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Discussing Death

Talking about death is not fun. Unfortunately, it’s part of the job for most nurses.

In this week’s episode of “The Sean Dent Show” on ScrubsBeat, Sean continues his course on “Things they don’t teach you in nursing school” by taking on the heavy topic of death. There’s a right and wrong way to tell family members that their loved ones have died, and thankfully we have Sean to steer us in the right direction.

How do you deal with this touchy subject? Please share your advice in the comments below!



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6 Responses to Discussing Death

  1. cinnybug LPN

    I deal with families of dying and deceased relatives frequently. Most of the time I have cared for their family member for a great deal of time. Months or even years. And yes, I do become emotionally connected to them. When I lose a resident I cry. I grieve privately as well as with the family. I consider it part of my job to help the family to grieve. As to conversations about death, well the hardest ones are when I have to tell a family member that their loved one is failing. They always want me to give them a time period. Even if they are aware that mom or dad is not the same as they used to be, they still are shocked when I bring up the fact that mom or dad is not going to be with us much longer. When the time comes for me to call and let them know that they should come in to say their goodbyes because death is imminent, they always ask me when the resident will die. I always put myself in their shoes and speak with caring, empathy and patience. I never cut the conversation short even though someone else is frantically trying to get my attention. In that moment, they have my full undivided attention for as long as they need to talk. Even if what they are saying doesn’t seem to make much sense at that time. Most people are just trying to work through some shock. I hug them if that’s what they need or simply sit quietly next to them holding their hand. People react differently to death and I am always careful to never show any shock or surprise if someone reacts in a strange way (like laughing or anger). I guess I kind of feel that once my resident has died their family members have now become my patients for as long as they need me. Thank you for confirming what I have found to be true…a nurse with no emotional response should no longer be a nurse. Empathy and caring are the cornerstone of good nursing.

  2. David Hanley

    Unfortunately it feels like it is getting too easy to support grieving families, respond in a way I feel I have become comfortable with! And once they’ve left my immediate environs, business as usual! It may be due to over exposure over the last 15yrs!!! They are always very grateful and I feel that I have done all I can! Despite this I feel a little troubled. I felt a little tearful when several similarities arose with a patient and a relative, of mine, who had died approx yr earlier! It is the only time I felt like that at work. That was approx a year ago… Joe it almost seems like the norm, eerily familiar, and a little comfortable…
    The feedback is always very reassuring but still! Could I have done more?

    • Lupa

      David I understand your worry that you aren’t as effected as you should be. I’ve had the same concern but I believe the fact that you think too question your reaction shows you care. Some people simply compartmentalize more at work and some feel it’s not there place to get super emotional while caring for patients. (ie empathy vs sympathy) many nurses have a “nurse mode” and that helps them care for their patients. Just my opinion.

  3. Jet City Jim RN

    As a hospice – palliative care nurse pronouncing a patients, or in my case, resident’s death is part of the job. It is sad and emotional for the family and myself. Though I must admit sometimes it is sadder for some residents than for others. Than you find your self doing a rating systems, was it a “good” death or a “bad” death. A person you loved (as a person after all) or didn’t care for as much (be honest, not everybody is lovable or even likable).

    Here in Washington, we have death with dignity, AKA physician assisted suicide. This brings up a completely different emotion. Usually the family is present at the time. Frequently our residents are admitted as hospice DX w/ three to six months prognosis. Than get such good care some live there for YEARS! We get really attached to these people and there families. There is no right or wrong way to share the news and to have a script is almost as inappropriate as to be flippant. Though I think families appreciate it when staff members are also sad about their loved one dying.

  4. Lupa

    I think some of it depends on your approach to death. Personally I don’t think of death as something I’m necessarily fighting. I am fighting pain, suffering, and a lack of dignity. Death is a certainty but dying can be so very hard. It seems more tragic when my patients are young but all death is a loss. That being said even if it was the patient’s time it’s still hard on the family. I am there to be supportive and try to read the family to see what they need from me. I think each situation is different and requires something different from the nurse

  5. tom combs

    Sean – As an emergency doc with 20 years in level one, acute care hospitals and now an author the impact of death on healthcare workers is something I’ve dealt with extensively. I love and agree with your observations. Here is a brief section from my book(previous Scrubs promotion) relating an experienced ICU nurse’s observations on caring:

    [[Tracy had heard it from her earliest days in nursing school.
    “You can’t allow yourself to care too much,” and “You have to stay detached or it will eat you up.” It passed as popular wisdom. The public perceives that doctors and nurses get used to dealing with tragedy—that it doesn’t affect them.
    Tracy knew better.
    You should care. And if you care, the bad things that happen rip you up. That never goes away. Sometimes you feel guilty or inadequate. You learn painful lessons. At times you can’t sleep at night. But you keep on caring. That’s the burden you accept when you do something that really matters.
    The bedside light shined on her patients closed eyes. He probably couldn’t notice, but she redirected it while touching his forearm.
    How do you not care? Flip a switch in your head? Tracy didn’t have any such switch. And she believed that the overwhelming number of nurses and doctors she worked with didn’t have that switch either.
    She hoped they didn’t.]]

    Some of us in healthcare will maintain they don’t “feel it” anymore. i think that is self-deception. We feel it. it impacts us. We can’t let it interferes with giving our patients what they need but it’s there.