Crying at work

Specialties Oncology

Published

Specializes in Oncology, Pediatric private duty nursing.

I am not sure if this is the correct place to post but had to vent about work today. I still remember my very first patient to pass away on my floor like it was yesterday. I can tell you what room number she was in and the look in her daughters eyes as she took her last breaths. The daughter looking helplessly at me to bring her mother back but unable to do so due to a DNR order. I started as a new grad in an Oncology floor and found myself unable to cope with so much death at first. Seeing a 31 year old woman and mother of 5 kids leave her children behind, or the 21 year old newly wed man with a child on the way, was just too painful for me to see. I often thought of these patients and thier families and it would just break my heart. Months and months have passed and although I still am saddened by the deaths that occur on my floor I somehow am able to see it in a way that I can handle it better. I see so much pain and suffering from the patient and sometimes when they are gone I console myself by thinking they are in a better place and no longer in pain. But there are still some that really get to me like the one I had today. There is something about caring for oncology patients and thier families that I just can't explain. You see some that are angry at the world and can be really mean, you see the ones that are full of hope, the ones that are depressed, and some that just want to give up. Today, as I prepared to change the dressing of my patient he looked at me and said, " what's the use of doing anything for him? Cause he was dying anyway." The look in his eyes was an all too familiar one, one that I have seen many times. I leaned towards him holding the knot in my throat and said for him not to think that way. Then I excused myself for a minute locked myself in the restroom and just cried for a good 2 minutes. There I was crying for a man and his wife I just met 2 days ago. These moments are the ones that get to me and this man will go in my filed memory of all the ones that have come and gone. So many I have had the pleasure of taking care of but the sadness of realizing they are gone. These strangers that let me in thier life and share thier beautiful family stories with me. I guess I am writing this because I want to know how other nurses can hold thier tears back at work. I often feel unprofessional because when I have cried at work even though it is not in front of patients or their families some of the nurses can probably tell from my face being red. It hasn't happened at work that often but thier are just some cases that get to me the most. Not saying that any of patients where more important than others but tht somewhat made a bigger impact in my career. Is it wrong for me to cry for a patient I just met? Does it somehow make me unprofessional? If there are any oncology nurses out there hoe do you deal with this and do you respond to a patient that says these things without giving false hope? I really do love my job, no, I do not like to see anyone suffer but I enjoy the fact that if I can make my patient have at least one good day then it was all worth it. No matter how many times I have to clean them, or thier throw up, or give them pain medicine, or simply help them get dressed because they can no longer do it. Some people will thank me for doing these things and cry when I have to change thier diaper and really appreciate it, but the truth is, it is an honor to do these things for them because It humbles me each time I do it. I as an RN am not any better than a CNA and can help my patients with these things. If I can at least make them have one good day then all of it is worth it. There are so many memories that I have of my terminal patients that will forever be embedded in my head. Does it ever get any easier to deal with at work? Will I ever be able to contain my tears till I get home? How do any of you all out there deal with terminal patients? How do you encourage your patients to fight the cancer without giving false hope?

As a CNA who just got a job on an oncology floor your post really touched me. I've always wondered myself, is it okay to cry? Are we allowed to feel even though we know we have to be the strong one for the families and patients?

I don't really have any advice because I'm so new myself but I think as long as you continue to do a great job, don't emotionally exhaust yourself, and cherish the life you lead then you're doing okay.

"How do you encourage your patients to fight the cancer without giving false hope?" is a great question and I hope more people reply on that because I'm very curious how to deal with that myself.

This is such a difficult question.

I'm not a big crier. I never cried at work throughout my years in oncology, but that isn't to say I haven't dealt with the stresses of that work in my own way, as does everyone.

First: never let a person tell you that it doesn't bother them. Chances are, something about working oncology gets to them. If it doesn't, they probably need to move on and do something else.

Second, your mind and heart are in the right place. You see it as an honor to work with the patients and families you care for. Even if it's tough for them, you know intrinsically that there is value in human life and that you can alleviate suffering, prolong life and make people comfortable, despite their diagnosis. The crazy thing about life is that even in the darkest of circumstances, it has the potential to be peppered with hope. Some of the happiest patients I've ever met are oncology patients. They are truly alive--engaged in life with the people they love most--because they are especially aware that their time is limited. Those are the easy patients.

The tough ones are the ones who don't have that support system. Don't fool yourself into thinking you can be everything for them and don't let their mentality get you down. Your work, whether they express it to you or not, is important.

Finally, as far as how to deal with it, find a way to release those emotions. If that entails crying in the bathroom, invest in Puffs or Kleenex and go for it! Other options include: exercise, eating healthy, taking up a hobby, hanging with friends, writing, traveling, and any other number of leisure activities that gets your mind off of work. Take care of yourself so that you can deal emotionally and physically with the strain that is inherent in caring for the patients we see in onc. If you're religious, you might find yourself drawing more and more on your spiritual beliefs. I myself had some pretty intense experiences at deathbeds that really bolstered my faith.

