Advice and development

A crash course in grief

Many nurses feel ill-equipped to help patients and families deal with loss. Nicola Davies looks at some misconceptions.

Many nurses feel ill-equipped to help patients and families deal with loss. Nicola Davies looks at some misconceptions.

Nurses provide compassionate care for people during times of suffering, so it is inevitable that you will witness the grief of patients and their families or carers in your career.

Many nurses accept that grief counselling is part of their role, but others feel ill-equipped to provide it, afraid to intrude or add to the pain of grief. Common misconceptions about the grieving process can act as a barrier that prevents staff reaching out to those affected by loss. Here we debunk some of these myths.

‘Grief is just an emotion’

Grief encompasses a range of physical and emotional reactions. Physical reactions include changes in appetite and sleeping patterns, upset stomach, muscle tension, restlessness or low energy, and tightness in the chest.

Emotional reactions include numbness, confusion, anger, sadness and anxiety.

A belief that grief is just an emotional response could lead to the presumption that a lack of emotional expression means an absence of grief.

‘Grief is an event’

Grief is a process of coping, finding comfort and acceptance, and adapting to life after loss. It is a way of working through pain and maintaining a connection with the deceased person while moving on with our lives.

Viewing grief as an event can encourage the misconception that the more time passes, the less pain is felt. People continue to grieve in sometimes subtle ways for the rest of their lives, even when they appear to be coping. Time may temper the intensity of the pain, but people do not tend to recover completely.

‘Grief has stages’

The five stages of grief described by Elisabeth Kubler-Ross in her 1969 study have since been found not to be linear. Denial, anger, bargaining, depression and acceptance occur when people grieve, but may well occur in a different order for each person.

Grief is not ordered or predictable, and everyone goes through the grieving process in their own way. How a person grieves is influenced by personality, gender and age, as well as cultural practices, spiritual and religious beliefs, the relationship to the deceased person and the way they died.

‘Grief always involves rituals’

Expressions and rituals for grieving are varied. Females tend to openly share their feelings with people they trust, while males may express their grief through actions. Male reactions can be misunderstood as cold and unfeeling.

‘Children do not grieve’

Children learn how to grieve by looking to the adults around them for appropriate responses. Children need clear and direct information and should be allowed to ask questions. In teenagers grief is complicated by the normal processes of this developmental stage – they may not accept support from adults, but this does not mean they are not grieving.

Practical ways to help others grieve

  • Give people time and space.
  • Allow people to grieve in their own way, and to express grief in different ways.
  • Allow people to show their grief through religious, cultural or personal rituals.
  • Listen when people want to share their feelings or memories of the person.
  • Allow people to cry and offer support if asked.
  • Answer questions as honestly as you can, especially about how the person died.

About the author

Nicola Davies is a health psychology consultant

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