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Nurses are both blessed and cursed to be with patients from the very first moments of life until their final breath. With those last breaths, each patient leaves someone behind. How do nurses handle the loss and grief that comes along with patients dying? How do they help the families and loved ones of deceased patients? Each person, no matter their background, must grieve the death of a loved one, but there is no right way to grieve and no two people will have the same reaction to death. It is the duty of nurses to respect the wishes and grieving process of each and every culture; of each and every individual (Verosky, 2006). This paper will address J. William Worden’s four tasks of mourning as well as the nursing implications involved – both when taking care of patients’ families and when coping with the loss of patients themselves. The Four Tasks of Mourning According to Leming and Dickinson (2016), in 1982, J. William Worden proposed the idea of a task-based mourning system, rather than a linear one. It is common for those experiencing grief to deny the death altogether. Many people do this by avoiding situations and places that remind them of the deceased (Leming & Dickinson, 2016). However, by simply avoiding the topic of death and pain, the mourner only achieves temporary relief while in turn creating more permanent lasting agony (Rich, 2005). In this stage, mourners will begin to feel the full weight of the circumstance. Whether the death of a loved one was sudden or long-term, survivors will feel a full range of emotions, such as sadness, guilt, anger, frustration, hopelessness, or grief. While many of these emotions can cause serious suffering, it is important for the survivor to feel whatever emotions come up and deal with those feelings, rather than trying to suppress any
Final Gifts, written by hospice care workers, Maggie Callanan and Patricia Kelly, includes various stories detailing each of their life changing experiences that they encountered with their patients. Hospice care allows the patient to feel comfortable in their final days or months before they move on to their next life. This book contains the information considered necessary to understand and deal with the awareness, needs, and interactions of those who are dying. Not only are there stories told throughout the book, there are also tips for one to help cope with knowing someone is dying and how to make their death a peaceful experience for everyone involved. It is important that everyone involved is at as much peace as the person dying in the
God tells his children, “He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away” (Revelation). Death is one of the most frightening and confusing times a person can go through. Watching a loved one pass away is also one of the hardest trials a person can experience. Many people assume that death is a time of pain and the only thing that they can do is mourn and watch their loved one fade away from the earth. This is wrong. There are ways that people can turn a bad situation to good. Dying doesn’t have to be painful and full of suffering. The County Hospice staff makes sure of this. The Hospice staff not only takes care of passing patients physically, but they also take care of the patients emotionally and spiritually. Hospice staff also plays a key role in helping families during the grieving process.
As a nursing student, I have had some exposure to death during patient care. My first encounter with direct death was witnessing a patient after attempted resuscitation efforts die in the emergency department. As I observed others reactions, I noticed I was the only one who seemed fazed by the preceding events and the end result, although I didn’t show it outwardly. During my Aging and End of life clinical rotation, I have been exposed to a near death experience with a family and I had the rewarding experience of forming a relationship with the patient’s wife during the short hour I was in their home. From reading the accounts in this book, it confirmed to me the importance of catering to the needs of the family and the dying as an important issue to address as they are critical to overall care.
The preface focuses on the type of care Hospice provides for the patient and family, while the section entitled "Hospice is..." provides a detailed definition of hospice.Chapter One demonstrates the sensitivity a hospice nurse must use when dealing with new patients and how the nurse must remain unbiased at all times. Chapter Two reviews the family emotional strains and stresses which can be experienced when a loved one is dying within the home and how different people deal with the change. In Chapter Three we can develop a deeper understanding of an individual's strength and acceptance through the story of Karen, a seven year old who is dying from cancer. The different coping mechanisms expressed by Karen's parents are very contrast dramatically as the needs of survivors vary.Chapter Four highlights patients' need for control and decision making over his or her own life. In Chapter Five, Henrietta, the patient had very little control over her treatment and pain because her husband refused to accept her dying, until Janice (hospice nurse) promised her dignity during death. In Chapter Six, William tries a new method of pain control and his spirits are lifted as he once again has some control in his life as expressed in his statement, "I can't believe the power I have"(1, p.194).
