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 […]

2018-04-09T18:43:00-04:00April 9th, 2018|family, family experience, Nursing, Patients|0 Comments
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‘A Story Bigger Than Himself’: Easter on the Oncology Unit

“Kevin refused to make cancer the meaning of his days. . . . He showed me that the smallest gesture has the possibility to create expansive love. His kindness reminded many of the patients that they hadn’t lost value and worth, no matter how humbled they had been by cancer.”

That’s from the lovely Reflections essay in the new (April) issue of AJN and is written by nurse Barbara Adams. The article recounts a memorable Easter episode on the oncology unit in which a 26-year-old firefighter demonstrates a different kind of bravery and selflessness. […]

2018-03-30T08:34:03-04:00March 30th, 2018|Nursing, nursing stories, Patients|0 Comments
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Caring with Intention: Palliative Care and the Human Family

Vivian Dee, APRN-BC, RN, lives in Texas. She works on a bone marrow transplant unit and is and a doctoral student in the DNP program at Walden University.

In 2008, our organization created a new palliative care wing. No one was certified yet or knew much about caring for palliative care patients. The leadership scrambled to put together learning instructions in the form of PowerPoints and seminars.

In the midst of this flux, our unit admitted a homeless man as one of our first patients. Larry was an alcoholic who’d been out on the streets for many years. His health had deteriorated, and he’d developed liver cirrhosis. Since he couldn’t afford medical care, he’d opted for palliative care.

Larry was unpretentious and polite, and he soon became one of my favorite patients. I met him at the initial team meeting, where we established goals of care. As the days passed, I got to know Larry and his wishes, dreams, and desires. He would talk about his family, his cousins, and his mother. How he longed to see them one more time. To ask forgiveness and to say goodbye.

Days soon turned into weeks, weeks into months. Larry became weaker. Soon it was apparent that it would only be days before Larry took his last breath. Knowing […]

2018-03-22T08:25:34-04:00March 22nd, 2018|Nursing, Patients|0 Comments
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Meeting the Nutritional Needs of Older Patients and Family Members

When copies of the print version of this month’s issue arrived in the office, AJN staff found different meanings in the Albert Anker painting (circa. 1895) that graces the cover. Is the man enjoying a cup of tea in peace and quiet, or is he isolated and lonely, perhaps sipping tea to stave off hunger because there isn’t much food in the house?

The artist’s intent may be open to interpretation, but we chose this cover because it suggests one of the many social, cognitive, physical, and economic factors that can affect the nutritional status of older adults: eating alone.

Many older adults are at risk.

In a March CE article, “Malnutrition in Older Adults,” registered dietitian Ann Reed Mangels, PhD, RD, FADA, summarizes the latest information on malnutrition in older adults, including risk factors, assessment tools, and practical ways in which nurses as well as family and friends can help to ensure good nutrition for elders in the community or in long-term care. Writes Mangels:

“Malnutrition diminishes quality of life, is a strong predictor of short-term mortality, and is associated with higher health care costs.”

[…]

2018-03-19T09:05:08-04:00March 19th, 2018|Nursing, Patients|0 Comments
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Wound Care: A Common, Often Stressful Family Caregiving Task

“Teaching Wound Care to Family Caregivers” is currently one of AJN‘s most-viewed articles. As the article points out, more than one-third of family caregivers have to perform wound care, and doing so at home “can be a stressful experience.”

In a recent study of the challenges faced by family caregivers, 35% of those sampled reported performing wound care. Importantly, 66% of these caregivers indicated that wound care was difficult for them. For almost half, fear of making mistakes or causing harm was even more of a concern than the time and inconvenience of providing wound care….

The CARE Act mandates family caregiver teaching.

A nurse teaches a family caregiver how to assess a diabetic foot ulcer and safely change the dressing. Photo courtesy of the AARP Public Policy Institute.

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Some other topics covered in the series include managing mobility and fall risk in the home, managing complex medication regimens, administering injections, and others.

As AJN editor-in-chief Shawn Kennedy wrote in a

2018-03-16T08:45:20-04:00March 16th, 2018|family caregiving, Nursing, Patients|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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