Oh, and with regards to the false hope question... that varies from patient to patient.

Some folks need that hope. Some of them desperately rely on the possibility of a cure and when there isn't one, they will need your support to get through it. They may go through the stages of grieving five times over, but I've come to find out that gentle honesty is the best policy. Other people want the truth and nothing but the truth with no sugar added.

Let's face it--no one wants to die in pain, with their affairs out of order, or unexpectedly. Nursing is in a great position to educate the patient on how to put things in order, how to prepare their families for their passing, and to educate the patient on pain control options. Take your patients case-by-case and be honest about their prognosis, but also reassure them that you'll be with them no matter what. That last part is usually what people are looking for.

You will find that certain situations will touch you and bring tears to your eyes.

I don't think that that necessarily means one is unprofessional.

One thing I took away from your post is that you are exactly where you are supposed to be as an oncology nurse. I love the fact that you are vulnerable enough to admit that you aren't afraid to feel the pain of seeing these people go through something that is difficult at best. I work in oncology, too. There are some patients that I still think about that have passed. There will be some that really impact your life. Sometimes I feel like I get more from my patients than I give. Their courage and hope is just so awesome to witness firsthand. And to be a part of it for them is an awesome responsibility as well as a humbling one, too. Your patients are so very fortunate to have you as their nurse. As far as crying, I'm a guy and I don't really cry. However, every once in a while I'll think of a patient that I took care of and has since passed and it will bring a tear to my eye. Working in oncology is emotionally challenging. Do you have a good support system at home? Someone to talk with and share how you're feeling? Take advantage of your hospital's assistance program, too, if you need to talk and vent your feelings. Keep fighting the good fight!

This post really got to me. I'm looking into oncology (pediatric in particular) due to the death of a loved one. I have often wondered if I could handle watching people suffer and die, however I always comfort myself by the thought of helping them/making their time better. Thought I still don't really have the answers, you've made me feel better that oncology nurses go through that, it's not just something I think I would experience.

Specializes in Oncology/hematology.

Thank you for your post. I am a new grad and have been in oncology for 5 months now. I have actually cried with a few of my patients at this point. I am touched by them all and blessed to be a part of their lives, even if it's the hardest part. I just hope I help them in some small way, whether it be pain relief, a hand to hold, an ear to listen to their fears, or the professional nurse who argues with their doctors on their behalf. I think you are in the right place and your emotions are completely normal.

For me, the strange thing about oncology is that at absolutely random times, not in the hospital but in the rest of my life, every now and then one of my patients will flash into my mind and tears suddenly flow. I can be doing anything at all when suddenly a patient hits my brain and I'm whacked! While in the hospital this does not happen, I mean, after all, I have to try to be useful to the families which I can't do too much if I'm crying - but for reasons beyond my control - once in a month or so - the loss of a patient hits me really hard. Anyway, that's my experience of tears with my oncology practice.

Specializes in Psychiatry, Oncology.

I am a new grad about to start my first nursing job in inpatient Oncology (my chosen field) in February. I am so moved by OP's post and all of your stories and responses.

As far as tears...I think it's normal as long as I don't make the patient and family feel bad for me or worse for themselves. Balancing act, I guess. I will let you know how I do.

I worked oncology for six and a half years until last June, and I nodded throughout your whole post!

Everything you feel and wonder about is so normal, but talking about it with other nurses can be hit and miss. I saw experienced oncology nurses be critical of nurses who cry, and we even had a nurse who cried at the drop of a hat (I cheered her on because the 'culture' of our unit was not very accepting of nurses crying). It struck me that we all process things differently and need to be OK with however it is we do process things like death.

I remember my 'first' patient death too, and the look on the wife's face, the room number . . . yep.

For me, when I cry, usually I need to go somewhere and CRY for a while and I'm no use to anyone during that time. So it 'worked' for me to allow that detachment to take hold, so that I could be there for the family and my other three or four patients who I felt didn't need to 'worry' about why my face was all red or be exposed to the death in the next room. It was a very practical decision.

But I still felt it, every bit of it, and by the end of six plus years, I couldn't do it any more. Compassion fatigue, maybe. I could be detached but at a price, and it took me a while to accept my time in oncology was over. I felt inadequate compared to the nurses who'd been doing oncology and loving it for fifteen or twenty years, how did they do it? I had to accept I am what I am, and I couldn't apply anyone else's yardsticks to ME. I think that's a good point for you, to accept how you feel, moment by moment, and be OK with that, and not measure yourself up against the other staff.

When you need to lock yourself in the bathroom and cry, by all means do it. For me it was a bit mysterious, which patient would 'get to me' and which ones didn't so much.

This is a difficult specialty, and if we nurses didn't get as much good as we get from taking care of oncology patients, whatever that mysterious human spirit stuff is, it would be an impossible job.

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