The first time we, as nurses, lose a patient, it can be extremely difficult. In fact, most nurses can always recall the circumstances surrounding their first patient's death. When this happens, the new nurse needs to be supported by her colleagues, and she needs to be shown that grieving and “feeling” is a part of nursing. Some patients will touch us in sincere ways, and the loss that accompanies their death can be difficult. Being supported by colleagues and being shown that grieving is healthy, and having coping strategies to get through this loss, is crucial. The following are coping mechanisms that nurses can employ to deal with the loss of a patient: Allow for debriefing with staff. The day after a patient dies, the grief process may be facilitated by an allotted debriefing. Debriefing can relieve existential tension. And, external tension is one of the components of unresolved grief. Quantitative studies show that those nurses with less tension report less of an incidence of burnout. Some palliative care units are considering adding “debriefing trainers” to their units to facilitate the debriefing process. Discuss the patient’s death. During a debriefing session, many nurses might want the content to be subjective. It can be a forum whereby they discuss how they felt about a particular death. Some of the content can also be the objective data surrounding the occurrence. Allow for debriefing with the patient’s family. When a patient dies, it can be important for that nurse to be allotted time to debrief with the patient’s family and friends. This interaction often will allow the nurse to realize how valuable she was in the patient’s care. Debriefing can simply be informal talk or brief stories about the patient. Refer to a bereavement counselor. In many institutions, a bereavement counselor attends clinical meetings. Furthermore, most nurses tend to prefer them as opposed to the employee-provided support. Communication skills and training surrounding death and dying are necessary for effective coping. Bereavement counselors might also be able to provide the nurse with strategies to prevent burnout. Provide grief education. Many nurses report feeling that they are not able to manage the stress of grief when a patient is dying. Caring for the family of the patient can be difficult as well. In order to support the co-assigned nurse, providing grief education can reduce feelings of guilt, depression, and physical distress. Allowing time to grieve is also important. Engage in social activities. It might be emotionally hard and exhausting for nurses to talk about the death and to interact with others, but having lunch with friends, or attending a religious service, or going to a movie, can be fulfilling. Social support is important; it is crucial that the nurse not feel alone. Set personal limits for time and energy. The loss of a patient can be exhausting. In order to prevent burnout and overall fatigue, it is crucial for the nurse to set personal limits. She does not have to be “superhuman.” Doing this can prevent “caregiver fatigue,” and “job burnout.” Engage in complementary therapies. Some complementary therapies such as relaxation techniques, guided imagery, and journaling can produce a significant effect in reducing stress and burnout. Massage therapy can also be effective in reducing stress. Express sorrow to the patient’s family. If the nurse feels that sharing a hug, a story or a cry with the family is appropriate, this can be a healthy strategy to deal with loss. Reminiscing can also be helpful for both you and the family. Regardless of the method, some intervention for grieving is important. Without such a modality, nurses would be emotionally exhausted; they would not be able to continue with their job. When a colleague loses his/her patient, it is important for other nurses to support him/her. It is important that he/she rely on a coping strategy; perhaps one of those listed above. source
