When Is It Ok to Cry?

Long Term Care Columnist / Guide · Sep 26, 2009

There is a big difference between showing some honest emotion and being a basket case. It sounds to me like you already know this down deep, and would probably make an excellent hospice nurse.

I've always thought that there's nothing worse for a patient---dying or otherwise---than a nurse who can't feel. If I were a patient, I'd rather have a nurse who's not afraid to cry with me than one who merely stands there, dry-eyed and passionless and devoid of human feelings.

This doesn't mean going to pieces and bawling all over everyone in the room when a patient passes away, but there is nothing wrong with a few tears, some shared hugs, a heartfelt prayer (the latter only if you are certain of your patient's beliefs, of course). Again, I think you know this in your heart and would react appropriately at the bedside when called upon to preside over a death. If you want to do hospice nursing, go for it!!

niteowlrn29 · Sep 26, 2009

Well first of all, I say that is wonderful that you have the heart to truley care for your patients. It appears you probably have a good bedside manner and patients can tell if your heart is there and that you care for them. Your caring and compassionate attitude will be remembered more by your patients than you can imagine.

Saying that, I too can get too emotionally involved in my patients. There have a few ociassions where I have either cried at the bedside holding their hand while they cry and plead with God to take their pain away. That was the night when I realized that I was helpless at times, when you've done all you can do, give all the pain meds you can. The only thing left is too just be there for them.

Another time that comes to mind is when I had this gentleman who was on our floor for quite some time. he had been in the hospital for a few months. I had him for like 3 weeks straight. (the other lady had been there for over 100 days) He had a trach, wound vac on belly or buttocks (can't remember) peg tube, pressure ulcers on every boney prominces. And he was about the size of my pinky finger, just no fat on his body. Well I was giving him his heparin every 8 hours as ordered. Well that morning he decided he didn't want it. He started whaling his arms around and i guess he was trying to block me but at the time it seemed like he was trying to hit me. So i raised my voice at him (not yelling) and said stop trying to hit me. Well long story short I was finally able to put his pacey mur on his trach and he was able to whisper he didn't want the shot and that he was "sorry, i wasn't trying to hit you" Well I started to tear up, but was able to hold it togethor while i finished up with him. Well when i left I went into the bathroom and balled like a baby. I felt so bad for this guy. First of all it is so sad and amazing what people can live through, i'll tell you that. But i couldn't believe that this man with all he had been through was apoligizing to me. I still remember his smile.

There have been other times I have just cried on my way home from work because what I experience, witness, and what people go through in life.

Nursing can be emotionally draining at times. And of course you will have some patients who will touch you more than others. Some you will never forget. Sometimes you won't have it in you to cry because you get so burned out.

With that said, I think its wonderful that you are able to express your feelings and sympathy for your patients. Now there may be times when you can do that in front of your patients or their family. Im sure they will appreciate your geniune care. But keep in mind you don't want them to start comforting you from your pain. lol. One of you have to be the strong one.

Good Luck with the rest of school and deciding what area of nursing you decide.

Werblessed · Sep 28, 2009

Confession time...I tear up from time-to-time when I am at the bedside of an imminently dying patient and family is praying. It feels so blessed and so sacred to me. I am touched and I am not ashamed of being human enough to show it. I haven't ever gone to a full-blown crying spell because as much as I connect and care for our patients, they are not our family and we will likely not be missing them next Thanksgiving or Christmas but their loved-ones will.

So...tearing up - yeppa! But if I'm getting to a place where I am more emotionally clobbered it is likely because the situation is reminding me of something much closer to home (like when I care for pediatric patients that remind me of my own kids or are of a similar age, etc).

tewdles, RN · Sep 29, 2009

The bottom line is this, some nurses feel comfortable shedding a tear in the presence of families and some do not. Crying is not part of the job description but it is clearly a hazard of the work. Most families are not offended by a nurse tearing up when their family member dies. In fact, most family members perceive a tear on the cheek as evidence that we "care" for their loved one. As is clearly posted in this thread, a tear or two is not out of line, but any demonstration of emotion which turns attention toward you is not desireable. For about a year after my mother died I found it very difficult to hold back tears in some situations...it was an enormous challenge for me to remain professional for families when every word that was spoken took me emotionally back to my mom's bedside. It might have been nice if my hospice had acknowledged that I was bereaved and had, say, opted to give the women dying of pulmonary diagnoses to my coworkers and let me care for other less "related" clients for a spell. But, I got past it and my families apparently tolerated my weaknesses ok. There was one specific occasion, visiting a new admission in the family home, when I had to step out of the house. I didn't break down, just needed to refocus, take some deep breaths and regain my perspective. It was callous of my agency to send me to this patient who was a 72 y.o. woman dying of her COPD needing some symptom management. My 69 y.o. mother had died from her COPD just 2 weeks before. My manager was completely insensitive to my request to reassign that patient. Most hospices are a bit more in tune to the needs of their employees.

The fact that you were touched by this woman's confession to you is a special and wonderful thing. You will probably enjoy hospice nursing...it is a tremendously rewarding nursing career.

sherylc · Oct 9, 2009

I'm new to Hospice, but have had 30 years of Nursing experience. In those 30 years I have shed a tear or 2 with patients or family members.

I don't feel uncomfortable at all when I occasionally tear up, especially now that I'm a Hospice Nurse. Emotions are human, and by showing that you feel along with them, even to a small degree, you can connect with both the patient and those left behind.

The first death I attended occurred on the 1 year anniversary of my mother's death. I admitted the lady at noon, spent 4 hours with her and her large family, controlled her symptoms so she could spend time with everyone from her husband of 70 years to her 1 year old great grandson, and watched the tone of the gathering change from tense and fearful to almost joyful. I went home, and 4 hours later was called back to pronounce her.

Was there sadness? Of course. Did I shed a tear as the family members hugged me and told me that the best decision they made was to have Hospice and that they were so glad that I had helped to make her passing easier? Of course.

Did I lose it and start sobbing and wailing? Of course not. This was about them, not me and the emotional impact I was hit with. But, halfway home, I had to pull over to the side of the road and grieve for my mother all over again.

I guess what I'm trying to say is that tears are fine, and don't mean that you are weak or "unprofessional". What you do have to remember is that you may sometimes have to compartmentalize your feelings so you remain in control. That's why it's important that Hospice organizations have grief sessions for their employees, with lots of Kleenex available!

tewdles, RN · Oct 10, 2009

Beautiful post sherylc.