Just about every nurse is familiar with the grief-stricken family member. Either they stoically and robotically listen to what you have to say, or they cry and scream at their loved one’s death. They are allowed to grieve because they just lost someone who may be the world to them. But what about the nurse?
A nurse is a human being, and they may have taken care of that patient for a long time. The act of caring for a patient is an inherently intimate one, and when that patient dies, nurses can feel grief, too. Even watching a patient’s family member break down can be distressing for a nurse, but so many nurses ignore it. In addition, nurses don’t often know they are experiencing it.
Debbie Gossen, RN, OCN, GMS, of the Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center in Zion, Illinois is an expert on grief in patients and nurses alike. She helped spearhead special Renewal Rooms on every unit in the CTCA to help nurses express their grief.
“Grief is not universally understood by many,” says Gossen. “Grief is a normal reaction to loss. Grief becomes problematic when it interferes with daily activities and reduced enjoyment in life. Grief can exhibit a wide variety of reactions.”
In nurses, some of these reactions can range from crying in the breakroom to acting out at home. For this reason, it is important for you to recognize and deal with your own grief. You should also know when to seek out help for the grief that may not have resolved.
Dealing with and Recognizing Your Own Grief
You can experience grief in many ways, and some of them are physical. “Grief can manifest itself in a wide variety of emotional and physical symptoms, such as anxiety, sleeplessness, ulcers, headaches, joint pain, et cetera,” explains Gossen.
However, those aren’t the only ways. Most of the symptoms are psychological. Acknowledging the feeling is one of the most important steps you can take, and then you can share your feelings with coworkers and other sympathetic persons. You need to find a healing, non-judgmental place that will support your grief rather than minimize it.
In fact, Gossen advises: “Do not hold on to or suppress these feelings. You will be less effective in dealing with the sick and dying patients if you do not work through the grief. Grief is a multitude of feelings that must be expressed and processed. Nurses also need take time for themselves and prioritize self-care.”
Only by making time for yourself can nurses fully process their own grief over the loss of a patient. It should also be noted that a patient doesn’t necessarily need to die to provoke a response. Simply dealing with a patient who is suffering or dying by inches can make symptoms appear, as well.
Nurse Versus Patient Grief
It can be difficult to separate your grief from your patient’s or the grief of their family. In fact, nurses may feel that they are not really experiencing grief at all, but simply observing the grief of others without the feelings affecting them. Thinking this way could be a possible mistake.
“Sometimes we are not as accepting, forgiving, and understanding of our own grief,” says Gossen. “Nurses can be hard on themselves with high or unrealistic expectations.”
Indeed, nurses are expected to be tough, especially when it comes to dealing with the emotional side of the profession. “There’s the old saying that ‘you need to check your problems at the door before coming to work,’” Gossen continues. “Well, that type of thinking just doesn’t work anymore. In order for a nurse to be effective and provide the care our patients demand, coming to work with a grieving mind is not ideal. They need to apply the same compassion, caring, and forgiveness that they allow their patients, upon themselves.”
Self-compassion is something that is not taught in nursing school, orientation, or continuing education. It is the practice of treating yourself as you would treat your patient. If your patient wanted to weep for all they lost, you would comfort them. However, if you wanted to weep for all you witnessed, you may be reluctant to reach out for help. That is the problem nurses face when they deal with their own grief, and self-compassion is usually the answer.
When to Seek Help
In addition to denying themselves compassion, nurses are often reluctant to reach out for help. This stems from a misguided notion that a tough nurse—a good nurse—doesn’t need help for emotional problems. A good nurse simply gets used to feeling that way and becomes inured to the pain around them.
This is simply not true, and it is unfortunate that so many nurses believe it about themselves and about the profession. It is not “tough” to allow yourself to hurt mentally and emotionally. One sure way to destroy your psyche is to ignore your feelings. But when should you seek professional help after exhausting the help of friends and family?
“It is important to seek professional help when you are unable to work through the anger and pain,” advises Gossen. “When the stress response affects your mood, behavior, and thoughts you would benefit from professional help to work through these feelings. It is important to tame the stress before it bites you. Be very aware of your feelings.”
When you are aware of your feelings, you are better able to make judgements about how you can navigate the waters. Grief is not a cookie-cutter “disease.” It doesn’t follow five steps, and it is often different for everyone. If you are feeling angry, sad, apathetic, or anything in between, you may be experiencing some sort of grief, and professional help may be necessary.
In the end, diagnosing and treating grief in nurses is difficult. Nurses often can’t recognize it and don’t want to face it when they do. However, it is one of the most important steps a nurse can take if they want to remain psychologically healthy. Grief is a slippery thing, and getting in touch with your feelings is the best way to deal with this potentially devastating problem.
As Gossen states, “It is not something you ‘do’ and ‘get over.’ Grief is a lifelong process of working with and understanding that in which we have no control. Acceptance, acknowledgement, and understanding are critical in the complex layers of grief.”