The Tough Stuff: How To Deal With The Death Of A Patient
Hospice nurse, Camille Adair, RN, shares her strategies for honoring the life and death of a patient – and nurses’ own suffering.Facing issues related to death and dying is a natural part of nursing – but that doesn’t mean it’s easy. For some nurses, the death of a patient can be one of the most difficult moments of their career.
Nurses deal with death on a daily basis, so you would think nursing curriculums would cover strategies for coping with death and dying. Unfortunately, many nursing programs focus only on ensuring students pass the NCLEX.
“I think that we’re ready for a new model that includes nurses learning to care for themselves – and that means learning to deal with losing a patient,” says Camille Adair, RN. Adair was a hospice nurse for more than 10 years and created the documentary SOLACE: Wisdom of the Dying. She also developed The Solace Teachings, an 11-part documentary-based teaching program on death and dying created specifically for physicians and nurses. Adair shared some strategies that nurses can use to cope.
Since grief affects the body physically, it’s important to care for yourself in that way. Make sure you’re getting adequate sleep, squeeze in regular exercise, and eat healthy. “If we don't do our own inner work and stay connected to our own quality of life, then we can either over identify with the dying and become lost in that experience or we develop armor for protection.”
Own your story
Often nurses hear so many people’s stories that they lose sight of their own lives and the lives of their patients, explains Adair. She used to encourage the nurses at the hospice she managed to put a small keepsake or stone to represent their own lives in their pocket. When the nurse entered the room, she would place the keepsake at the door. Then the nurse would be fully present for the patient (and try not to think about his/her own issues outside of the hospital). Then, when it was time to leave the room the nurse would pick up the object and put it back in her pocket. This practice can help nurses be present for their patients, but it also reminds them that they are not the patient.
Talk to a grief counselor or your supervisor
In addition to caring for yourself physically, during times of stress, it’s crucial to care for yourself emotionally. Although hospitals often have grief counselors or spiritual care, it’s usually only available for the patients’ families, not the staff. “When nurses ask their supervisors if grief counseling is available, it helps spread awareness about the need for grief services,” says Adair. She also suggests reaching out to your state nurses association to ask about available resources.
Acknowledge each death
Death may be easier for hospice nurses to process, because they witness death frequently and help patients and their families go through the natural end-of-life process. “We get to see patients experience transformative, even healing moments within themselves and with their families. We saw how they died and are often able to go to the funeral. We process death as a natural, normal part of life,” says Adair.
However, other nurses may have seen the patients as they suffered through trauma, were in a lot of pain, or fighting for their lives. Adair created a bridge program at her organization, in which hospice nurses would share stories about the end of a patient’s life (with permission) to their former oncology nurses. “There was a continuity of information with the oncology nurses who'd been really involved and had strong attachments. The patients also wanted them to continue to be aware of their status. That was really powerful,” says Adair.
Know it’s OK to experience joy
It’s important to give ourselves permission to experience humor and joy in the face of the dying process. “Any hospice nurse will tell you there’s often an amazing amount of gratitude and inspiration at the end of a patient’s life,” says Adair. Humor also helps to relieve stress in unique ways. Death is part of the human experience. It can be very hard, but there’s beauty in it, too.
Heal however you can
Because every nurse and situation is unique, there’s no one-size-fits-all approach to dealing with death. Each of us has to take time to reflect and process the experience in our own way. Certain situations can be even more difficult or can cause more pain for a nurse, such as the death of a child, a sudden death, or a suicide.
As hard as it may be to cope with death, research shows that health care workers who care for dying patients find meaning and satisfaction in their work.
Sharing stories and feelings with trusted colleagues or friends can help with the grief process.
Tell us how you dealt with the loss of a patient in our discussion or in our private Facebook group. You also may want to read ANA’s Call for Action: Nurses Lead and Transform Palliative Care.
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McGrath, P., & Kearsley, J. (2011, February 08). Caring for dying patients can be a satisfying experience. Retrieved September 11, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3033918/
The solace documentary - Camille Adair, RN -. (n.d.). Retrieved September 11, 2017, from http://camilleadair.com/solace-wisdom-dying-movie/watch-the-solace-documentary/
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