How Nurses Deal with Loss


By David Sanchez, Brookdale Hospice Care Coordinator

One of the most common challenges nurses struggle with in their work is experiencing death in the workplace. Often, this experience brings the very real experience of grief, a strong sense of loss for the patient. Unfortunately this grief is often disenfranchised or unacknowledged. The nurse may find themselves having to bottle up the loss and push forward, usually that same day. As the losses come, we stack those traumas until we inevitably experience burnout or compassion fatigue. Recognizing the significance of death in the workplace and taking steps to process the losses can strengthen a nurse’s coping abilities and can help continue to make the work meaningful not draining.nurses (1)

Compassion comes from the Latin word “to co-suffer” and is an apt reminder that when we care for others, we can feel great pain ourselves. When we make a connection with a patient and their family we will experience loss when the patient dies. The common symptoms of grief: loss of focus, heightened emotions, fatigue, distraction, etc. can affect the life of a nurse at work and at home. Compassion fatigue occurs when we are emotionally tired but continue to do demanding physical and emotional care. It’s similar to being “in the red” and instead of stopping to re-charge our batteries, we simply chug along. Even though it’s been identified as a real experience for decades, it’s often been considered simply “the cost of care”.

The way that a nurse can support herself through the traumatization of multiple losses in the workplace is to find positive ways to express the grief. Grief needs to be expressed since the alternate approach, bottling the feelings, leads to compassion fatigue. Grief is expressed in whatever way speaks to the strength of the nurse. Sometimes nurses write a letter to patient, getting out in words their feelings of connection. Some nurses plant a garden to symbolize the people served or meet with co-workers to toast someone significant or bring in a pot luck of their favorite foods. Creating a ritual to express the grief and to celebrate the person who impacted their life helps deal with the long term effects of caregiving when death occurs.

Self-care is the other necessary component of dealing with grief and avoiding compassion fatigue. Nurses are givers by nature and learning how to take care of yourself is a critical skill. Re-charging our batteries keeps us strong as caregivers and can be done as a small, daily activity. The music we take time to listen to in our car, the treat we give ourselves at the end of the day, the breathing exercises we do as we remove our badge are all ways we can take a minute here and there to re-charge. Even taking 10 minutes to stop and drink a coffee instead of drinking as we go can make a huge difference in our mood. Self-care should be fun and energizing and individualized to the nurse.

Recognizing grief, committing time for self care, and finding support from peers can help all nurses navigate a death in the workplace so that they can continue the meaningful work of care.

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