Grief and Oncology Nursing
My earliest experiences of observing nursing in action occurred during my last two years of high school. My father was diagnosed with cancer during the spring of my junior year and died right before my senior year. During that short time I watched as the nurses cared for him and I could see compassion and empathy in the way they looked at him. It never occurred to me until after I had raised my children that I wanted to be able to help people in the same way those nurses helped my dad. But now when I tell people that I want to be an oncology nurse, people often respond by saying that they would never choose that type of nursing. They say that they could not stand to watch their patients die so frequently. Their reactions, along with this course in death and dying, have made me question how I might be able to bear the challenges of nursing in an area where death of my patients may be common. I believe that oncology will be a positive specialty to work in because of the consistent advances in prevention, early detection, and treatment of cancer. Furthermore, I believe that William Worden’s four tasks of mourning as presented in our text book is a good framework for the oncology nurse to use in order to cope with the repeated losses inherent in this type of nursing (Leming and Dickinson, 2011).
The American Cancer Society publishes current advances made in cancer research on their website. Many of the exciting discoveries about how best to treat the disease focus on the genetic aspects associated with certain types of cancer. In addition, treatments aimed at genetic solutions to cancer may be more effective and may cause fewer adverse side effects than traditional cancer treatments (American Can...
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... four tasks of mourning are good guidelines to help nurses in this specialty to continue to care for patients with empathy, yet not be overwhelmed with sorrow.
References
American Cancer Society. (2014). Explore research. Retrieved from http://http://www.cancer.org/research/index
Boyle, D. (2000). Pathos in practice: exploring the affective domain of oncology nursing. Oncology Nursing Forum, 27(6), 915-9. doi: 0190-535X
Leming, M., & Dickinson, G. (2011). Understanding dying, death, & bereavement. (7th ed., pp. 471-4). Belmont, California: Wadsworth.
Papadatou, D., & Bellali, T. (2002). Greek nurse and physician grief as a result of caring for children dying of cancer. Pediatric Nursing, 28(4), 345-53, 363-4. doi: 2003016885
Puckett , P., Hinds, P., & Milligan, M. M. (1996). Who supports you when your patient dies?. RN, 59(10), 48-50, 52-3. doi: 1996037794
After reading the different stories in the book “Final Gifts”, I believe I have a better understanding of the nurse’s role in caring for the needs of the dying patient and how their families need to be guided through this experience. The different stories in this book provide insight into the experiences of the dying as well as how their loved ones cope with their loss. The authors Maggie Callahan and Patrician Kelly, experienced hospice nurses who have extensive exposure to dying patients and their families, through their shared stories, paint a picture of what the dying want. To many, death is a difficult concept.
On February 14th I spent a day doing something I never thought I would do in a million years, I went to hospice. I always thought I would hate hospice, but I actually didn’t mind it too much, it isn’t a job I see myself doing in the future but it is a job that I understand why people do it and why they enjoy it. During this observation I was touched by how much these nurses really seem to care for each of the patients that they have.
Compassion fatigue is a complex form of secondary traumatic stress often experienced by nurses and other health care professionals due to their stressful work environment. Compassion fatigue is extreme exhaustion that penetrates all aspects of one’s wellbeing, including the physical, emotional, psychological and spiritual aspects of life (Murphy-Ende, 2012). Dealing with children who are both chronically ill or in palliative care is known to be extremely stressful. Not only are nurses faced with dealing with the physical symptoms of their patients, they also must attend to their fragile emotional state and be of assistance to their anxious family members. Oncologic diagnoses can put a child and their family into turmoil. Since the nurse is the first, and most constant point of contact, they are often the ones who become responsible for ensuring well-being of the entire family throughout the ...
Vachon Mélanie, Lise Fillion, and Marie Achille. "Death Confrontation, Spiritual-Existential Experience and Caring Attitudes in Palliative Care Nurses: An Interpretative Phenomenological Analysis." Qualitative Research in Psychology 9.2 (2012). 151-172. Academic Search Complete. Web. 22 Oct. 2013.
...nate in their work and genuinely care for their patients, but to do this they must set professional and personal boundaries and be aware of the effect pain; trauma and death may have on their lives. According to Bush (2009), nurses must learn forgiveness and love themselves to prevent and overcome compassion fatigue. “Nurses should treat themselves with the empathy and compassion that they give others” (Bush, 2009, p. 27). Nurses should take time to nurture themselves by maintaining a healthy lifestyle and diet. They should also continue to participate in activities that they enjoy, get plenty of rest, and have a sense of self-awareness throughout their career. Additional resources are available to any caregiver to educate themselves on compassion fatigue at The Compassion Fatigue Awareness Project’s web site at http://www.compassionfatigue.org/index.html.
