When grief is in the job description

Happy nurse's week to all the hard-working nurses! The theme for this year's nurses week American Nurse Association is balance of mind, body, and spirit so I thought I would write about a relevant topic. Nurses are notorious for being the worst patients, and also for not putting their own health as a priority. I recently read an article about the rates of diabetes and heart disease are alarmingly high among nurses, hence the theme for this year's nurses week. This does not come as a shock to me, as the long and variable shifts, make eating and sleeping adequately difficult. In addition the stress and emotional toll of the job can worsen poor eating and lack of sleep. What I find is often overlooked in the conversation about the health of the nurse, is the emotional toll witnessing trauma and grief can take on nurses. Recently there has been more attention to PTSD and mental health issues surrounding witnessed trauma by military, police, firefighters, and other first responders. It seems nurses, however are left out of this conversation. I can say from firsthand experience nurses do witness trauma and grief frequently as part of the job. As a new nurse I had little experience with trauma, grief or death. Sure, I had experienced loss and had taken psychology courses that discussed the stages of grief and issues around death and dying, but it is a completely different experience first hand. As a nurse, unlike some other professions, you are often the only person at the bedside when a patient dies. You are often the one handling the paperwork, calling the coroner, arranging for organ donation services, and doing post-mortum care all while answering the questions of the deceased's family and expected to be composed and collected. While working as an ER nurse the hardest part was witnessing unexpected deaths, especially of children and infants. As mentioned previously as a nurse you have to keep going about your job, even when there are hysterical grieving family members. Every hospital or healthcare organization has different policies on debriefing and dealing with traumatic situations that occur.  My experience is that most of the debriefing that occurs is informal and between peers in the breakroom or after the shift is over. I remember one particular hard end of the shift when we had the loss of a five month old baby. The image of the grieving mother still brings tears to my eyes when I think about it. After the shift the staff went out for drinks together as we often did, as it was a way to be there for each other after this experience. The majority of my bedside nursing was spent in the ER, however nurses in all settings experience loss of patients and grief on many levels. I remember when I was a nursing student doing my clinical rotation at Children's Hospital, my clinical instructor and preceptor who were seasoned pediatric nurses were telling lots of off colored jokes about the children on the wards. My clinical instructor explained to me later that these jokes were a way to deal with the grief. "Sometimes you have to laugh so you don't cry" she explained. I grew to understand that statement more as I saw more sad cases, loss, and death. The emotional toll does wear on you, and there aren't a lot of resources to help you cope, and thus often to deal with it we use humor or just try to block these experiences out. I think we can do better to support our nurses. I think starting a conversation about how we can support our nurses is a start. I also thought I would share this poem written by an ER nurse I read on NPR on her experience with "compassion fatigue"
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