The American Nurses Association (ANA) thinks that nurses should stay away from doing euthanasia, or assisting in doing euthanasia because it is against the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001; herein referred to as The Code). Overall, nurses are also advised to deliver a quality of care what include respect compassion and dignity to all their patients. For people in end-of-life, nursing care should also focus on the patient’s comfort, when possible the dying patient should be pain free. Nurses have also the obligation to support the patient but also the patient’s family members during these difficult moments. We must work to make sure that patients and family members are well informed about every option that is
Granted, textbooks and nursing classes deal with death, but Marks explains that you do not really understand it until it is right in front of you. Overtime it becomes something that nurse’s become accustom to. To clarify the subject of death never becomes easy, it just becomes bearable. After 31 years of experience Marks explained to me that nurses have to learn how to distance themselves, yet still be caring at the same time; a trait that does not come easily to most. In the same way treating someone with a terminal illness is just as hard. In these cases nurses must step into the role of councillors. They must learn how to comfort their patient, yet not become too attached. As well they must learn how to explain to them what is happening, which can become especially hard when dealing with
Mourning is not just confined for the death of a person but can be extended to such things as a job lost or the breakup of a relationship. This second beatitude asks us to be concerned about the pain and suffering of others no matter how small we may see it to be. When we take the time to care for those who may have lost a loved...
End of life care in the Intensive Care Unit (ICU) can be very stressful for ICU nurses due their need to rapidly transition from curative care to end of life care, therefore the interventions they choose are very important. The qualitative study “A Study of the Lived Experiences of Registered Nurses who have Provided End-of-Life Care Within an Intensive Care Unit,” by Holms (2014), explores the experiences of ICU nurses who have provided end of life care to dying patients and their families in the ICU. End of life care according to Radbruch and Payne, is “synonymous with palliative care yet it is more specific to acutely unwell patients who require palliative care in the last few hours, days or weeks of their lives” (As cited in Homs, 2014, p. 549). Sadly, patients in the ICU are critically or terminally ill, and most are unable to plan their own end of life care. Therefore, nurses in the ICU are needed to help guide patients and family members through this process. According to Wright, “95% of patients within the ICU may not have the ability to make informed decisions” (As cited in Holms, 2014, p. 549). The discussion of end of life care in the ICU continues to be a very controversial because care is highly inconsistent due to conflicting opinions on what to base the care for the patient.
The end-of-life nurse’s primary objective is to provide comfort and compassion to patients and their families during an extremely difficult time. They must satisfy all “physical, psychological, social, cultural and spiritual needs” of the patient and their family. (Wu & Volker, 2012) The nurse involves their patient in care planning, as well as educating them about the options available. They must follow the wishes of the patient and their family, as provided in the patient’s advance directive if there is one available. It is i...
The nurse becomes the confidant, the guide through the darkness, a source of comfort for those experiencing the trauma of losing a child. To successfully fulfill these nursing roles, in addition to roles that must be fulfilled to meet other patient’s needs, one must acknowledge their own definition of death and educate themselves on cultural and societal norms associated with death and dying. It is important to identify one’s own definition of death and dying but also understand that one’s preference does not define the death experience for others. The individuality and uniqueness of each death experience means that one definition of death may be hard for one to accomplish. It is important to maintain an open mind, nonjudgmental spirit, and impartiality for the cultures and practices of others surrounding death and dying. A culturally competent nurse is not only responsible for acknowledging the cultural norms of others but also respecting and educating themselves about the death rituals of their patient’s culture and providing the family with as many resources to safely and effectively fulfill their cultural practices. Education is empowering for the nurse who is navigating the death and dying process. Education often supplements ones credibility with the dying patient and their family which can ease overall anxiety and further promote ones role as a patient advocate and provider of
The characters in Alice Sebold’s The Lovely Bones are faced with the difficult task of overcoming the loss of Susie, their daughter and sister. Jack, Abigail, Buckley, and Lindsey each deal with the loss differently. However, it is Susie who has the most difficulty accepting the loss of her own life. Several psychologists separate the grieving process into two main categories: intuitive and instrumental grievers. Intuitive grievers communicate their emotional distress and “experience, express, and adapt to grief on a very affective level” (Doka, par. 27). Instrumental grievers focus their attention towards an activity, whether it is into work or into a hobby, usually relating to the loss (Doka par. 28). Although each character deals with their grief differently, there is one common denominator: the reaction of one affects all.
