Abstract
Nurses are prone to deal with death, whether they would prefer it or not. Although, there is an increase of medical advances to slow the progression of death, it is inevitable that patients will die. When a patient dies, nurses must deal with the grief and emotions that encompasses death. Due to the nature of how often nurses deal with death, it leads to an increase awareness of how they will someday face their own death. The increase in emotions and grief leads to an overwhelming increase in stress for nurses. Continuous increase in stress can lead to burn out in nurses. Therefore, nurses must learn effective coping methods of death to reduce any devastating emotions and maintain professionalism.
Key Words: nurses, death, coping, grief
The Importance of Coping with Death in Nursing
Introduction
Death is inevitable at some point everyone must face it. Whether it is the death of a family member, friend, or a family pet, people are forced to deal with the death. Nurses however have more frequent encounters with death than the average person does. When a patient dies in a healthcare setting his or her nurse is obligated to deal with that as well. They must find ways to cope with the increased amount of death that
…show more content…
Cumulative grief is known as a caregiver’s emotional response to many episodes of grief (Shorter & Stayt). The multiple encounters with death give a nurse no opportunity to grieve adequately or completely for each individual patient that has died (Shorter & Stay, 2010). The unresolved grief accumulates and can lead to emotional and physicals problems which can then effect a nurse professionally and personally (Shorter & Stayt, 2010). The effects of cumulative grief include denial, feelings of decreased personal competency, overwhelming grief, low self-esteem, and pre-occupation with death (Shorter & Stayt,
This author’s personal perceptions concerning patients facing a lingering terminal illness, have been shaped by over 20 years of critical care nursing experience. Facing death and illness on a daily basis requires self-examination and a high degree of comfort with one’s own mortality, limits and values. Constant exposure to the fragility of life forces respect for the whole person and the people who love them. A general approach to patients who are actively dying is to allow them to define what they want and need during this time. The nurse’s role
One is to help the bereaved to develop their own ways of coping and the other is to ensure that their own difficulties, needs and attitudes relating to death and dying of their patients do not compromise their psychological well-being. It was noted by the same author that the psychological impact and after events prevalent in a critical care nurses’ working environment remains relatively unexplored. Michell (2010) also felt that repetitive exposure to resuscitative measures, end-of-life care needs, prolonging life by pharmacological and mechanical means and the continuous adjustment of these critical care nurses to this hostile environment, results in psychological disorders such as post-traumatic stress
On reading this article and identifying the study, there was a clear insight on how death and dying, and even improved health, impacted those nurses (Conte, 2014). Nurses, who worked closely with their patients, through the perils and suffering, culminating of death and losses, had grief not readily explored to enable that comfort zone (Conte, 2014).
Patients that qualify or use palliative care also have a terminal diagnosis but usually have a longer life expectancy than those with hospice. The definition for hospice and palliative care is something many nursing students learn during their program. Young-Ran, Min, and Kyoung-Soon (2015) found in a study that 70% of nurses in a general hospital setting that had cared for a terminal patient had no prior education or training for palliative care. Nursing education continues to evolve in attempts to better prepare nursing students for life after their program completion. Attempts to better familiarize students with end of life care some programs are using simulation. Simulation has been found to be an effective method of teaching when related to high stress and emotional situations (Moreland, Lemieux, and Myers, 2012). It is great that there have been attempts to increase the amount of education in this specialty area especially since 76% of dying patients are receiving nursing care at time of death (Moreland, Lemieux, and Myers, 2012). Now it will be important for current nurses and educators to continue to increase the amount of information provided in nursing programs and to novice nurses about hospice and palliative specialty
Nurses: Assist the patients and families to cope with the end-of-life process such as assessing and
Death is a part of life and eventually everyone on this earth will experience it. Nurses play an important role in death. Mourning the death of a loved one is something that almost everyone will experience in this lifetime because it is a natural response to death. Bereavement, grief and mourning are all effected by one’s culture, religion, the relationship with the deceased, personality, and how the person died.
