DiversityNursing Blog

As Nurses, death can be a regular, everyday occurrence. But just because we encounter death frequently does not mean that experiencing the loss of a patient won't impact us. In this profession, we care for people when they are at their most vulnerable, and we create meaningful relationships with many of our patients and their families.

When we lose a patient, it’s common for Nurses to experience grief and it can be challenging to navigate the grief you feel. Here are some ways to help you cope with the loss of a patient.

Acknowledge the Loss

Losing a patient is just as real as losing any other person in your life. Try not to minimize the impact the loss of a patient has made on your life. Allow yourself the time to feel your feelings and emotions.

It is normal to experience emotions of sadness, anger, shock, or even disbelief. Some Nurses may also experience physical changes in response to the loss, such as trouble sleeping, nausea and fatigue, anger, or poor concentration. Acknowledging the loss and honoring the person's life can help you move past your grief.

Find Support

Finding support from your peers, colleagues, friends, and family is essential for coping with the loss of a patient. Having a good support system allows you to express your feelings of grief and helps you get some of the emotions you are experiencing off your chest.  

For example, many facilities offer briefings after a patient is lost so that all healthcare team members can express their thoughts and feelings and discuss how to improve patient care in the future. In addition, some Nurses may find that speaking with a therapist or grief counselor can help them navigate feelings and offer support after experiencing the loss of a patient.

Practice Self-Care

Grief can often manifest itself physically, so it is essential to prioritize your physical health after losing a patient. Nurses should get adequate sleep, eat healthy, and exercise regularly to maintain their physical well-being. In addition, some Nurses find that meditating or practicing yoga can help heal the mind and body.  

Take a Break

Death is an emotional experience, and as Nurses, we are only human. It is not unreasonable to feel all the emotions surrounding the loss of a patient. It is OK to take a break when things get tough. If you are overwhelmed with emotions after losing a patient on the job, it’s ok to take a break to cry, take a walk, or call a friend to talk. It is important to care for your personal needs so you can get back to taking the best care of your patients.

Coping with the loss of a patient can be challenging, but the first step in learning to cope is acknowledging that grief is a normal reaction to any loss. Acknowledging your feelings, seeking support, practicing self-care, and knowing when you need to take a break can help prevent Nurses from experiencing burnout and get you back to providing your patients with excellent patient care.

The holidays are a joyful time but also a stressful time for many people. The pandemic has also added an extra layer to the holiday blues. So here are some tips for managing this season's stressors.

According to Psychology.org, common symptoms of the Holiday Blues are:

Symptoms often begin in November and last until the start of the new year.

Triggers of stress vary for each person but many common themes arise this time of year such as finances, family gatherings, isolation and loneliness.

The thought of holiday spending is unquestionably stressful, but with a little planning, you may be able to alleviate some of that stress.

Budget - creating a budget is most important. Understand what you have for resources and then prioritize. For example, make a list of the people you need to buy gifts for, figure out how much money you have to work with, then allocate your resources in order of priority.

Plan and shop early. It's usually a good idea to start buying gifts earlier in the year. When you see that certain item on sale months before the holidays, grab it. It can be overwhelming hunting down limited items and spending a lot in a short amount of time.

Also don't stress about cutting back on pricey gifts. The important people in your life will recognize that, ultimately, it's still the thought that counts.

For many people, the pandemic is adding to the typical holiday stress of navigating how to approach family gatherings.

Discussing family plans in advance is always a good idea. If you're feeling stressed about attendees being vaccinated or not, try keeping the gathering immediate family only and utilize facetime tools to include those who couldn't be there this year.

If traveling to see loved ones is stressing you out, consider inviting them to your home.

Are there family members who are choosing to skip the full-fledged family gathering? Try spending time with them on other days throughout the holiday season or meet for a meal or some other meaningful activity.

Sending greeting cards to your loved ones during this time of year is another great way to let them know you are thinking of them.

People who don't have the opportunity to gather with loved ones this year may be feeling bouts of loneliness and isolation.

Try taking some extra special care of yourself. It may not completely erase feelings of loneliness, but self-care can help you feel better. Whether you take a relaxing bath, read a good book, practice your favorite hobby, or learn something new, doing something for yourself is important during stressful times.

Volunteer – it’s a great way to beat loneliness. Spend time volunteering at local shelters, fundraisers, and even animal shelters. There are plenty of charities that could use an extra hand during this busy season of giving.

In addition to the stress and anxiety caused by the holidays, many people suffer from seasonal affective disorder (SAD).

