April 1, 2008 | American Society of Registered Nurses®
Nursing Today

Coping with Death and Dying

Alison Palmer, BSN

The nurse who experiences the loss of a patient can go through many emotional responses.  These responses can be magnified for those who deal more closely with death and dying.

The nurse experiences loss in working with the dying and their families  Grief is the emotional response to these losses and needs to be expressed in order to facilitate adaptive coping.  The nurse may experience feelings of anxiety and grief as well as cumulative loss when he or she is unable to cope effectively with each loss.  Ineffective coping mechanisms may include avoidance and emotional distance.  Additional stressors may result from circumstances requiring the nurse to either withhold or express personal emotions appropriately and portray empathy toward the patient and family.  Losses may be compounded beyond the aspects of the death of a patient.  It may include the loss of a close relationship with the patient, losses of professional boundaries and unmet goals and expectations.  The nurse may also experience a compromised personal belief system or assumptions about death that make it difficult to overcome a loss.

The caregiver needs to be able to recognize symptoms of unhealthy stress.  Practicing good nutrition, exercise and meditation help control symptoms.  Establish a spiritual belief system and allow yourself time to grieve losses both personally and as a member of the care team.  Maintain a connection with nature, a sense of humor, and an appreciation for music as therapy.  Maintain a healthy balance between work, home and leisure time and stay connected with family and friends.  Find a confidant who can understand your work related stresses, be open to new ideas and solutions and don't be afraid to seek help when it is needed.

http://www.medscape.com/viewarticle/516107_5 Nurses, November 2005 Journal Scan

From

American Association of Nurse Anesthetists Journal

October 2005  ( Volume 73, Number 5 )

The Certified Registered Nurse Anesthetist: Occupational Responsibilities, Perceived Stressors, Coping Strategies, and Work Relationships

Nurses have long been identified as a group that works very hard under trying conditions and often experiences burnout over time. There are many accounts in the literature where nurses lose interest in their jobs, lack satisfaction, and dislike the pressure and stress associated with caring for critically ill patients under less than ideal conditions.

Some of the coping mechanisms that the nurses used to combat these stressors were staying focused on patient care, the use of humor, verbalization and internalization of concerns, and adopting personal hobbies. Production pressure and workload were handled through close teamwork. Role blurring was evident under some stressful conditions. How relationships among different healthcare professionals developed and whether "politics" were involved could either decrease or increase stress.

Six major themes surfaced as part of the analysis of data using the constant comparative method. These major themes include:

1. The role of being an attentive, reliable coworker alleviates antagonism found within operating room relationships.

2. Maintaining open lines of communication is an effective way to address concerns and prevent staff conflict.

3. Among the CRNAs, occupation-related stressors create concern for patient safety.

4. Interpersonal work relations cause more stress than any of the other perceived job stressors.

5. Engaging in personal hobbies assists the CRNA in coping with work-related stress.

6. The nurse anesthetists' work lives are not as stressful as their personal lives

 

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