Advice and development

The death of a patient may trigger complex emotions, but you can learn to manage them

How to ensure self-care while doing your best for patients and families at the end of life

How to ensure self-care while doing your best for patients and families at the end of life


Reflecting on your feelings when a patient dies will help you develop coping skills 
Picture: iStock

Life and death are part of nursing, but caring for a dying patient can be daunting, especially if you have never witnessed death or experienced grief.

I wasn’t exposed to any patient deaths during my clinical placements, so experiencing my first deaths as a newly qualified nurse was tough. I felt like a student all over again.

Experience can help you learn and adapt

Whether it’s expected or not, you can never truly prepare for dealing with a dying patient. Every situation is different, and each time, a new emotion will be sparked. Although it doesn’t really get easier, you can learn how to adapt and manage the situation.

As a student, you will have the guidance and support of your mentor and other professionals to help you. So if the opportunity arises to help care for a dying patient, I advise you to take it.

‘Make sure you communicate with the patient and their family. Understanding what they need will enable you to provide the best possible care’

Even if you don’t feel confident enough to be hands-on, there is a lot to learn by observing, asking questions, and noting the verbal and non-verbal communication used. You will learn about the official procedures and processes involved.

One of the biggest personal concerns when caring for a dying patient is how you are going to react, especially whether you are going to become emotional. Nurses are human, and it is normal to wonder how you will feel, and what to do if you cry or feel scared.

3 actions to help you cope with patient’s death 

The death of a patient can unleash many emotions and it is important you have support in managing these. The following coping mechanisms can help:


Witnessing death can change you as a person, so talking about how you are feeling
is essential. Picture: iStock

Debrief

Debriefing after a patient death is vital, especially if it’s your first experience. This is a safe space for those involved to share how they feel, and a good opportunity to think about what went well and what could have been done better. If a debrief isn’t offered, request one. Death can trigger many emotions, so it is important to be able to talk. Witnessing a patient death can change you as a person and may affect how you feel about nursing.

Reflect

Ask yourself how you are feeling and whether you are coping. Is there anything you would do differently next time? What skills do you need to develop? Although you may care for many dying patients in your nursing career, every death is different so never lose your compassion and empathy, and the ambition to get it right.

Talk

If you are struggling following the death of a patient, tell someone. Talk to your peers on your course, your tutors, nursing colleagues or family and friends. Don’t feel like you have to be ‘strong’ – expressing your emotions can help you cope.

 

Maintaining professionalism and knowing when to step back

A level of professionalism needs to be maintained to support your patient and their family, but it is okay to feel. If the emotions becoming overwhelming, consider stepping away from the situation to gather some clarity before returning.


Communicating with patients and relatives will enable you to tailor your care to their
needs. Picture: iStock

Managing your expectations is crucial. Speaking to your mentor will help you understand what is likely to happen and give you the opportunity to ask questions, such as 'is there anything I should avoid saying?' or 'are there things I need to be mindful of?'.

Make sure you communicate with the patient and their family. Although this can be difficult because you don’t want to say the wrong things, understanding what they need from you will enable you to provide the best possible care.

It will also stop you from feeling like a spare part, and remind you that you're a valued member of the nursing team.

Patient outcomes are not always favourable as we know, and when a patient dies, you may feel like you didn’t do enough. But I’m sure you did. Take comfort from knowing that you were there for that patient and their family at the end of life, providing dignified and compassionate care in their final moments.


Nicola Wiafe is a staff nurse in a neonatal intensive care unit 

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