Chapter 10 Nurse-Patient Relationships During Grief, Mourning, and Loss - PowerPoint PPT Presentation


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Chapter 10 Nurse-Patient Relationships During Grief, Mourning, and Loss


Chapter 10 Nurse-Patient Relationships During Grief, Mourning, and Loss Grieve big and small losses throughout life Weddings, graduations; off to kindergarten ... – PowerPoint PPT presentation

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Title: Chapter 10 Nurse-Patient Relationships During Grief, Mourning, and Loss

Chapter 10Nurse-Patient Relationships During
Grief, Mourning, and Loss
Grieve big and small losses throughout life
  • Weddings, graduations off to kindergarten,
  • Divorce
  • Loss of a job (financial security)
  • Loss of loved ones
  • Losses associated with illness (self-esteem,
    belief systems, faith, hope, dreams)
  • Often producing feelings of guilt

Patient-Safe Strategies for Crying
  • Use empathy I can see youre upset
  • Allow emotional release through tears and words
  • Raging and cryingallow patient to regain control
    (blow off steam) keep silent and accept response
  • Quiet cryingsit on same level, hold hand, offer

Encouraging Emotional Release Using Tears A
Good Cry
  • Tears reduce emotional pain levels
  • Release of stress-related tensions and hormones
    in tears
  • Relieve feelings of loss, sadness, grief,
    frustration and anger
  • Initial release of catecholamines increases heart
    rate and blood pressure, followed by
    parasympathetic response generating systemic

What not to say..
  • Theres no need to cry. Youre doing fine.
  • Please stop crying now.
  • Get hold of yourself. (stop)
  • Think positive. (advice)
  • Think of your family. (guilt)
  • You must be strong.
  • You must be a man about this.
  • Its time to get on with your life.
  • I know how you feel.

Gender Differences
  • Women vent tensions, anger, and frustrations by
    crying across cultures, women cry more than men
  • Men more often yell or shout
  • Pressure for men not to cry for fear of being
    labeled sissy or crybaby Youre a big boy.
    Big boys dont cry.
  • Men generally tend not to express emotions as
    much as women

Why Do Women Cry and Express Themselves More
  • Socialization? Girls encouraged to express
    themselves and cry
  • Physiological? Women secrete a hormone prolactin
    (30 times more than men) involved in tear

Shock, disbelief, denialAngerLack of
controlGuilt and fearAm I being
punished?Depression and sadnessNothing will
ever be the same againCome to terms with loss
and make plans
Grief Associated With Death and Significant Loss
Before helping others grieve/mourn losses
  • You must recognize your own vulnerability to loss
    and pain
  • Acknowledge you can never be in total control
    of your life
  • Acknowledge your own mortality
  • Anticipatory grievingemotional responses to
    potential loss

Grief work After death of loved one, intense and
  • Loss of pet20 hrs crying
  • Spouse, parent, friend, child200 to 300 hrs
  • Talk through tears review good and bad memories
  • Restructure and rebuild lives without the loved

Grief work takes 1-3 years
  • People, events, objects evoke memories of the
    deceased, bringing on feelings of sadness,
    depression, tears
  • Holidays, special events
  • Dysfunctional grieving Unsuccessful responses at
    working through the process of loss
  • Sadness turns into depression
  • Emotional depression unable to function in
    personal lives or jobs
  • Physiological depression of immune system

Successful Resolution of Grief
  • Never forget but go on without the other
  • Become actively involved in meaningful activities
    once more still see purpose in life
  • Greater understanding of life, greater compassion
    for suffering and the needs of others

Emotions are contagiousWe feel the same
emotions as those around usWe must acknowledge
and accept the emotions in ourselves and our
Health-Care Providers Cry, Too!
  • When caring for patients and families, you will
    become close to some and experience grief along
    with them.
  • Crying with a family member or patient is fine,
    as long as the other cries first.
  • Avoid crying unless the patient cries first. If
    you are upset, you may need to excuse yourself
    and go to a private place.
  • Discuss your feelings with a trusted nursing
    student/ faculty.
  • Journaling to express feelings.

Non-emotional health-care provider doing tasks,
procedures, paperwork comes across as uncaring,
task-oriented, too busy to be bothered