Unattended grief

How do you handle work-related grief? Can you leave it at work, or do you take it home with you? What support is the most helpful to you when a patient dies? 

CASE

Tracy washed her hands at the sink behind the nurse’s station. I leaned against the wall next to her. “How are you doing?” I asked.

“Me?” She looked up with surprise. “Oh, I’m fine.”

“I wanted to check in. Seems like we’ve lost quite a few patients lately.”

“I’m OK.” She focused on scrubbing her hands.“Just have to keep going.”

I took a step back. The last thing I wanted was to make her feel like I was grilling her. “Sure, but let me know if you want to talk.”

She shrugged. “Thanks for checking.”

I walked down the hall knowing that for the moment there was nothing else to do. I was satisfied that I had at least made an effort to check in with her. In oncology, we share patients and are impacted by their disease process in different ways, yet how we choose to handle it is a personal choice.

There is a saying that bad things happen in threes. For oncology nurses, it feels like a true statement rather than a saying. There had been a trio of deaths on the unit; all three were relatively young patients, which made it especially difficult on everyone involved in their care. One patient in particular touched many of us. Susanna was a young mother, that was part of it, but perhaps a bigger part was that, in the face of what was clearly her own impending death, she faced it full on, and with grace. Her husband embraced the care we gave his wife. I don’t know why it happens that we get attached to some patients more than others, but she was one of them. Her death hit us all hard.

A day after Susanna died I stopped by the unit and spoke with Kate, a nurse who had taken care of Susanna more often than the others.

“Doing okay?” I asked.

She smiled but did not look up. “Yeah.”

“Been a tough couple of weeks.”

She looked up then, blinking back tears.“It’s just so sad. I thought I was okay but later, when I was getting meds for another patient, I started to cry.”

“It’s hard.”

“I didn’t want anyone to see me crying.”

As a new grad, Kate worried that showing her grief would make her look like a “bad” nurse to the more experienced staff, as if showing her grief made her weak when she was supposed to be strong. In the article, “A Time to Grieve,” the author says many nurses follow an unspoken code of silence in regards to grief, and just as Kate did, worry that showing grief will make them look weak to other nurses.¹ We nurses learn this early in our practice. We are trained to assess our patient’s needs, everything from physical to psychological, but at times we may not look up long enough to assess our fellow nurses or even ourselves.

“Let me know if you need to talk.”

She wiped a tear, “Okay.”

As I walked away I realized I was more comfortable with Tracy stoically washing her hands while we spoke than I was when Kate told me she had gone into the med room and cried. I followed the unspoken code of silence, too. It wasn’t that I judged Kate negatively because she cried, but it made me uncomfortable. It was easier if she nodded and said she was okay.

---

JOIN THE CONVERSATION Are you comfortable talking about your grief to other nurses? What do you do when another nurse (health care provider) expresses difficulty coping with loss and grief? Go to the bottom of the article to comment and share your thoughts

---