Dying is a process that involves the entire family; that is to say, the family that is defined by the person. The nurse must be aware that this is not only an individual process but a family process. This involves recognizing family dynamics and communication patterns and facilitating healthy interactions.
Individuals enter nursing with a wide array of experiences in how they grieve the loss of someone or something. These experiences follow them into their career and express themselves in the way they grieve for the loss of a patient. Evidence shows that this has historically been inadequate and unhealthy. To prevent the negative impact that ineffective grieving has upon the individual the approach to the grieving process must change. In doing so nurses will become more emotionally and physically stable while going through these difficult times, ultimately helping the healthcare institution to thrive.
Occasionally, the best care a nurse can provide is providing their patient the ability to have a good death. In a survey of acute care nurses conducted by Becker, Wright, & Schmitt (2016) it was found that dying well was
Grief is a personal adaptive reaction to the loss of a relationship or a serious attachment and it’s a process that takes time. Nicholas Wolterstorff in his book, Lament for a Son, narrated this grief process as he reflected on his son’s death. Provoked by death, grief can impede a person’s thought process and can take a heavy toll as they become emotionally labile (Brosche, 2003). In a healthcare setting, a nurse may experience grief after the death of a patient and often this emotion is masked and kept private. It is crucial for healthcare providers to recognize and deal with emotions appropriately to competently function in the workplace. This paper will examine the five stages of grief as defined by Kübler-Ross and how these stages are in parallel to Nicholas Wolterstorff’s grief process and how he eventually finds joy in understanding the significance of death.
At times the dying patient’s loved ones become the nurse’s patients. As stated in End-of-Life Care: Caring for the Dying Patient and Family of the Dying Patient, “End-of-life (EOL) care of the dying patient and the patient’s family encompasses a variety of interventions that meet the physical needs of the patient and the emotional/psychosocial needs of the patient and the family. The rationale for EOL care is to provide physical comfort for the patient by managing pain and reducing emotional stress, and to promote effective coping and spiritual comfort for the patient and family” (Woten and Schub, 2016). As future nurses, it is critical that we acknowledge the potential we hold, we treasure the gift we have been given and we take our responsibilities
In the nursing profession, It is a nurse’s duty to make sure that patients are medically taken care of and that various needs are met in order to apply the most comfort for the patient. Nurses are needed to make sure that medication is administered on schedule, wounds and body care are cleaned, and educational teaching is involved with the patient care. It should be the nurses’ goal to make sure patients will be able to leave the health care facilities feeling physically and mentally better before they came in for said reasons. Sometimes the nurses can do so much for some patients that all they can do is to provide care until their end of life. Usually end of life scenarios are that some patients have been through a traumatic accidents such as vehicle on vehicle collision or terminal illness such as cancer.
In relation to the purpose of this study, the driving force behind the research are three questions. What are nurses experience following patient’s death? What are their actions and coping strategies following patient death? Would better learning opportunities and supportive practice environments be provided once there is an understanding of nurses’ grief and coping process, if yes, was it beneficial. The researchers proceeded with a broad question which allowed the focus to be sharpened and delineated later in the
Many nurses are regularly confronted with the hopelessness and exhaustion of patients and their families making it difficult for them to find balance between the preservation of life and the enablement of a dignified death. Nurses must acknowledge their own feelings of sorrow, fear, dismay and helplessness and recognize the impact of these emotions in clinical decision making. These distressing pressures may cause a nurse to contemplate intentionally assist in ending a patient's life as a humane and compassionate answer, however; the conventional goals and standards of the nursing profession mitigate against it.
The theory of chronic sorrow is a middle range nursing theory explored largely by Georgene Gaskill Eakes, Mary Lermnann Burke and Maragret A. Hainsworth. The theory provides framework for understanding and working with individuals who have experienced a significant loss of a loved one. As stated by Eakes et al. (1998, p. 179), Chronic sorrow is described as “…the periodic recurrence of permanent, pervasive sadness or other grief related feelings associated with a significant loss.” As nurses, it is vitally important to understand and be aware of the high potential for chronic sorrow to occur when treating patients across the life span with chronic and traumatic conditions.