Humanity has long experienced grief after death; however, only recently has the realm of anticipatory or preparatory grieving been explored to any degree. Our article below covers several aspects that may help those going through such a life event recognize the most common underlying symptoms and understand the process. Hopefully, it will help not only the families affected but the very loved one that soon will not be a part of the family unit.
...spectives Of Bereaved Family Members On Their Experiences Of Support In Palliative Care.” International Journal of Palliative Nursing. 19.6 (June 2013): 282-288. Academic Search Premier. Web. 5 Nov. 2013.
Some of the current issues surrounding paediatric palliative care is that health care providers, mainly nurses are feeling the burnout and frustrations of caring for a dying child. Many nurses have claimed to have moral and ethical distress which in turn, can lead to feelings of helplessness and anger (Morgan, 2009, p. 88). Health care providers may also feel personal pain during the care of a dying child (Morgan, 2009, p. 88). Many health care providers and families feel like there is a lack of communication about the disease and treatments the child is receiving, as well as the patients often feel like they do not have a voice about treatments (Hsiao, Evan & Zeltzer, 2007, p.361). The lack of education and knowledge about paediatric palliative care leads to society treating the subject of paediatric palliative as taboo and forbidden to talk about because no one wants to admit that children unfortunately die (Morgan, 2009, p. 87).
Loss is an inevitable part of life that everyone goes through. As a nurse, it is my duty and obligation to have an understanding of what each of my patients’ reactions and responses are in order to help them in their grieving process. Each person deals with grief differently, in their own way and their own time. It is a process that people will experience at some point in their life. No two people are going to experience the same grief. Grieving is not an easy process, therefore, it is important for the individuals experiencing grief to know that they are not alone. It is important to express their emotions and feelings in order to gain acceptance of the situation and to facilitate healing.
My first encounter with hospice was on the receiving end and I remember asking the hospice nurse that first day, “How can you do this every day?” I will never forget her answer, “Hospice is not about dying, it’s about affirming life, helping people live their last days to the fullest.” During the next several months, I began to understand how true her words were. Today, as a volunteer, those words echo in my mind each time I’m about to meet a new patient.
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.
Newsome, B. R., & Dickinson, G. E. (2000). Death experiences and hospice: Perceptions of college students. Death Studies, 24(4), 335-341
Nurses work in many situations where they will observe patients and their families experiencing grief and loss. In order for patients to receive the utmost care it is imperative for nurses to have a comprehensive knowledge and understanding of these theories and the stages of grief and loss to facilitate support to their patients and their patients families.
Upon receiving MM in to care I was focused on caring for an acute care client and not one at the end-of-life. In reflection I felt that my client was not going to live much longer, but I did not know it would be only a few short hours after I left my shirt that she did pass away peacefully (this was share with me from a fourth year nursing student who was at her side when she died). Unfortunately I was not able to meet or communicate with MM’s family to help support them through this transition of life. I was able o come to know that MM had 5 supportive children and an elderly husband whom come to visit after my shift. This was comforting to know that they were able to say their good bye. As far implementing healing initiatives, I felt
The nurse stated during the interview that “holding the hand of the patient just diagnosed with a terminal illness” (Appendix A) is difficult and requires a variety of techniques to face the situation. There are many ways to approach a dying patient, and one study identified four themes that help nurses in creating a “’curtain of protection’ to mitigate the grieving process and allow them to provide supportive nursing care” (Gerow et al., 2010). Of the four approached, there is one that appears to make the greatest impact on the nurse; the fact that initial patient deaths are formative. In this case, a study found that “significant death experiences early in a nurse’s career set the foundation for how the nurse began caring for future dying patients” (Gerow et al., 2010), which was further explained as the fact that those who had enough support and mentorship early on in their nursing practice were more likely to not be emotionally damaged by the event, and were able to better approach similar situations in the future. I plan on implementing this strategy in the future by surrounding myself with colleagues and mentors within my practice that I am comfortable confiding in whenever I happen to be struggling. A strong support network is key for maintaining proper emotional health, which is important for a nurse to have when working with vulnerable patients and providing competent