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Nursing a patient at end of life can be an emotional challenge.

Helping nurses come to terms with patient deaths: Strategies for nurse managers

Date: February 24, 2017

Nurses work on the front lines of patient care, and kindness and compassion are crucial attributes that all nursing professionals should exhibit. Consequently, it is common for nursing staff to form emotional attachments with patients and subsequently become affected by feelings of grief after a patient dies.

Although grief can impact nursing professionals of all ages, a joint paper from researchers at Monash University, Australia, and Lancaster University, U.K., reported that a number of studies have indicated that nurse grief and death anxiety tends to impact younger nurses in higher numbers. As a result, the study authors called for wider implementation of death education for younger nurses, particularly those under the age of 30.

Given the potential for nurses to experience grief, it is important for nurse managers to be cognizant of effective strategies that can be implemented to help nursing staff cope in the aftermath of a patient’s death. Some of the most effectual steps include the following:

1. Holding debriefs after a patient’s death
As detailed in the article “Strategies for Teaching Loss, Grief and Bereavement” published in the journal Nurse Educator, it is important for nurse managers to conduct debriefing sessions with nurses after any patient dies. Debriefing sessions allow for nurses to express their emotions about the loss, as well as recap important details that led up to the event. Study authors stressed that it is important for the debriefing sessions to be safe spaces in which all nurses are able to articulate their feelings.

2. Offering bereavement counseling
Jennifer Ward explained in an article for Nurse Together, bereavement counseling can be an effective strategy for nurses who continue to struggle after a debriefing session. It is fairly routine for nurses to eschew support services offered by hospital staff. In this instance, nurse managers should be sure to connect their struggling staff members with independent bereavement counseling. This approach can be effective, as counselors can help nurses work through their grief and devise strategies for moving forward in a healthy way.

Nurses should be encouraged to express their grief.

3. Providing death education
One of the most effective ways to reduce the severity of nurse grief and death anxiety is to provide nursing students with a comprehensive education concerning how best to approach end-of-life care, according to the Nurse Educator article. With a nuanced understanding of the end-of-life process, from caring for the patient to necessary procedures in the aftermath of the death, to responding to the grief of a patient’s family, nurses likely will feel more prepared and able to navigate this difficult and emotionally challenging period. Education in this area also can help nurses to feel more confident and able to help patients in their final days.

4. Encouraging conversations with family members
It is important for nurse managers to inform nurses that, in many cases, it is appropriate for them to hold discussions with a deceased patient’s family and friends, as well as for them to express grief and sadness, explained Kathy Quan, RN, BSN, PHN, in a Nursing Link article. Grieving with the family can help nurses process their emotions more effectively. It should be stressed, however, that this advice comes with a caveat — nurses should ensure that the family in question is comfortable with having the nurses express their personal grief. For example, if certain families choose not to discuss their loved one’s death with a nurse, instead opting to grieve privately, this choice should be respected. It is important for nurses to not let their own grief impact their duty of care to the grieving family.

5. Allowing nurses time to grieve
As also stated in the Nurse Educator article, it is important for nurse educators to allow nursing students time and space to grieve in a way that best suits them. This strategy also should be employed by nurse managers — all nurses should be afforded the opportunity to grieve openly and in their own way, whether that is taking time away from work, spending time with family and friends, meeting with a bereavement counselor or attending group counseling. As medical staff editors at The Mayo Clinic noted, grief is a complex process, and it will manifest itself in various ways in different people. Consequently, nurse managers need to be aware that there is no “right” or “wrong” way for nursing staff to grieve after a patient’s death and that each nurse should therefore be permitted to approach the situation in a manner of his or her choosing.

Journalist Anne Windermere wrote in the Houston Chronicle that nurses should be encouraged to express their emotions openly — crying and discussing the incident, for example — in the company of other nursing professionals. Open expressions of grief, however, must be kept away from the view of patients. Appropriate spaces for the open articulation of grief include the nurses lounge or during a private meeting with a nurse manager.

Consider Bradley University
If you are interested in developing your career in nursing, consider applying to Bradley University’s online Master of Science in Nursing program. Designed to help you study at a time that best suits your professional schedule, the online program is taught by a renowned faculty and can prepare you for roles in nurse management and nurse education. For more information, click here.

Sources
http://www.nursetogether.com/how-ease-pain-losing-patient-first-time
http://work.chron.com/deal-death-nursing-9202.html
http://nursinglink.monster.com/benefits/articles/7481-how-to-deal-with-a-patients-death?page=2
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3565229/
https://pdfs.semanticscholar.org/c93b/cde209762467207ae4f46fbb3fde9ba18e59.pdf
http://www.mayoclinic.org/healthy-lifestyle/end-of-life/in-depth/grief/art-20045340
http://onlinedegrees.bradley.edu/nursing/msn/

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