Nurses Grieve Too

An underexplored or ignored aspect of nursing professional life: how nurses working in a Labour and Delivery unit grieve over the loss of their patients, and how this grief affects care and support of survivors. What is really striking about the film is the culture of mutual support and respect among the nurses working in this unit — I hope it’s real and not just the product of the filmmaker’s eye, but the cynical side of me wants to think it’s idealized.

Though the film’s focus is in L & D, it makes me think of how nurses deal with loss in the Emergency department. The prevailing culture and mores of most EDs does not encourage touchy-feely moments, at least in not many of them. The expectation, frankly, is to suck it up and tough it out. The Emergency department is not for the weak of heart. Shrinking violets need not apply. Et cetera. But the question is whether we as nurses are able to provide good care to our patients without acknowledging and reflecting on how grief affects us. Or whether unacknowledged and unvalidated grief leads to higher burnout — and also some unintended psychological effects like PSTD.

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  1. #1 by jess6577 on Sunday 29 April 2012 - 2146

    So true…just wrote a post about PTSD this past Tuesday, and will be posting two more in following weeks. My experiences in the ER, CVICU, and NICU all contributed to lasting impressions on my psyche…

  2. #2 by torontoemerg on Sunday 29 April 2012 - 2201

    i really wonder sometimes about that… and how it accounts for “difficult” personalities we sometimes see in high acuity areas… what do you think?

    • #3 by jess6577 on Thursday 03 May 2012 - 1203

      I think it can be absolutely true. I used to be the sweetest, most innocent person, and now look at me…lol. Well, seriously, I think some people try to compensate for the feelings of inadequacy related to being unable to “save” everyone, or “fix stupid” as some patient circumstances indicate…by taking on very “A” type personalities, being overly critical of others, always pissed off at something or another, or the opposite: being so unable to cope with death and trauma, they can no longer function in areas that encompass those.

  3. #4 by jeanhill on Wednesday 02 May 2012 - 1043

    I had a very difficult time with the loss of a patient who happened to be a coworker’s child nearly two years ago. I Took time off at the urging of coworkers/friends. I couldn’t talk about the patient’s passing without crying (at work, which felt embarassing) and angry with individuals coming in for sore throats, year long pains, etc… I called an Employer Assistance Program to see what sort of support they could provide me. I spoke with an intake person on the phone who was remorseful and caring but the typical questions were asked: If I was using or abusing drugs and/or alcohol, thoughts of self harm, and so forth. She indicated in 2-3 business days someone would email me asking me how I felt and I could email my feelings back and get a response from that in the following day. I asked if there was any way to speak with someone over the phone or meet a counsellor to which she replied, “well its easier for everyone to use email and convenient” I was appalled. In the week that passed I received a package from EAP with a “don’t sweat the small stuff” book, a relaxation cd and some other stress coping techniques. I found the whole thing insulting.
    Fortunately speaking with my spouse, my friends and colleagues and time helped more than anything. I fail to see how “not sweating the small stuff” would have helped me get over the loss of that patient. If we treated our grief as a small thing it would create a huge problem in our practice and our regular lives.

  4. #5 by Darlene on Wednesday 02 May 2012 - 1339

    I will always remember the 13 weeker that was delivered in a bedpan that made gasping motions for a while after delivery. For a very long time whenever I closed my eyes I saw that baby and remembered how I held it until it died. I never talked about it-I had been called in to cover for a 4 hr evening shift. We did have EAP, but like jeanhill, I had always found them cold and clinical, and not much help over the phone, especially when they called during the day when I was trying to sleep off my night shift. Excellent article and video.

  5. #6 by torontoemerg on Wednesday 02 May 2012 - 1831

    A little while ago there was a particularly awful bit of horrendous nastiness at Acme Regional — talking about nightmare inducing stuff — and I know several staff members were affected badly. I’ve been away, on vacation, doing some other stuff, and I texted a friend whether anyone had thought about debriefing. The reply: “Hahahahahaha.”

    Is this right? Or just realistic?

    • #7 by jess6577 on Thursday 03 May 2012 - 1207

      So right. Debriefing should happen at MINIMUM on a monthly basis for all healthcare providers in critical care areas, unrelated to any specific event (because you never know how close to home an event may hit one of your coworkers)…but in the 11 different facilities in which I’ve worked, NONE have provided even a hint of debriefing.

  6. #8 by kathleen Schulz on Wednesday 02 May 2012 - 1904

    I had a similar frustrating experience with EAP after the death of a coworker (not work-related). But I persevered through the first (horrible) encounter and got a referral to a really great therapist. I will never forget how belittled and insulted I felt after the initial EAP consultation, but I am so glad I didn’t let that lady stop me, because my therapist has been a huge positive influence in my life.

    On another note, I find it hard to talk to non-nurses about some of what I have seen and some of my resultant idiosyncrasies. For example, I can’t look at those ‘cute’ pictures of posed sleeping babies because they always remind me of caring for stillborn babies when I worked L&D. I also can’t open any kind of plastic sheeting (i.e. shower curtain liners) because they look and smell like the old ‘morgue kits’ we used to wrap bodies when I worked in the ED. Weird, right? Not that other nurses are always supportive. There is a definite attitude of ‘suck it up and move on’ in the ED and the ICU in my experience.

    Thanks for the link. It is a goal of mine as an educator to help cultivate a supportive compassionate environment for working nurses. We face unique forms of physical and emotional stress in our jobs. We need to take care of ourselves and each other.

  7. #9 by Orthodontists Calgary on Tuesday 08 May 2012 - 0728

    Very true!! sometimes nurse’s behavior is so rude. They even don’t care about humanity. In some hospitals, they don’t follow rules.Once i was admitted in a local hospital in Calgary. A nurse was taking care of me. She was behaving with me so rudely. Even she was asking for money also. That time was so painful for me. That’s why i hate to be admit in hospital for long time.

  8. #11 by Family Portraits bristol on Thursday 17 May 2012 - 0623

    Well it depends on person to person how they behave. Sometimes i think it also depends on patient as well. If a patient is treating well the staff hospital will definitely get the same response. This is one of my personal experience. They are not only doing job over there they are doing all this for a good cause as well. So, i think its our responsibility as well to treat them with a polite and good behavior.

  9. #12 by Rahul Sharma on Thursday 17 May 2012 - 0625

    I am completely agree with the last comment, It really does depends on ones behavior. How he/she will behave will get the same in return.

  10. #13 by Dentists in Calgary on Monday 28 May 2012 - 0931

    These are not white coat people or doctors who take care of patient these are only nurses who take care of patients, after that all sometime nurses have to face trouble because of patients. Almost all nurses perform their duty from heart so we should show extra concern toward nurses.

  1. correct interpretation of “to the pure, all things are pure” (Titus 1:15) « the magic of language blog: partnering with reality – by JR Fibonacci

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