According to the National Institute of Mental Health (NIMH), SAD is a type of depression that comes and goes with the seasons, typically starting in the late fall and early winter and going away during the spring and summer. People who suffer from SAD typically see the onset of symptoms annually, coinciding with the same time we roll our clocks back.

Treatments are available that can help many people with SAD. They fall into four main categories that may be used alone or in combination:

• Light therapy
• Talk therapy
• Medications
• Vitamin D

Talk to your health care provider about which treatment, or combination of treatments, is best for you. With these tips, hopefully you’ll have a happy and less stressful holiday season!

Frontline healthcare workers face stressors during normal times, but especially now during a pandemic and hospitals are finding new ways to help their staff cope. 

Recently, University Hospitals in Ohio announced they would be trying out a 10-month pilot program that provides sleep pods for their teams. Doctors, Nurses and staff in the UH Cleveland Medical Center Emergency Department will have access to two HOHM units as a space to safely recharge.

Each 43.5 square-foot pod is designed to block out sound and features a twin-sized bed, a privacy and sound-blocking curtain, charging stations, and a tablet to control reservations. 

“Our UH Cleveland Medical Center Emergency Department frontline caregivers have been working tirelessly for months to combat the COVID-19 pandemic,” said Robyn Strosaker, MD,, University Hospitals Cleveland Medical Center Chief Operating Officer. “In the midst of all this trauma and stress, we’ve continuously looked for new ways to support our team, and HOHM sleep pods are a way we can help address their wellbeing.”

Some hospitals are making design changes to their break rooms as a way to try and help healthcare workers manage their stress throughout the day. 

Nurses may be reluctant to take breaks especially during times of crisis. But taking breaks during your shift can help prevent burnout. So when a Nurse does decide to take a break, there should be a space where they can fully decompress and have time to gather their thoughts and recharge. 

Research has found strong evidence between exposure to natural environments and recovery from physiological stress and mental fatigue. Break rooms are becoming a green space with plants and images on the walls of natural landscapes. Create a sitting space with cushioned chairs or ottomans by windows that have a nice view outside. Offer the option of listening to calming music or nature sounds inside the break room. 

Hospitals are also offering time for their staff to spend with support animals. 

Nonprofit organization Canine Companions for Independence provided Jordy, a lab/golden retriever cross to help frontline workers at Santa Rosa Memorial Hospital. 

“The science confirms what we already know, pets provide comfort and support during hard times,” said Jessica Lacanlale, MSN, Trauma Program Manager at Santa Rosa Memorial Hospital. “The stress of caring for patients and working long hours is intense; but spending a little time with Jordy lifts my spirits and helps me get through the long days.”

Health Systems like Yale New Haven Health are offering confidential well-being check-in programs. This offers employees an opportunity to meet with an expert social worker or clinician one-on-one to discuss their needs and access resources to manage stress and improve well-being.

“People often downplay their own needs, saying ‘I’m OK’ when asked how they are doing,” said Javi Alvarado, YNHHS’ director of social work and co-chair of the WELD Council. “These visits create an opportunity to be better than ‘OK’ and truly grow from recent challenges.” 

During this pandemic, it is critical hospitals and health systems recognize what stress looks like and takes steps to help their staff cope with it. Equally as important is that healthcare workers know where they can go for help. This means internal communications to staff is key to express your awareness of the stress and the assistance being offered.

In order for a healthcare system to be successful in having high engagement, job satisfaction and retention, the Nursing workforce should be able to combat the stressors of the job and burnout.

Nurses can better accomplish this by having help from peer support groups and mindfulness programs.

According to a report from the National Academy of Medicine (NAM), between 35% and 54% of Nurses and Doctors experience burnout. Among medical students and residents, it is as high as 60%.

Symptoms, the NAM report said, include emotional exhaustion, cynicism, loss of enthusiasm and joy in their work and increasing detachment from their patients and the patients’ ailments. The problem has been linked to higher rates of depression, substance abuse and suicide.

Many institutions are implementing stress management and self-care programs to provide caregivers with easy-to-use tools and resources to build their resilience and help them cope.

