Christmas… a terrible time for someone you adore to die. Research says I will mourn him the most during the first year, the first holiday, birthday or special event that I would normally have celebrated with him.
My dad was a wonderful person, he was the true meaning of joie de vivre, anyone who met him liked him. He said the same jokes day in and day out for probably 60 years or so. He was all about family. He never said a bad word about anyone. He was 88 but a ‘young 88’, he swam 30 laps per day, six days per week at the local pool. He is missed.
The Other Side of Nursing
During my father’s illness, which was short, I was on the ‘other side’ of nursing, I was the family member who was worried, anxious and apprehensive. From the onset of his illness, I didn’t think my father was going to make it, my gut ‘nursing’ instinct knew it was his time, whether I wanted to face it or not. I had to put on a brave face and instill hope in my ‘non-nursing’ family members. I tried to “not be that overbearing nurse-daughter” that interrogated the doctors and nurses about his lab results and CT scans, when he was repositioned last or whether he had Tylenol that he requested 45 minutes ago.
Nonetheless, I still needed to balance the needs of my father with my nursing knowledge and the power that the nurse role has. I knew what he needed and I wanted to ensure he was comfortable. He received exceptional care, and for that, I am forever grateful. Never did the staff hint at “his age of 88”. Rather, they gave him every chance at life. Alas, he was able to cross over with minimal suffering. Even so, I grieve.
Stages of Grief
Grief is a broad term used for an individual’s response to a death or loss. It is natural to go through a myriad of emotions during this time. Back in the late 60’s, a revolutionary psychiatrist (Elisabeth Kubler-Ross) sparked a debate over death, a topic that was rarely talked about. Her book, On Death and Dying, pioneered five stages of grief: denial, anger, bargaining, depression, and acceptance. They don’t always occur in a horizontal fashion but can occur in any order, and conceivably on more than one occasion.
Grief will influence many aspects of a person’s life. For me, I have gone through three of the five stages in about a week’s time. At first, I denied he was gone, even though I was there to hold his hand. This quickly turned to anger, and then sadness. Although it is hard to fathom, one day I will be able to accept that he is gone. I know in my heart that bargaining is futile and I will likely revisit all the other stages of grief again.
There are various bio-psycho-social signs that one is grieving. Physical symptoms of mourning can consist of: muscle aches and pains such as headaches, chest tightness, heart palpitations and shortness of breath, low energy and fatigue, change in eating leading to weight loss or gain, over/under sleeping and waning chronic illness.
Cognitive symptoms may include cloudy thinking and forgetfulness, poor concentration, disorientation, distorted thinking, psychosis, and an inability to problem-solve or make decisions.
Social implications can include isolation from loved ones, an absence of longing to attend social outings, and a failure to go to work or school. Emotional symptoms might contain: increased irritability and resentment, feeling numb or detached from others, a fixation on the loss, an inability to experience pleasure, and indicators of depression and anxiety.
Emotional symptoms might contain increased irritability and resentment, feeling numb or detached from others, a fixation on the loss, an inability to experience pleasure, and indicators of depression and anxiety.
As nurses, there are many things we can do to help our patients, or even ourselves and our co-workers, when working through grief.
Some helpful tips to comfort the grieving:
– Provide culturally sensitive care. Our values and culture do not always mirror those we are caring for. Provide resources where needed to help grieving families. Be considerate of the diversity of our patients.
– Become familiar with the different stages of grief. We can provide support by validating that the emotions experienced are a normal part of the mourning process.
– Assess one’s support network. A support system might include family, friends, co-workers, Employee Assistance Programs (EAP), neighbors, bereavement counselors, church members, community centers, and family doctors.
– Help people generate grief rites such as making a memory box or starting a Facebook page where people can share remembrances.
– Know when to assess an individual for complicated grief. Watch for signs of clinical depression, anxiety and suicidal ideation. When grief festers and confines you, is inflated, excessive, incapacitating or crippling; it’s time to seek medical attention and psychotherapy.