A Pediatric ICU Nurse Finds Relief in Not Compartmentalizing Hard Emotions Like Grief

Editor’s note: Hui-wen Sato is a pediatric ICU nurse in California and a regular writer for this blog who has gone deeply into the topic of grief, her own and that of patients and their families. Her insights reverse our usual ways of understanding grief, finding a generative energy instead of a wasteland. Here is a key passage from a TED-style talk (see video below) she gave at the last End Well Project conference in November 2023. End Well is “a nonprofit on a mission to transform how the world thinks about, talks about, and plans for the end of life.”

And so I realized that what I was going to need to learn how to do was not compartmentalize, but integrate all of my experiences into all of who I am. And as I started to learn how to integrate all of my experiences, there came a curious relief and freedom with this integration. Because I no longer had to pretend that I didn’t grieve for my patients. I could just grieve. And I could then get in closer and actually learn more about who they were, who their families were, and I could start to provide a kind of care I think I perhaps had always wanted to provide, but perhaps was a little too scared to get close enough to learn how.”

Making Sense of Loss, Finding Strength as a Nurse

Maria, day 6.

It was bright outside, the sun was shining, and as I looked at the window in Room 303, I saw the light peering through. Maria, a 78-year-old Hispanic woman, mother of three, could not move and did not see that spring had begun as she struggled to breath. She looked at me with her helpless teary eyes trying to communicate, but I could not hear the words.

I’d d been Maria’s primary nurse for five of the six days that she has been hospitalized. During that time, I had witnessed the tension and anxiety that existed within her family around her admission with Covid-19. I hoped silently that a DNR order would be initiated if her breathing worsened instead of her being placed on a ventilator. But I tried not to express my feelings to her family about this when I helped them to communicate with and see their mother using FaceTime.

Maria’s family watched as she slowly declined, and saw how she didn’t respond to treatments. Feeling hopeless and overwhelmed, I tried to schedule a time to speak to my nursing manager about how I was feeling, but she was always too busy scheduling and assisting on the floor after other staff called in sick.

Hard […]

2021-05-13T10:24:41-04:00May 13th, 2021|COVID-19, Nursing|0 Comments

Addressing Health Care Worker Trauma with an Off-Site, Overnight Workshop

Everyone experiences loss and other personal trauma, but those of us who work in health care are obliged to cope with our own personal grief and stress as well as witness the suffering and pain of our patients. Do these words ever describe you at the end of a shift at work?

” . . . angry . . . anxious . . . hopeless . . . stressed . . . depleted . . . depressed . . . frazzled . . . “

One health system gets serious.

There’s a lot of talk these days about addressing clinicians’ burnout, and in some workplaces staff now are offered a meditation room, or aromatherapy or massage.

But since 2013, Montefiore Health System in Bronx, New York, has seriously invested in their staff’s mental and emotional health by offering a two-day, off-site experiential and educational workshop twice a year. And by paying for the program, retreat center, and meals for all participants so that staff can attend for free.

In “Helping Care Providers and Staff Process Grief Through a Hospital-Based Program” in the July issue of AJN, Ronit Fallek and colleagues share their experiences in developing this program along with their analysis of feedback about its effectiveness. They offer enough detail to […]

2019-07-25T11:18:15-04:00July 25th, 2019|Nursing, nursing career, wellness|0 Comments

July Issue: Implicit Bias in Nursing, Grief Support for Hospital Staff, Understanding Malpractice, More

“Get to know patients’ former selves. Ask different questions. Discover their answers. I am so glad I did.” —Jennifer Chicca, author of the July Reflections column, “What Joanna Would Have Wanted”

The July issue of AJN is now live. Here are some highlights.

CE: Original Research: Helping Health Care Providers and Staff Process Grief Through a Hospital-Based Program

This study investigated the feasibility and effectiveness of offering an intensive bereavement support program—aimed at addressing grief and loss related to both professional and personal experiences—to hospital employees in a large health system.

CE: Addressing Implicit Bias in Nursing: A Review

This article describes the ways that implicit, or unconscious, bias among health care providers can contribute to health care disparities, and offers strategies nurses can use to discover and overcome their own implicit biases.

Special Feature: Rising to the Challenge: Re-Embracing the Wald Model of Nursing

The author discusses how Lillian Wald’s model of health care, in which nurses work at the intersection of medicine and society, may be useful today as nurses seek to address diseases of despair and improve health equity.

Transition to Practice: Surviving Your First Code

This article prepares new nurses for their first code, describes what happens during a code, and reviews the responsibilities of the resuscitation team.

2019-06-24T10:12:42-04:00June 24th, 2019|Nursing|0 Comments

The Invisible Nature of Grief

Most nurses know the stages of grief by heart: denial, anger, bargaining, depression, and acceptance. We know the stages do not occur in an orderly, linear fashion. People flow in and out of each stage, circling back around to earlier stages as needed.

But I’m not aware of anyone discussing the invisible, insulating environment grief surrounds its survivors within. An acquaintance described it like this:

“We had just taken our son off of life-support, and sat with him as he passed. Our entire family had gathered to say goodbye. After leaving the hospital, we went to eat. I sat in the café, marveling at the world outside, that people were going about their daily lives, and I had just lost my son.”

When grieving periods were the norm.

collage by julianna paradisi/2018

A cultural understanding of this phenomena developed during the Victorian era, and still exists in period romance novels: People of means, after suffering the loss of a loved one or recovering from traumatic illness or injury, were sent to live with relatives in the country or at the seaside. There, they had no household responsibilities beyond taking long walks through the forest or along the shore, keeping journals, or sketching. In romance novels, the grieving heroine gets the added bonus of discovering a Fabio-like love to […]

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