Written by Sam

Giving palliative care and nursing a patient during their last days can be one of the most rewarding parts of any nurse’s career, but seeing death on a daily basis can also be one of the most emotionally and psychologically stressful and demanding parts of the job, and it can be crippling if not dealt with.

Being by the side of your patient and caring for them as they take their last breath can place a heavy burden on any nurse, and learning how to deal with that, understand how it can affect you and cope with it is imperative. If you don't then the pressure can lead to a lot of strain, exhaustion, burnout and even mental health issues. 

Here are just a few techniques and tools you can utilise to deal with the death of a patient.

Don't shy away from it.

Death is inevitable in nursing. It sounds horrible but you really just have to accept that fact. At some point, despite all your best efforts and all the hard work you and your team have put in, you will lose a patient. It will happen.

It is so important to remember that this is just a normal part of the natural life cycle and sometimes there is nothing you can do about that. Your role isn't to change that fact, but to make those last moments as comfortable and as peaceful as possible.

Don't blame yourself. 

Nurses are on the whole martyrs for their profession. They take the world on their shoulders and still worry about everything they couldn't do for their patients when they go home, and the same is true when a patient dies. First, the questions and the second-guessing comes, then inevitably the nurse will start to blame themselves for not doing enough. As admirable as it is, this is not healthy. 

Remember that death is natural, you did your best and whatever the outcome you are not responsible for it.

Remember losing a patient does not mean you are a bad nurse.

There is a natural tendency to blame yourself when you lose a patient but you really shouldn't. It really is just time for some people and losing them is no reflection on your skill or dedication. It is not a reflection on you as a person or your role as a nurse. Just remember all those other people you help every single day.

Shut yourself off, just a little bit. 

Empathy is one of a nurse's greatest tools, it allows us to understand our patients, care for them and be there for them on a deeper level. The bond we create with our patients allows us to do the job to the best of our ability. But it can also draw us in too deep. That is why it is essential to be able to switch off, especially if you work in a highly demanding environment like an emergency or palliative care.  

There is a huge difference between empathy and sympathy, and putting up a barrier to protect yourself does not in any way mean you are any less caring or compassionate as a nurse.

You can still form bonds and empathise with your patients, but just have that professional boundary where you can shut off at a certain point. Be kind, be caring, but remain professionally detached too. 

Remember that grief is normal too. 

As important as it is to keep that professional line and a certain level of clinical detachment, it is also important to remember that grief is normal and healthy too and you are allowed to give yourself a little time to do just that. The death of a patient, of anyone, is not something anyone should ever get used to completely and nurses are still human too at the end of the day.

Lean on your colleagues.

Nursing is one of the single most stressful, demanding and draining careers out there with a specifically unique set of demands and problems, and no one but another nurse can understand what you go through on a daily basis, not even your friends and family. So use your colleagues, lean on them. Let them help you and give you a bit of advice, because you can guarantee whatever it is you are feeling or going through, your more experienced colleagues will have been through the exact same thing.

Give yourself a break.

It is a tradition for nurses to work 80 hour weeks with no breaks and then stay behind even longer to finish the paperwork, but it really isn't healthy, and it is certainly not healthy when you may be going through a grieving process. So make sure you get a good work-life balance. Stop accepting all those overtime shifts and enjoy your days off, leave on time and hand over any unfinished tasks, don't take on so many extra jobs on shift.

If you do, especially when you are dealing with the emotional baggage of a patient death, it will lead to exhaustion and burnout. 

Give yourself an outlet. 

When you do have time off make sure you have an outlet away from work to pour all your energy into. It doesn't matter what it is, a faith, a hobby, it doesn't really matter. Just something to remind you that there is more to life than work and take your mind off things.

Exercise.

As well as a hobby outside of work you should also make the time to exercise regularly every single week. Exercise has been proven time and again to reduce stress and improve overall mental health and wellbeing, and there is no better way to take your mind of a patient’s death.

These are just a few of the coping mechanisms experienced nurses use to deal with losing patients. It will never get easy, and it shouldn’t, but by using some of these techniques you will at least be able to do your job, care for your patients and not allow yourself to be overwhelmed.