Dear EFAP: recently lost a patient

Thank you to those who have written to “Dear EFAP” for input on your dilemmas. As you are aware, we read every inquiry that comes in but we are only able to print a small selection of responses. Our “pithy” answers are modeled after the lighter hearted Dear Abby style and are grounded in common sense. If your issues require a more personalized level of support please call Employee Wellness/EFAP (1-800-505-4929) and we can confidentially book you a counselling appointment with a senior level therapist.

We welcome all inquiries – please submit these to dear.efap@efap.ca. All printed responses use the anonymous descriptor that you sign your inquiry with and do not reveal any identifying information. Our goal is to support you through insight and common sense.

Below is our response to the next selection – enjoy!

Dear EFAP

I am a nurse. I recently lost a patient. It was a difficult death and I am very sad. I don’t know what to do. Can you help?

• Grieving

Dear Grieving

We most certainly can help. Please know that you are not alone. If you call 1 (800) 505-4929 at any time or any day 24/7, you can speak to a senior level confidential therapist who can debrief this difficult event with you.

You can also ask your supervisor to call and request a group debriefing for your team. 24/7, a senior level debriefer can attend at your site and hold a critical incident stress debriefing. This is a voluntary session for those involved in a critical incident and it allows a group who went through a difficult experience to confidentially process their feeling around it together. It is a very healthy opportunity to share feelings with others who have been through the same event. We have a special team who does this that runs out of our EFAP/Employee Wellness program. I encourage you to give us a call today. We most certainly can help.

It is interesting that often we as care givers are taught how to help family members of our patients grieve but not always are we taught how to manage our own feelings of the loss of a patient. I checked and the research on this is pretty scarce. But the studies I did see said that how nurses manage the patient death process is important to their well-being. Stifling emotions is not so helpful. Talking them out with colleagues is recommended. Not doing so and walking around with pent-up emotions can affect personal relationships, eating and sleeping properly. The literature on this subject also noted that it is  not uncommon for a little black humor to sometimes show up in these situations. It is not disrespectful to the recently departed patient or their family, and it can be, for some healthcare workers, recognized as a way that helps them keep their own sanity in a difficult situation.

Self-care is also strongly recommended as a coping strategy when dealing with the grief over a difficult patient death. As a nurse, I wonder if you might be a bit better at taking care of others than doing so for yourself. If so, you would not be alone. In having just lost a patient, particularly one who you may have developed a relationship with, it is important to take care of you. This is so that, most importantly, you remain healthy, but also so that you can continue to take care of others. It’s kind of like the old practice of putting the oxygen on yourself first so that you can take care of the child you are holding.

There are a number of ways to practice self-care. Think about what might be best for you.  Some nurses use their spiritual practice to grieve and heal, some use exercise, mindfulness, yoga, hot baths and relaxation. Some process with journals and some like to get active and get out into nature to ease stress. According to nurse.com, nurses who take care of themselves better, grieve better. If they don’t care for themselves after a traumatic event, they [can] put themselves at risk for eventual burnout, compassion fatigue or moral distress.

The literature on the subject clearly says that talking with co-workers is probably the most helpful coping strategy in getting through a difficult patient death. Attending a voluntary debriefing in the workplace after such an event with colleagues who also went through that experience with you, is likely the best way to process and deal with a difficult  patient death or adverse event.

We are ahead of the game on this, and completely support this practice through our Enhanced Critical Incident Stress Management Program (ECISM). I encourage you to give us a call and either let us help you, either one-on-one with processing this experience, or to arrange for a debriefer to come and speak with your team.

Thank you for your service to patients and for caring, and for bringing this important issue forward. Too often, care providers suffer alone with these feelings and you do not have to do so. You are not alone in this, my friend – let us help you through this and please do, give us a call.

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The advice offered in this column is meant to be used as general guidance based on the facts provided. The opinions or views expressed should not be relied on as treatment or counselling services. If you are a VCH staff member and find yourself in need of counselling or support, please contact Employee Wellness/EFAP toll free at 1(800)505-4929 or (604)872-4929, your family doctor, or another appropriately trained and qualified specialist.