Good Grief: How are Nurses Coping with Patient Deaths?

Nursing students learn how to help family members grieve but seldom learn how to deal with their own grief. Time spent on how nurses cope with patient death is scarce and mainly anecdotal. Studies suggest nurses should be prepared that their patients may die and how they manage this process is important to their well being.

“Stifling personal emotions about patient death has been equated with professionalism for nurses and physicians. Unfortunately there are still feelings of, “Suck it up and move on,” says Robert S. McKelvey, MD, a professor of psychiatry in Portland, Oregon, who wrote a book titled, “When a Child Dies: How Pediatric Physicians and Nurses Cope.”

In interviews with nurses and physicians about the subject, McKelvey found that “nurses, on the whole, did a lot more talking about these things than their physician colleagues.” Those who allow themselves to go through the grieving process do better. Those who hold it in, he says, pay a price by not being able to deal with their feelings at the time and place. Sometimes the price includes difficulties with personal relationships or having trouble sleeping or eating properly.

Some coping strategies that nurses are utilizing include: rituals to help the patient and family better face funerals or posting obituaries, praying or drawing strength from spiritual beliefs and exercise to help ease stress caused by the patient’s death. “The nurses that care for themselves will grieve better,” says Catherine Miller, RN, MSN, CCRN, clinical education program manager at County General Hospital in Columbia, MD, who also advises her nurses to turn down extra shifts and avoid working with insufficient sleep. “If they don’t care for themselves after a traumatic event then they will face eventual burnout, compassion fatigue or moral distress.”

Nurses often use humor to deal with death, though they must take care to not use it inappropriately. Talking with co-workers is probably the most helpful coping strategy in getting through a difficult death. Nurses understand what other nurses are going through. It is important to be supportive and acknowledge that a patient’s death affects the nurses that were working and caring for that patient.

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