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Death is a natural part of life but that doesn’t make it any easier. Intensive care nurse Rhianna Ferial says that, “as healthcare professionals, we are there for people and their families during the final moments. This can be hard emotionally, so it’s important to recognize and find ways to deal with your feelings.”
Watch the video or read the transcript below [edited for length] — and use the comment tool to let us know how you deal with patient death in your own work.
Rhianna Ferial: Hi, everyone. Today, I wanted to have a little nurse talk, a sit-down talk, and I wanted to talk about dealing with patient death. I want to tell you about my first experiences with patient death, my experiences since then in some ways that I think help coping with patient death and dealing with your grief or your emotions over the situation.
I honestly think the most stressful and emotionally taxing part of dealing with patient death is being there for their families, and this is something that’s very important. I feel like we don’t get enough education or practice with this part because we’re there for treatment and I know how to take care of patients. I know how to do ACLS. I know what to do to save them. But when we can’t save them, what comes after that is dealing with the family while they say goodbye to their loved one. We’re there with them afterwards while they’re grieving.
That’s the hardest thing for me in my career. It was the hardest thing for me to get used to from the beginning, and I always thought the actual scenario of trying to save somebody or them passing away would be the hardest. For me, it’s actually the emotional part of dealing with the remaining family members who are just grieving and so upset.
My #1 piece of advice in dealing with the families is it’s okay to be silent. I always used to feel like I need to say something when a tragic situation was going on. I was in the room with a family who’s saying goodbye to their dead loved one and I felt like I should be saying something or talking to them, trying to console them, but there’s nothing you can really say to help them. There’s nothing you can say to take their pain away. Sometimes just being there, handing out tissues, trying to hand out waters or anything you can to just make them a little more comfortable is all you can do.
Sometimes people just need a hug. Not everybody is a hugger, but sometimes family members just want you to be there with them. Sometimes they need a hug, a shoulder to cry on, and you can be that person. You don’t always need to be saying something. Don’t be scared of saying the wrong thing. Don’t be worried that you’re not saying enough. Honestly, there is no right answer here, and all you can do is what feels right. Oftentimes, for me, I found that that’s silence and waiting for them to start talking. If they talk and initiate and want to have a conversation more about what’s happening, I’m there and I’ll talk to them as well.
The second piece of advice I have… and these are in no particular order. I’m not saying one of these is more important than the other. But the second thing I would say is please try not to blame yourself and try and find things wrong with what you did when somebody dies in your care. We’ve tried everything we can to save somebody. We’ve given blood and ACLS, done CPR, done everything we can think of, tried to save this person, and they just couldn’t make it. Their body couldn’t handle it, and it was just time for them to go, even though it doesn’t feel like it’s time and doesn’t feel like it’s right. There’s nothing that you could have done, not one thing specifically that you could have done or changed what you did, or change the timing is something usually that would have saved that person.
There’s too much, too many factors going on, so try not to blame yourself, try not to replay scenarios over and over again in your head blaming yourself. I know a lot of newer nurses or younger nurses that are dealing with death for the first time tend to do that. I’ve had people tell me they do that. I’ve done that in the past before, too. Just realize that that’s not a productive way to deal with your feelings, and it’s just going to make you feel worse.
This kind of leads me into the third thing that I wanted to talk about and that is don’t compare your feelings to how other people are feeling during this situation. Everybody processes situations and feelings and emotions differently. Just because one nurse is extremely upset and one doesn’t seem to be upset at all does not mean that either one of them is dealing with the situation in the wrong way. We all just handle things in our own unique ways. Obviously, you need to be able to keep it together during the situation. You can’t really be functioning during the code or like a mass transfusion protocol or any kind of dire situation if you’re completely overwhelmed and upset. If that’s happening during the situation, obviously that’s another issue that needs to be addressed, but I’m talking about afterwards.
Take things at your own pace, deal with things how you feel like you need to deal with them. If you’re upset and you need to go in the bathroom or the break room and cry for a second, do that and don’t think there’s anything wrong with that. If you’re not upset and you feel like you can go right into your next patient’s room and provide them with care, and you feel like you need to keep going, keep yourself busy, do that as well. There’s no right answer here. Everybody deals with it differently. I just wanted to say that because often in healthcare there’s this kind of vibe that you shouldn’t get upset about things. You should keep a wall up. You shouldn’t get upset about patients or situations. You should kind of just move on to your next task. That’s not always the case.
The fourth thing I wanted to say is something that has really helped me in the past and continues to help me is find an outlet for yourself, whether that be working out, whether that be crafting, whether that be continuing education, something that you can focus on and spend your time on that’s for you. This isn’t just with patient death, but with stress in general. Having something for you is very helpful, something productive that makes you feel good, which makes you feel like you’re getting stuff done and you can put your mind and soul into and really focus on that.
Now, the last piece of advice I have, I think it would be tip #5, is to talk with others, whether this be your co-workers who are there with you during the incident or whether this be a therapist or a counselor, or somebody who can help you deal with your feelings. Obviously, don’t violate HIPAA if you’re not talking to your co-workers who were there in the situation, but you can talk about situations without giving details. If you need to see a therapist or a counselor, do not feel bad about that. Sometimes you need somebody objective to talk to who’s very neutral and can just give you advice and just be there for you to listen and you don’t feel like is judging you.
Talking to your co-workers can be great, too, if you have good co-workers and just depending on the situation. If you come home and you just had a really bad day, you lost a patient, something horrible happened, don’t be afraid to tell your family that you’re just really not feeling good and you had a bad day at work. You don’t need to go into detail or make it gruesome for them or tell them anything specific. Maybe you just need to go take a bath or listen to some music or read a book or go sit in your room by yourself for a little while, but oftentimes they’ll be very understanding of this. I’m sure they know your job is stressful. Just don’t be afraid to vocalize when you need a little you time.
That’s it for my tips for dealing with death. Obviously, there’s many more things you can do. That’s just kind of some things that I found that are helpful. I hope they were helpful to you guys as well. If you have any tips or things that you do to help you cope with loss, please leave them in the comments below because people who have dealt with stuff before can help new nurses, new health care workers who are just now dealing with it for the first time. By sharing your feelings and experiences, you can really help lift them up and help them realize that they’re not going through this alone.
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