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... ... middle of paper ... ... 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
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.
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.
In 1969 Elisabeth Kübler-Ross, a psychiatrist, published the Pioneering book On Death and Dying. The work acquainted the world with the grieving process, called the five stages of grief. Kübler-Ross gathered her research from studying individuals with terminal cancer (Johnson, 2007). The first stage of the grieving process is denial. In this stage the person refuses to believe that their loved one is deceased, a common thought during this period is, “This can’t be happening to me” (Johnson, 2007).The second stage of the grieving process is anger. In this level the person becomes frustrated with their circumstances, a customary complaint is “Why is this happening to me?” (Johnson, 2007). The third stage of the grieving process is bargaining. At this point the individual hopes that they can prevent their grief, this typically involves bartering with a higher power, and an ordinary observance during this time is “I will do anything to have them back” (Johnson, 2007). The fourth and most identifiable stage of grief is depression. This phase is habitually the lengthiest as...
Pediatric oncology nurses are given the unique opportunity to make connections and build long-term relationship with their patients and families. Standard treatment protocol for many childhood cancers span over the course of years, with long-term surveillance and follow up visits after treatment has finished. Due to their patient’s chronic diagnoses and the acuity of their conditions, pediatric oncology nurses work in an environment of increased stress. The high stress environment puts the nurses at an increased risk for compassion fatigue; so it is the responsibility of both the nurse, and the institution to be aware of the symptoms and to effectively manage the condition should it arise. Without proper attention to the stress management of pediatric oncology nurses, compassion fatigue may be of concern and put patient care at risk.
...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.
It reflects trust, intimacy, and responsibility, which are elements essential to any nursing relationship. It is the core of nursing. In the article, “Dimensions of Caring: A Qualitative Analysis of Nurses’ Stories”, an analysis was done on over two hundred stories submitted by nurses around the world, illustrating the point that the practice of nursing encompasses much more than just technical skills. In one of the stories, a nurse stood by the side of a young mother grieving the loss of her baby with nobody else to turn to. This nurse accompanied the 19 year old mother to the cemetery the day after the baby’s death, New Year’s Eve, to bury her baby that had been born at just 22 weeks gestation. She bought her a book on grieving and loss and supported the woman during that difficult time. This nurse did not have to do that—she did not have to go above and beyond for this stranger. But she did. She felt empathy and compassion for this woman and she acted on that. That is what nursing is about, going above and beyond, making emotional investments into the lives of other people. The significance of the actions of this nurse cannot be overstated. We will never know the full impact that this nurse made on that young woman’s life; perhaps she saved her life, or changed the direction of it for the
pass away. Pediatric nurses must also witness the fear, sadness and emotional pain of children
Lynn, J. (2008). Improving care for the end of life: A sourcebook for health care managers and clinicians. Oxford: Oxford University Press.
The pediatric oncology unit has become a heavily studied area for those interested in prevention of compassion fatigue, burnout, and identification of those character traits that offer increased resilience. Nurses are expected to maintain professionalism and appropriate work-life balance but this may become a difficult task on a unit where children have a chronic, intensive, and potentially life-ending condition. Nurses become close to the patient and their family and when death occurs they too may feel a great sense of intense grief and loss. The acknowledgment of this grief and the promotion of adequate self-care habits, work-life divisions, and the ability to recognize when help may be needed are amongst the most important means in prevention of burnout and compassion fatigue. In addition to utilization of positive coping skills by the nurse a responsibility by the organization is also necessary to prevent staff burnout and turnover. The organization is responsible for acknowledgement of a loss on the unit. Presentation of prompt and anonymous counseling services to everyone on the unit following a death and regularly on high-risk units is just one of the many ways an organization can continue to decrease the loss of good nurses to compassion fatigue and
The field of nursing provides one the opportunity to make a difference in the lives of others. Nurses interact directly with patients at times of hardship, vulnerability, and loss. The nursing profession has been around for decades. Due to the contribution from historical leaders in nursing, the nurse’s role has progressed over time. Although the roles of nurses have evolved throughout the years, one thing has remained the same: the purpose in giving the best patient care.
... support for people with cancer. The story of the patient and his family is inspiring, encouraging, informative, also comforting, all at once. This book has given me new understandings as a student nurse about how I should look at our patients, their families, and their caregivers. As a family member that played the role of caregivers they took their concerns and fears to God, they had the strength and courage to face their painful journey. I learned how to deal with the most complex of challenges which includes fear, denial, and how to find the way to spiritually prepare the patient and the caregivers. The most important part that cough my attention was the genuine compassion from the nurses changed and helped the family to reach that internal peace by giving the greatest care to the terminally ill and encourage the family to find the spiritual peace and comfort.
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...
Newsome, B. R., & Dickinson, G. E. (2000). Death experiences and hospice: Perceptions of college students. Death Studies, 24(4), 335-341
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
Ruth presented aspects of “An education model for explaining hospice services” (Welk, 1991). She discussed the four dimensions of support for the patient and family within hospice care, which are physical, emotional/psychological, social, and spiritual and gave examples of how the various dimensions of support could occur. She explained the purpose of hospice is to allow the patient to live as full as possible and comfortably until the end of life. She explained hospices services takes the “…conflict out of social situations, helps to subside the fear emotionally, attempts to remove as much pain physically and addresses decreasing despair spiritually thus easing the suffering” (Welk, 1991, p. 16) of the patient and