In Straight Talk About Death and Dying, Robert DiGiulio and Rachel Kranz explain that, “as reality creeps in, all sorts of feelings emerge and people respond in many ways,” citing embarrassment, anger, loneliness and depression as some of the assorted feelings that may emerge. It is critical to note that these reactions are completely normal reactions to such a devastating event and that they should be treated as such. Individuals should allow these feelings to be fully felt and dealt with so that they may move on with the healing process. “It is important to remember that the anger surfaces once you are feeling safe enough to know you will probably survive whatever comes,” Kübler-Ross and Kessler explain. Not all of the emotional reactions that arise from a loss or the anticipation of a loss may be tied to the actual loss. Some individuals, like Baldwin in Notes of a Native Son, choose instead to cling to the feelings that they may have fostered previously towards the dying or the deceased in order to try to maintain a sense of normalcy, “I imagine that one of the reasons people cling to their hates so stubbornly is because they sense, once hate is gone, that they will forced to deal with
There are a number of theorists with a range of views on the grief process. They have developed various models to support clients dealing with grief and loss. The key theorists are William Worden, Robert Neimeyer, Pauline Boss, Elisabeth Kubler-Ross, Mal and Dianne McKissock and George Bonanno, among others. This essay will focus specifically on the theories and practices of Kubler-Ross, McKissock and McKissock and Bananno and show the contrasting views of each. It will also show how the theory of ambiguous loss relates to grief and which theories would work best with this theory.
In discussing theories of grief it should be noted that a theory, in and of itself, is a technique used to map out, explain and understand an event or process. Most individuals experience grief in a subjective manner depending upon events surrounding the death, support, spirituality, personality and unique situation of their own life (Jackson-Cherry & Erford, 2014). However, most will experience similar attitudes and feelings with the many aspects of the grieving process. I like the way Worden approaches the grief process in that it seems natural and humanistic. Worden views the individual experiencing grief and loss as participating in an active and engaged process and not merely stages one must pass through (Jackson-Cherry & Erford, 2014). He indicates that while trying to construct a sense of homeostatic balance individuals will take part in four tasks of mourning (Lista, 2013). The tasks are listed in a particular order although individuals may proceed through them in any random order according to Jackson-Cherry and Erford (2014). Additionally, they indicate one may find themselves frequenting or working through one or more of the tasks more than once and may experience a more cyclical progression of grief. Worden leads me to visualize grief as a dynamic and ongoing process rather than a static or one time event. Jackson-Cherry & Erford (2014) say the first task, after the initial impact of a loss, comes in the form of acknowledgment that a loved is gone and is not going to return. The second task revolves around allowing one’s self to experience all the emotions they will encounter. Worden suggests, according to
Upon acknowledging that the palliative patient had passed away, the feeling of agony and confusion appeared. The feeling of agony because of the death of a patient and confusion over what I had just seen. The sense of confusion left me acting quiet and reserved. I was self-aware of my feelings and behaviour towards the death of a patient. The feelings that occurred after seeing the dead body of the patient were a recurrence to the last memories of my grandfather. Being present beside the deceased patient felt like a painful flashback to when I sat beside my terminally ill grandfather and said my final goodbyes in Hospice. I acknowledge that my personal experience of the death of my grandfather produced the same feelings of agony and confusion that I felt after witnessing a lifeless patient. The feelings were influenced from a similar previous situation. The only difference between the two scenarios is that despite his cold skin and pale body, my grandfather was still alive, and the patient was already dead. My parents pulled me from the room before my grandfather passed away. The observation of the patient’s lifeless body finalized the memory of my dying grandfather and perceived the feeling of closure. My reaction to the death of the patient was a reflection on my grandfather’s death. As a result of identifying and recognizing the factors that influenced my