Comfort in the Midst of Grief: A Spiritual Care Journey

A mother’s grief.

Photo by Khamkéo Vilaysing on Unsplash

As a member of the spiritual care team, I received a request one morning to visit Ms. L, a patient who had just received devastating news: her son had unexpectedly died the previous night. Ms. L was recovering from a major surgery and in the process of being discharged from the hospital. The details surrounding her son’s death were unclear, but they only added to the profound sadness of the situation.

It was evident that the bond between Ms. L and her son was incredibly strong and loving. They had faced numerous physical challenges together, overcoming obstacles that strengthened their deep connection.

When I entered her room, there was a sense of familiarity about Ms. L, though I couldn’t quite place it. After I introduced myself, Ms. L turned to me, tears streaming down her face, and asked the agonizing questions that often arise in times of tragedy. “Why did this happen? Why were we subjected to so much pain? What had we done to deserve this punishment from God?” Ms. L, a devoted Catholic actively involved in her church, had always drawn strength from her religious beliefs for herself and her […]

Just One Braid: The Power of Small Gestures to Restore Patient Dignity

Have you ever found yourself walking around your unit, overwhelmed by the prospect of managing your ever-growing workload? It sometimes feels like a never-ending cycle of assessments, medications, admissions, and discharges. I believe I’m not the only nurse who has experienced this frustration.

It is difficult to admit that, when COVID-19 entered our hospital doors, these thoughts consumed me. We witnessed the first casualties—not just of lives, but also of hope and intimacy—as we struggled to provide care and overcome our own anxieties amidst a scarcity of personal protective equipment (PPE).

Over time, we all learned a great deal about adapting to and managing a pandemic, and I have become more aware of my role within our flawed health care system. Focusing on my own fears and needs was valuable, of course, but these years opened my eyes to the injustices patients face. A significant proportion of the lives lost from COVID-19 due to ill-prepared infrastructure were from vulnerable communities. These realities transformed my perception of these injustices from distant awareness to concrete urgency.

Braiding a patient’s hair, restoring a sense of self.

The question of injustice brings to mind a recent encounter with a patient that deeply impacted me. This particular patient was young […]

Preventable and Aggressive Care for Cancer Patients: To the Bitter End

There have been a couple of recent studies that confirm what I have observed as a palliative care nurse practitioner (NP) in an academic medical center: that there’s still a tendency to pursue very aggressive care with older people with cancer. While every situation is different, the evidence shows that people with cancer could also benefit from palliative care and advance care planning to make sure they’re getting the best and right care for them.

Palliative care could prevent many ED visits.

The first study to catch my eye as a former ED nurse was Trends and Characteristics of Potentially Preventable Emergency Department (ED) Visits Among Patients With Cancer in the US. This study reviewed data on almost a billion (854,911,106) ED visits, of which 4.2% were made by patients with cancer. The mean age of those patients, not surprisingly, was 66. The study found that more than half of ED visits among patients with cancer, 51.6%, were identified as potentially preventable, with the absolute number of potentially preventable ED visits increasing substantially between 2012 and 2019.

The authors concluded that this highlights “the need for cancer care programs to implement evidence-based interventions to better manage cancer treatment complications, such as uncontrolled pain, in outpatient and ambulatory settings.”

This […]

40-years of Forensic Nursing and Current Opportunities in Remote Sexual Assault Care

Remembering an influential article.

Patricia Speck

Timing is everything. Forensic nursing service through telehealth is possible today, as reported in a recent Kaiser Health News story, but it wasn’t always that way. Fifty years ago, Ann W. Burgess, a psychiatric–mental health nurse working in the emergency room, wrote a paper with a sociologist colleague about what she was seeing in patients who complained of being raped. “The Rape Victim in the Emergency Ward” (pdf), published in AJN, was reported nationally and informed 1970s kitchen table conversations about what rape is, is not, and when “no means no.”

Naming the trauma and its effects.

The ideas in this article were new at the time. Burgess wrote that sexual assault causes acute emotional trauma, requiring time for recovery, and she named phases of what she eventually called “rape trauma syndrome.” Prior to the article, victims of sexual assault often did not report the assault, and when they did they waited hours for a newly minted physician intern who had been punished with “rape-duty.” These physicians had no knowledge about what to do.

In accordance with societal views at the time, victims were often blamed for their rape—the way you dress, how you act, […]

When Studying Mental Illness in Nurses Means Studying Yourself

Carrying the burden of depression as a nurse.

As I read Anna’s (not her real name) description of how much effort it took to drag herself into work, how much she felt like a burden to her family, and her fear of being “found out,” tears welled up.

“I know,” I said to myself.

I was analyzing an interview transcript for a qualitative study of psychiatric-mental health nurses (PMHNs) who have experienced mental illness. More specifically, my colleagues and I wanted to know how their illnesses impacted their work as nurses.

I have been a PMHN for over 40 years, with an even longer experience of a mental illness. I recognized many of the participants’ stories in my study as my own, but none affected me the way hers did. An alarm bell inside my head went off. If I couldn’t create a clear boundary in my mind between Anna’s experiences and my own, I might be at risk of unduly influencing the study results.

Reflecting on shared experiences of depression.

I was grateful that a colleague was also analyzing these transcripts; to minimize the effects of my own potential bias, I took the opportunity to write down my thoughts and feelings in my reflexivity journal. This is […]

2023-02-02T10:33:57-05:00February 2nd, 2023|mental illness, Nursing, patient experience|1 Comment
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