re-evaluate their feelings and deal with them, allowing us to really "move on." Many hospitals now have "debriefing" sessions designed for that very thing. It is a place for the hospitals resident nurses to open up and share their feelings with other professionals dealing with the same thoughts and feelings. Personally, I think that every hospital or critical care setting should have these sessions.

Specializes in Peds Critical Care, Dialysis, General.

Our entire unit is beginning the mourning process for one of our children. He's been with us for a month and is gradually going downhill. We are all attached to him, even though we didn't know him except through his family. He has a most wonderful family. We love this family - they are exceptional! We have all fought to have this young man because we can see the possibilties that this young man will never have or know. We are already crying with this family.

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.
Our entire unit is beginning the mourning process for one of our children. He's been with us for a month and is gradually going downhill. We are all attached to him, even though we didn't know him except through his family. He has a most wonderful family. We love this family - they are exceptional! We have all fought to have this young man because we can see the possibilties that this young man will never have or know. We are already crying with this family.

That family is very fortunate to have such compassionate nurses and healthcare team caring for their loved one. This is a difficult situation for all involved. As hard as it is, the family's grief is and will be somewhat softened by feeling the love and compassion of those caring for their son. Don't be afraid to show your emotion......From what you are describing...that would almost be impossible.

Is the hospital chaplain available to talk to the staff as well as the family?

My heart goes out to you and your unit, as well as the family.

Hi all,

I am new to this site. I am a 3rd semester ABSN Nursing Student. I am presently doing a weekly rotation in a Critical Care Unit at a local hospital. I am writing because hopefully by doing so it will help me deal with a tough experience I had in clinical yesterday. I was assigned a patient with esophageal cancer that had metastasized and spread since he was originally diagnosed with it two years ago. He was admitted last month for SOB. He had respiratory distress, was intubated, but ended up having to go on permanent mechanical ventilation. His prognosis was poor. He was bed-bound, with soft restraints around his wrists. When I first saw him, he had extreme anxiety yesterday morning (respirations 40/minute). The nurse that I was working with gave him some anti-anxiety meds and Norco. The patient had methodone on his list of regularly prescribed medications for pain, but his wife was adament that she did not want him to have any pain or anti-anxiety medications during the day. So we could not give him any methodone per her instructions. He could not talk because of the trach, was very weak, and could not communicate. He was restless, though. It was obvious he was in pain. He would look at me right in the eye, and I felt and sensed that he was trying to communicate to me that he was in pain. It seemed like he was saying, "Please help me!" All I could think to do was to just hold his hand, look back at him, smile. After talking to the nurse I was with, and reading some of his history, I understood that he was not doing well, and getting worse. I didn't know why he wasn't in palliative care. I didn't think that this situation would upset me or affect me this much, but it has. I had to go to the bathroom and "pull myself together" a couple of times, remind myself why I was here, and go right back in. But this morning, I've cried several times, and I am so sad about this patient and his pain that he's having to endure. I feel like I'm grieving. But I barely know him, and I only spent 10 hours with him. I didn't expect to see or feel this in nursing school. I know I need to figure out how to cope with situations like this again in the future. I didn't know I would be feeling the "aftershocks", so to speak, the day after. I just felt so helpless, and hopeless for the poor man. When the wife came later yesterday afternoon, she was rude to the nurse, and staff, and wanted to know, "why he was so doped up. I know you all gave him something!" & she said that he just "needed to get up and walk around." My jaw dropped open! The level of denial! I am trying to by sympathetic and understand that perhaps that is her coping mechanism, and not to judge. I guess this experience has really shaken me. Anyway, thanks for having this blog here. Any feedback from anyone is greatly appreciated. Thanks.

Dave

Specializes in ICU, PIC, BURN UNIT, PEDS, MED SURG, PSY.

God, I cried over so many of the people who died "on me!" I loved them, cared for them, lost them, and grieved. But as I got older, I realized that some things in life are worthy of tears. One of the things that saved me was that many of my patients gave me so many gifts of their wisdom, their experience, what they had learned in their life that it helped fortify me as I went through my own life. I still remember many of them and as strange as this may sound to some, one of my favorites-a doctor I took care of until he died- met me when I had a near death experience and walked me back into life! Boy was I surprised, I'd heard about spirits of light meeting one and guiding them into the light, but this doctor, my patient, met me and walked me back!! So I learned to really pay attention and see my "caring" as a great gift to whomever I cared for and about, because I realized that it really did matter. Nursing is the most intimate connection one can have, and I know I myself am grateful for all those people who allowed me "in." And yes, it does hurt, but that's okay too. I think its wonderful in a world that's becoming less and less personal, that some of us can still really feel. I think nurses are great. I think we're great