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.

I enjoyed reading your post I definately sometimes get overwhelmed by the intensity of caring for those who are dying. Nurses have to be compassionate to the patient they must also be supportive and listen to the family. When the patient passes away we as nurses are so busy with our tasks such as last offices and also looking after our other patients that we dont even have time to reflect upon how we feel or how we are impacted by the death. I find that sometimes it is at the end of the shift when i change into my own clothes or I could be driving home it is then it can hit me. Or it may not happen for a number or days and weeks even and I may have some other form of grief in my own life or just see a sad movie or hear a sad song on the radio and that will trigger it all at once and I find my reaction would be a very emotional one. It is like the grief has been enclosed for weeks and it all comes flooding out

You're in my thoughts and prayers

Specializes in school RN, CNA Instructor, M/S.

dpsd, I am proud of you for taking such an interest in your patient's well being! Do you have to return to that clinical site anytime soon? If you do and that patient is still there, see if there is a case manager or social worker assigned. Also, is there a DNR or even more importantly a health care proxy? Who gave the wife all this authority legally? If a patient is in that much distress he is not being properly managed and ther should be some kind of intervention. You were absolutely right to mention palliative care. That would be an excellent start because that or hospice would include people experienced in dealing with the issues that come with a terminally ill or severly compromised patient AND their family. KEEP UP THE EXCELLENT OBSERVATION SKILLS!!!!!

Specializes in pediatrics.

As a person in nursing uniforms we must have that very brave heart to encourage an ill individual to live each hour, minutes and seconds that life here on earth is indeed wonderful. I prefer patients to see the sunset and made him feel that each of us are a very lucky creature of God and that we have our own purpose. It's takes great courage for us nurses to be in the kind of situation where your patients is dying and all you can just do is pray and be beside that person. If we can have just power to heal but then again the power that we all have is the the strength and love for our patients.

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

There was a wonderful story and article this morning on Fierce Health Care regarding an story written by a doctor about Hospice in the New Yorker magazine. Because I took care of so many dying patients and worked in hospice myself, I found it wonderful. "Medicine" may begin to understand how important bedside nursing is, and hopefully respect them more, after this article. But even more important, I think, is that patients will be given some info that will help them understand their choices. It really does show the heart of a healer...

1. Live for today: Atul Gawande makes the case for hospice care by Sandra Yin

In what could turn out to be a seminal article that helps raise demand for hospice care and helps the terminally ill consider a more thoughtful approach to the art of dying, Brigham and Women's surgeon Atul Gawande describes the difference between standard medical care and hospice in terms we haven't necessarily read before in The New Yorker.

The difference according to Sarah Creed, a nurse with a hospice service that his hospital works with, lies in priorities. It is not the difference between treating and doing nothing.

In regular medicine, the goal is to extend life. Doctors sacrifice your quality of life in the short term--by performing surgery, providing chemotherapy, putting you in intensive care--in hopes of gaining more time later.

Yet the top priorities of patients with terminal illnesses include avoiding suffering, being with family, having the touch of others, being mentally aware, and not being a burden to others. "Our system of technological medical care has utterly failed to meet these needs," writes Gawande, who also serves as an associate professor of surgery at Harvard Medical School.

Hospice puts the emphasis on the here and now, rather than on raging against the dying light. It deploys nurses, doctors and social workers to help people with a fatal illnesses have the fullest possible lives in the present. As a result, the focus shifts from goals like a longer life to goals like freedom from pain and discomfort, or maintaining mental awareness for as long as possible, or getting out with family once in a while.

"Spending one's final days in an ICU because of terminal illness is for most people a kind of failure," Gawande writes. "You lie on a ventilator, your every organ shutting down, your mind teetering on delirium and permanently beyond realizing that you will never leave this borrowed, fluorescent place."

To learn more:

- read Atul Gawande's New Yorker article

Specializes in Labor & Delivery, Med-surg.

I too looked after my mother when she was dying. It was hard being a nurse at times but I was also thankful for the skills it gave me to cope with a difficult situation. She appreciated me being with her through chemo and paracentesis appointments and looking after her when she became too weak to leave the house any longer. She gave me the nursing metal she had won in 1939 for excellence in bedside nursing. She said I deserved it more than she had, which told me how much she had appreciated my care. She said that she was surprised by me as she knew I had never liked that kind of nursing. I was so blessed by the experience of caring for her in the final weeks of her life that I left Labor & Delivery and went into Geriatrics after she died, much to the shock of those who knew me well. I love the old people I now care for and am so thankful for the blessings I received caring for my own mother.

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

judybsn......thanks so much for posting. What precious moments you spent with your mom and what wonderful memories you now hold in your heart. It is hard to walk along beside those we love as they get nearer to death, but what a wonderful gift you gave your mom.

I have volunteered to work in Hospice care. I found it challenging to keep losing the people I talked with. I started to volunteer after I had a near death experience, it was a great help to me after understanding death. I would hope many would read about them and get help and understanding.

Specializes in lots.
I too looked after my mother when she was dying. It was hard being a nurse at times but I was also thankful for the skills it gave me to cope with a difficult situation. She appreciated me being with her through chemo and paracentesis appointments and looking after her when she became too weak to leave the house any longer. She gave me the nursing metal she had won in 1939 for excellence in bedside nursing. She said I deserved it more than she had, which told me how much she had appreciated my care. She said that she was surprised by me as she knew I had never liked that kind of nursing. I was so blessed by the experience of caring for her in the final weeks of her life that I left Labor & Delivery and went into Geriatrics after she died, much to the shock of those who knew me well. I love the old people I now care for and am so thankful for the blessings I received caring for my own mother.
Judy,I remember when I first got in2 nursing,I thought to myself,"this is so stressful and depressing,how would I continue to be around so much sickness when I lose someone close 2 me?" That ws 10 years ago. And than it happened. Lost my mom 2 years ago with an out of nowhere dx of stage 3 multiple myeloma than she died 3 weeks to the day after dx. I went right back to work,it was good for the routine,but,it has now done me in. Bad. I love your upbeat positive outlook on it,but I cant seem to get it together. I was doing better the 1st year after she died,but now,I am crashing. And,2months prior to her death,i was dx with stupid multiple sclerosis. Still was fine. didnt have x for my dx to sink in than her dx than her death and so on and so forth. I had a Dr. friend tell me the other day that she thinks Ive had a nervous breakdown. I was like ***,no i havent,i havent had time!!!!!!!!!!!!!!!! While the dx of ms and my mothers death made me a more compassionate nurse 2 my pts.,I am not being compassionate to myself. Again,I like your story and your ability to look at it the way you do made me smile.

I used to work med surge in a rural hospital. One of the oncologists was known for not telling her patients the truth about malignancies, terminal, end stage cancer. Her philosophy was that if they don't ask specifically, she wouldn't tell. She would also forbid any discussion regarding treatment or prognosis from the bedside nurse. I know it's not our job to "tell" but it was so difficult when you would be present for a medical round and afterwards the patient would say "am I dying?"