The Cleveland Clinic Abu Dhabi implemented a new mindfulness program known as the ‘Compassionate Intension Program.’ The sessions introduce caregivers to mindfulness as a wellness tool they can utilize in both their workplace and personal lives. Currently, there are three sessions in place:

• In Tune Tuesdays: Held biweekly, ‘In Tune Tuesdays’ are 20-minute classes designed to further educate attendees on mindfulness and how to improve mindfulness in their work environment. The classes are held at three different times to accommodate caregiver schedules.
• Mindfulness Rounding: Also a biweekly activity, ‘Mindfulness Rounding’ features a team of mindfulness experts who visit clinical units. The experts conduct learning huddles and one-on-one conversations with caregivers, sharing quick tips. Their pocket cards or guides offer information on easy-to-implement mindfulness techniques.
• Introduction to Mindfulness Workshop: This 8-week workshop, featuring 1-hour weekly sessions, was developed around the evidence-based standards of mindfulness experts, including, Jon Kabit-Zinn, PhD, of the University of Massachusetts Medical School, Center for Mindfulness, and Richard Davidson, PhD, of the University of Wisconsin’s Center for Healthy Minds and Oxford University’s Mindfulness Center. It offers a deeper dive into various mindfulness techniques.

Johns Hopkins Hospital, Pediatric Nurse, Cheryl Connors, RN, MS, created a peer program to provide immediate support for health providers affected by stressful cases.

The Resilience in Stressful Events (RISE) program was developed with a Pediatric Chaplain, a Patient Safety Director, a Doctoral Student, and General Internist Albert Wu, MD, FACP.

According to the American College of Physicians, the RISE program provides a team of 39 peer responders who volunteer their time to support those who call the service. RISE team members include Nurses, Doctors, Nurse Practitioners, Respiratory Therapists, Pastoral Caregivers, and Social Workers. They undergo didactic, video-based, and role-playing training.

The team has been called by more than 700 Johns Hopkins employees. The hospital previously had a program offering free professional counseling but, Ms. Connors said, “They actually prefer somebody who knows what they're going through—another health caregiver who can relate—and when they need it, not a week later.”

As supporters of patients and their families, Nurses deal with a lot of stress. Health systems can help their Nurses by surrounding them with support and offering them the tools to overcome and cope with stress so they can provide the best care for their patients and for themselves.

The holidays are meant to bring feelings of joy and cheer, but this time of year can also bring a lot of stress. No matter what holiday you celebrate, this season can affect us all. Especially Nurses, who work in an already stressful environment, as you juggle more difficult demands of your time, emotions and patience. 

Most people celebrate the holidays with family and friends at home, but you miss many holidays to take care of your patients. Having celebrations with your coworkers is nice, but nothing feels like home. Some families will try to move dates around so they can all celebrate together.

If you're missing holidays to treat patients, then those patients are missing out on their holiday celebrations too. Spreading extra holiday cheer can make you both feel some joy. Fortunately, you get to go home at the end of the shift.

Another stressor can be financial as people go crazy buying gifts and worry how to pay for them. Try not to overspend. Perhaps you’re crafty and can make some of those gifts.

The loss of loved ones is more difficult this time of year. In your profession, you witness the passing of patients and often you’re coping with your own feelings of loss as you try to console the family. Lean on fellow coworkers and managers to help relieve some of the stress. Don't hold it all in and try to get through it alone.

In colder climates, as the season changes to winter, many people are affected by SAD seasonal affective disorder. With less daylight, spending more time indoors and the sense of isolation it can bring, dealing with the cold, and extreme weather conditions, can be quite depressing unless… you love outdoor winter sports! To combat SAD, try light therapy, exercise, planning social get-togethers, talking to a mental health professional, or using medication to help lighten your mood.

The Mayo Clinic offers more tips to help with holiday stress.

• Acknowledge your feelings. It's OK to take time to cry or express your feelings. You can't force yourself to be happy just because it's the holiday season.
• Reach out. If you feel lonely or isolated, seek out community, religious or other social events.
• Stick to a budget. Before you go gift and food shopping, decide how much money you can afford to spend. Then stick to your budget. Don't try to buy happiness with an avalanche of gifts.
• Learn to say no. Saying yes when you should say no can leave you feeling resentful and overwhelmed. Friends and colleagues will understand if you can't participate in every project or activity.
• Don't abandon healthy habits. Don't let the holidays become a free-for-all. Overindulgence only adds to your stress and guilt.
• Take a breather. Make some time for yourself. Spending just 15 minutes alone, without distractions, may refresh you enough to handle everything you need to do. Find something that reduces stress by clearing your mind, slowing your breathing and restoring inner calm.
• Seek professional help if you need it. Despite your best efforts, you may find yourself feeling persistently sad or anxious, plagued by physical complaints, unable to sleep, irritable and hopeless, and unable to face routine chores. If these feelings last for a while, talk to your doctor or a mental health professional.

At the end of the day, no one is going to be happy around you if you’re not happy. It’s so important to take care of YOU. We’ve offered some suggestions to help you deal with stress during the holidays. Now it’s up to you to choose what will work for you. Good Luck!

Happy Holidays, Peace and Joy from your friends at DiversityNursing.com!