By Holly Wheeler Careers & Training


Death, grief are the inevitable — and human — side of nursing


Losing a patient is distressing regardless of the circumstance. But some situations can help nurses prepare better for patient deaths. Those who are called to work in ICU, for example, know they’ll face patient deaths in the line of work.


“[People] are called to different types


of nursing, and that does affect how you think and how you process and how you prepare,” said Tony Reynolds, RN, BSN, CCRN, nurse manager of the ICU at Community Hospital South. While ICU patients


Reynolds


have a more tenuous hold on life, no unit or field of nursing is immune to patient mortality. In long-term


care settings, death is the end of each resident’s care experience. “We have the long-term care units


where some of the nurses assistants and nurses have worked there for years taking care of that resident,” said Martha Herron, RN, director of clinical services for American Senior Communities. “Those types of situations are probably the most difficult because you’re not only losing a resident, you’re losing a family member. Sometimes [you’re] the only family member they have had.”


Knowledge and understanding | Physiological training gives nurses an understanding of illness and the life cycle, which helps them mentally cope psychologically with patient deaths. Another part of successful coping is experience. “You have to be


able to understand the dying process and accept it yourself,” Herron


said. “You still go through the grieving process, but I guess you learn to deal with it better. It’s a learning experience. That’s just part of life.” As nurses become more seasoned, they


learn how to manage their own feelings in the face of a family’s grief. Herron said American Senior Communities makes sure new nurses don’t go through a patient’s dying process by themselves. “I think you can ask any nurse,


whether they’re in a hospital or nursing facility, and they’ll always remember that first death,” she said. ICU nurses often have years of


experience on the unit and are inured to death. For less-experienced nurses, coping often comes with extensive support from co-workers. Other nurses, chaplains and managers are sources of consolation and can help colleagues through the grieving process.


Less- experienced nurses rely on the support from coworkers when coping with death.


“Sometimes, if we just


ask them, it validates how they feel,” Reynolds


said. For particularly upsetting


losses, nurses can access formal services such as employee assistance programs.


Comforting


through your own pain | Nursing isn’t limited to caring for patients — it


includes caring for the patients’ familes. “Some people


just want you there to listen and to


answer questions,”


Jill RN. This, the only information provided


on her employee badge, identified the woman who was with my father in the last moments of his life. My father’s unidentified illness didn’t seem real until five days before he died, when doctors diagnosed him with stage IV esophageal cancer. He spent those five days on a


telemetry unit — a situation he hated until “Jill RN” took over the last two days of his hospitalization. Jill was everything my dad needed then — funny, easy-going, upbeat, bossy in a good way and approachable. But father coded suddenly as Jill


helped him out of bed — then died within a few minutes. She was as stunned as we were, crying as she consoled us. At that moment, Jill was more than my dad’s nurse — she was a member of my family.


— Holly Wheeler


Reynolds said. “A lot of it is setting up what to expect — ‘This is normal. We’re going to keep your family member comfortable.’ And letting them know it’s OK to grieve.” When a family member dies —


whether expected or unexpectedly — a nurse usually is first on the scene. If the nurse has built a relationship with the family they’ll look to the nurse as a health care professional, as well as a source of support and understanding. Nurses who’ve experienced the death of a loved one have a different level of compassion for the grieving family. “It is part of the job,” Reynolds


said. “It’s almost like a ministry. You get a sense of pride and comfort knowing you’re there for them during this time.” ●


Indiana Nursing Quarterly • indystar.com/nursing • Fall 2011 15


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