Grieving as a Nurse 4948

Grieving as a Nurse

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How to manage loss and support your coworkers as they grieve

Losing a patient can be devastating. As a nurse, you may feel there is not enough time to process the loss, especially when coworkers and other patients need your attention.

But ignoring the grieving process isn’t healthy either, says #healthynurse Terri Bogue, PCNS-BC, APRN. Terri is a clinical nurse specialist, speaker, and author. She helps health care professionals manage difficult situations such as grief and trauma processing, suicide prevention, and nurse burnout.

So, how do you manage grief while still doing your job?

“As nurses, we’re used to having a protocol for everything, but there’s no protocol for grief,” Terri says. “The goal is not to shove it away, but not let it take over. Every patient we care for changes us somehow, and we need to let their loss become part of our story.”

The Challenges of Grieving
It’s not uncommon for nurses to struggle with the grieving process. In the moment, Terri says, nurses tend to deal with losing a patient in 1 of 2 ways:
  • Compartmentalizing (“not now”): When there is a lot going on, it’s easier to put the hurt and loss away to think about later.
  • Disassociating (“not me”): You may deal with an emotionally challenging situation by distancing yourself. This may feel like you are watching it happen from above or seeing it happen to someone else.

Both of these processes are normal and useful in the moment. Difficulties arise when they are never unpackaged.

Hiding your feelings away or removing yourself emotionally can lead to feelings of guilt. It can also make it harder to deal with your feelings later.

“Tucking it away doesn’t make you a horrible person. You are just doing what you must do,” Terri says. “But as a nurse, you need to eventually pull those feelings back out to process them. It’s important to find a way to get to a place where you feel safe to process and grieve that loss.”

When you don’t intentionally deal with your grief, it may sneak up on you. Common symptoms of grief include:
  • Emotional instability, which may include crying, increased anger, or reduced patience
  • Negative thinking, like feeling cynical and having trouble staying positive
  • Sleep changes, which can include either a lack of sleep or sleeping too much

What to Expect While Grieving
The way you experience grief is unique to you. Many factors can affect the process, including your relationship with the person you lost. Terri shares that 2 nurses caring for the same patient will likely respond differently to losing that patient.

“There are some losses that you accept quickly,” Terri says. “Other times, the grief never really goes away. It lingers. It may not traumatize you daily, but it’s still there.”

There are 5 commonly accepted stages of grief as outlined by psychiatrist Elisabeth Kübler-Ross in her book “On Death and Dying”:
  1. Denial: Doubting that the loss happened is a common first reaction to death and can serve as a defense mechanism. You may even feel numb.
  2. Anger: You may begin to question why this happened, especially in the face of an untimely or tragic death. You may be angry with the situation or how it was handled.
  3. Bargaining: Negotiating may help you feel like you have some control over the situation. You may think in terms of “if only” during this stage.
  4. Depression: You may feel intense sadness as you face reality.
  5. Acceptance: Acknowledging the loss can help you find a healthy path forward.

Most people experience all 5 stages of grief to some extent. But how quickly you navigate those steps and in what order can vary. There is no right or wrong way to grieve. The stages are not linear — you do not complete one and then move to the next. Most times, we bounce around the stages of grief and may repeat stages multiple times.

“Grief and the emotions surrounding it change — sometimes, many times a day; sometimes, not at all for extended periods,” Terri says. “When I talk about grief, I compare it to waves on the beach. Sometimes, they lap peacefully at your feet; other times, they are giant sneaker waves that literally knock you to the ground.”

Coping With Grief
Because everyone grieves differently, Terri says there is no magic formula to make the experience easier or pass more quickly. You must give yourself the time needed to process grief and find ways to make sense of the loss. She recommends listening to your inner voice and being open to the feelings accompanying grief.

“When you lose someone at work, you may have the option of going home or taking a break, and it’s important to think about what you need,” Terri says. “Taking time to sit with your feelings may feel overwhelming if you’re not ready to process it. Staying busy may be the best choice for you for a period. Give yourself time to grieve at the right time for you.”

Terri adds that reaching “acceptance” does not mean you forget the person who died. It means you found a way to make them a positive part of your life.

Supporting Others in Grief
As a nurse, you can also help coworkers who are grieving.

“There’s an unspoken pressure that some nurses feel. They believe that letting their coworkers see a patient loss rock their world may change how they are perceived,” Terri says. “But support for each other is essential. It builds our bond as nurses.”

When a colleague is grieving, Terri suggests:
  • Ask what you can do: Open the lines of communication with reassurances like, “It seems like you are having a hard time. I know you lost your patient recently. Is there something I can do?”
  • Avoid judgment: Everyone reacts to loss in their own way, and how someone reacts does not make them less of a nurse.
  • Say the name: You may be afraid to mention a deceased patient. But including the patient’s name or situation makes the support feel more personal.

“We all have patients we remember for years,” Terri says. “We take those pieces with us as part of who we are, so the people we lose never really go away. They help us become better nurses and better people. As nurses, we must learn ways to care for ourselves and our colleagues as we care for our patients.”

How do you cope with grief at work? Share with us in our discussion below.

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Blog Mental Health 12/03/2024 10:30am CST

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The nature and stresses of the nursing profession can take a toll on your mental health. This domain deals with your psychological affect and health. Mental wellbeing practices, stress relief resources, and personal stories are just some of the assets included here.

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