Guest Author - Lorraine Hover
Each of us has experienced the death of a patient. Even though health professionals are taught to not become attached to patients and become emotionally involved with those they care for, as nurses, we care, we provide comfort, and I believe that the most effective nurses are those who are “emotionally involved” with those they care for. So, what can we do to help deal with the grief of a patient’s death, whether we care about the patient or if we feel we might have been able to do more to prevent them from dying?
Kübler-Ross discussed the stages of grief as shock, anger, bargaining, depression, and finally acceptance. Sometimes these stages happen quickly and overlap with each other and sometimes it may take years to work through all the stages and come to terms with the death of a loved one, a patient we knew well, or a patient we feel we could have saved by doing things “better”.
There are many suggestions for dealing with the grief associated with the death of one we have cared for, but the one most mentioned and discussed is that of having an opportunity to talk about what has happened. Some facilities offer a formal group for those who cared for a patient to remember, to talk about what was done, to de-stress in many ways. Some might call this a de-briefing of sorts. Having the opportunity to talk about what has happened is very important, whether or not it is at a formal group meeting at work or just to find a friend or fellow colleague to talk it over with. Finding a friend to talk to helps us put things in perspective and deal with the trauma of having a patient die.
Many nursing home, extended care facilities, long term acute care facilities hold memorial services for those patients who have died. This is another opportunity to formally deal with grief. Funerals and memorial services offer up society’s way to say good-bye. If your facility does not offer this, attending the memorial service of the patient or client you cared for may be an option, or planning on remembering the one you cared for by planting some flowers, meditating on what impact they had on your life, or by doing a ritual of your own such as lighting a candle at church.
If the grief you feel carries on, or if you feel guilty about an aspect of care or that you could have done “more” to help this patient/client to live longer (which is common when our patients are young adults or children), it is important to seek out someone to talk this over with. It does not necessarily need to be a therapist or your manager, but being able to talk through your feelings with someone who knows nursing and what we go through can be the most helpful. Working with a mental health professional should be considered if the grief and guilt cannot be put aside or if it begins to interfere with the ability to do your professional duties.
The feeling of “I could have done more” or “I should have done X” is common and one I believe shows that we are truly caring professionals. Take the opportunity to look at the care you gave, the actions you took, and examine if there truly was something “more” to be done. Learn from the experience and grow professionally and personally by using all your experiences to become a better nursing professional.
As nurses we care, not just provide nursing care. It is natural we will mourn those who died under our care. I know I have patients I have cared for who are clearly in my memory and I try to use that memory to help me be a better nurse. Just as we honor the memory of our loved ones and family members, honor the memory of your patients by always striving to do better, learn more, and become a better nurse. Then each of us can move forward, each of us can march ahead to be the caring and kind professionals we are.