Published Sep 21, 2007
vashtee, RN
1,065 Posts
I am a nursing student, and I wonder if you all could give me some tips on how to deal with patients that are grieving.
I had a patient with multiple problems today, the worst being inoperable lung cancer, and she was crying because she was afraid... afraid of pain, afraid of not being able to breathe, money issues, self care issues... lots and lots of worries, the poor old thing.
I feel so inadequate not knowing how to comfort her, and I am a little overwhelmed by the grief some days.
Also, as a nurse, what do you all DO with all the sadness, or do you just toughen up over time?
JBudd, MSN
3,836 Posts
Most of the time your words wouldn't be heard anyway, you are there to listen and hold a hand, offer a Kleenex, provide companionship so they won't be alone. You aren't expected to solve the problems, and frankly, you can't.
Once in a while there will be something active you can do, refer to social services, get an omsbudsman, tell them about indigent funds, help get home health. But during moments of grief, just being there is what is needed.
Yes, after a while you (okay, I have) learn to empathise while you are there, and then walk away again. I may pray for them for a time, but if I carried all the grief for others I've run into over the last 26 years, I'd be insane. Part of it is learning to live in the moment, and move on. It's why ER nurses can care for horrific things, and then go eat. Callous? a little, but necessary in the long run. Just don't be callous when you are with someone who needs you.
Larry77, RN
1,158 Posts
I have shed a few tears in my day with patients families and I think if the situation warrants it there is nothing wrong with it. Now if you are in the corner of the room sobbing that probably would be unprofessional but if your patient just passed and the family is grieving you tell them you are really sorry for their loss and you have tears in your eyes--I think that is human.
I work in ED where we really are a close nit "family" and are very good at venting/grieiving to each other plus we have formal debriefings when a difficult case occurs (ie big trauma, death of a child etc).
Bottling up emotions is never healthy and they tend to "boil" over in a negative way in other aspects of your life so do find a way to share your emotions with others.
I work in ED where we really are a close nit "family" and are very good at venting/grieiving to each other plus we have formal debriefings when a difficult case occurs (ie big trauma, death of a child etc).Bottling up emotions is never healthy and they tend to "boil" over in a negative way in other aspects of your life so do find a way to share your emotions with others.
That too :smackingf
al7139, ASN, RN
618 Posts
Hi,
I work on a cardiac unit, and we have lots of pts who pass, or are newly diagnosed. I have found that the pts and families really just need a good listener most of the time. We care for these people for extended periods of time, or they are "frequent fliers" who we know well. I personally can relate to the family and the patients, having lost a father to cancer, and watching him deteriorate and die. I am a person who cannot hide my emotions, and I find that even if I do not know what to say, they appreciate that I am able to cry with them, hold a hand, give a hug, etc. So many family members have said "Thank You" to me for just taking that extra five minutes to show I care, even if I cannot do anything to ease their pain or grief. It used to be that as nurse we were supposed to remain emotionally detatched, but that is not the case now. You are there for the patient and the family, and do not be afraid to shed a tear, give a hug or hold a hand. Just be sure that it is about them and not you. If you are really having a hard time talking with the family, suggest a Chaplain, or a Palliative Care consult. They can help so much with grieving patients and family. I try to listen to them when they talk to the pt/family to get ideas on how to be there for them. They are also great to talk to if you yourself need an ear. I am also lucky that my fiancee understands when I come home and need to have a good cry about a situation at work. I can talk to him (keeping in mind HIPAA) about the patients that really get to me. At work, if I feel my emotions are getting the better of me, I take a short break, and go to the break room or bathroom and get myself together, and then go back to the floor. Nursing is a tough job. We are not emotionless robots just pushing meds. I believe that when it does not affect you to lose a patient, it's time to retire. We chose this career because we are caring people.
Find someone that you can talk to when it gets really tough, lots of hospitals have Employee Assistance that is a great resource for sharing and coping with your feelings.
Hang in there! You will be a great nurse!
Amy
fultzymom
645 Posts
I have cried with families. Not is the sobbing way that they are but out of compassion for one who has lost a loved one. There have also been times that I have called my hubs after someone has died at work and cried on him. And occasionally nurses here cry together after someone has died. I work in a LTC setting so we get attached to them. The important thing to remember is that you have to be strong for that family. They need you to be the one who is helping hold everything together. If we are a total wreck then how can we offer comfort to them? You do get somewhat "calloused" over the years but I think it is for your own protection. Like another poster said, we would go insane if we carried around all the grief from all the different situations our patients/families go through. I do not think there is anything wrong with showing your emotions to your patients as long as they do not end up with feeling the need to help you and give you the support instead of vise versa. I have learned to try to look at it as it is part of my job and seperate my feelings from it at the time that I am dealing with it and then going to co-worker/friend/hubs for comfort afterwords.
Thank you all for responding.
I should have mentioned that I have not yet cried in front of a patient (been close, though). So far I have been able to hold it in long enough to get to my car. I just find that I think about them sometimes for a few weeks after I've been with them.
Thanks for all your words of wisdom and support.
nyapa, RN
995 Posts
I remember the first time I experienced a death. It is part of the culture of the family whos relative died to wail loudly, and it is very distressing, and I found myself crying.
In another situation I had become quite close to a lady who passed away. I was unable to hold back tears as I was handing out tissues et al. I think though that the family appreciated the fact that I cared. In their case, I gave them privacy. But it depends on the person or family.
You become 'used' to some things, and that helps you be more supportive in most cases. But many things one can't get used to and it depends on the individual nurse as to what those things are. That's one of the reasons nurses should support each other.
Some ppl say "leave your work at work as soon as you walk out the front door of the hospital". I personally can't do that. But you do have to develop strategies to cope, for example a good social network, hobbies and exercise, something away from nursing. Oh, and visiting Allnurses, where you can share your experiences, helps too!
Zookeeper3
1,361 Posts
When someone is sharing those deep dark feelings, I try to use body language first to show I care, hold a hand, arm on the shoulder even hold them (you just "feel" what they need and back up a bit if needed).
The hardest part for me is being silent in the long uncomfortable pauses, when we want to talk it away, being silent usually works or saying "go on".
I use that crazy validation thing, "your frustrated because you've done everything you should have, fought hard and it still isn't working... it's not fair is it" Or I ask, "what is the worst fear you have about this". Sometimes prompting out the worst makes everything else a bit easier.
This is so hard to answer because everyones struggle and needs are different, as well as my relations with them. I've cried with strangers, even 12 years in, as long as you can reign it in and still be therapudic and supportive to them, shedding tears is OK.
Sure it gets easier with experience, sure we get a bit "tougher", but on some occasion, someone will pull the tears right out of you, I've just said, "yes it does hurt".
You're not a cry-baby, you CARE. There are nurses that you can't pay $200/hr to CARE, it's a beautiful quality, NOT a fault.
Daywalker
93 Posts
Don't be ashamed of your compassion and humanity, and know that over time, you will find your own way to deal with the grief that comes with the territory. If you are having real trouble coping, or are always carrying the pain of others with you, go for some counselling.