As nurses and midwives, we are privileged to witness the beginning and end of the lives of people we care for in a professional and personal sense. Sometimes, people die peacefully and we see both sadness and relief. Sometimes they die in chaos and we are left with the lingering terror and confusion of their death.
As professionals, we often have unrealistic expectations of ourselves. We think we need to be strong and mask our emotions in the face of a patient’s death. That is not necessarily the healthiest, nor the most helpful reaction. It is ok to feel sad or cry with family and loved ones. Many people find it both affirming and helpful to express feelings of loss as it is an example of our shared humanity.
However it is important to remember that it is not ok to be so upset that they need to comfort you in the midst of their grief. If you feel that this is a possibility try to remove yourself from the situation, talking to your manager about having particular triggers may be helpful.
Sometimes, the grief hits harder than normal. Maybe the person who died reminds you of someone you loved. Maybe they’re so young that their death feels unfair or premature. Maybe you just really liked them. You also might be reeling from the cumulative effect of multiple deaths in a short time.
At times like this, it’s possible you might recognise in yourself a profound reaction that feels extreme — or the opposite. You might feel jaded, cold and unaffected in a way that feels unnatural. Either way, it’s helpful to seek support from peers, pastoral care, an employee assistance program, or Nurse & Midwife Support.
Taking a step to recognise your feelings contributes to your emotional health. Self-care helps you to replenish your caring resources so you can continue to help your patients and your families through these difficult moments.
Under ‘normal’ hospital circumstances, The Nurse & Midwife Support clinician team suggested a range of strategies to help people in the immediate aftermath of the death of a loved one:
- Ask if there is anybody you could ring on their behalf.
- Offer to gather and pack belongings and personal items.
- Ask if they would like to help wash and prepare the person.
- Be mindful of their cultural and spiritual needs — everybody grieves differently.
- Offer space, respect, and privacy.
Some of these strategies will need to change in the circumstances of COVID-19. Many will find it confronting to deny people the opportunity to visit a dying loved one. Even if you’re not a believer, the serenity prayer can be helpful here:
Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.
You don’t have the power to make it safe for people to visit their loved ones in hospital right now, but you do have the power to protect them by enforcing new guidelines around visitation. You are doing everything you can to honour your patient by protecting their loved ones.
Focus on the things you can do, and forgive yourself for the things that you can’t.
If you’re struggling, it’s important to take a moment to attend to your own grief. Do something easy and automatic: make a cup of tea, focus on a breathing exercise, or apply some hand cream in a mindful manner. Consider calling a friend or NMSupport when you get home. Treating yourself with kindness will help to ensure you have the strength to ensure your patients’ families are well cared for in their time of grief.