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Chaplaincy in Palliative Care Settings

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Post supporting grieving nurses
Author: Chapdavid
Date: Jul 29, 2009 12:54 pm
I am looking for ways to support our floor nurses,as they grieve patients' death, and in particular, when they have multiple deaths on a shift.

Any ideas on resources would be appreciated.
Replies: order by [Date] [Author] [Subject]
Re:supporting grieving nurses (by ghandzo on 08/10/2009)
I thought there would have been some responses to this. It may be that the response of others is the same as mine. That is, the most effective (and maybe the only) resource we have to offer at these times is ourselves, our presence, and our empathy. I think the best thing we can do is literally "stand with" the nurses we support, listen to them, and let them know we appreciate the emotional investment they make in the patients and families they care for. Beyond that, the following may be appropriate as the context dictates:

1. A group debriefing possibly including prayer and readings.
2. Making sure there is a chapel or other quiet space available off the unit for the nurse(s) to take a quiet time out for a few minutes.
3. A memorial service periodically for those patients who have died. I think these are most helpful if they are planned by the nurses themselves with advice and facilitation from the chaplain.

Hope this helps.

The Rev. George Handzo, BCC
Vice President
Pastoral Care Leadership & Practice
HealthCare Chaplaincy
New York, NY
+ Re:supporting grieving nurses (by szaglifa on 08/10/2009)
I have to say, this is one of the most challenging aspects of my job! Nurses are a tough group in that it is very hard to them to turn their care/compassion on themselves! And, given their job description, there is very little time to do anything particularly "helpful" for them.

I have found success in taking a few moments at the end of mandatory staff meetings to honor their roles, and to have a moment of silence/prayer/reflection for the patients they have lost and the impact it may have on them. This normalizes their experience and doesn't force anyone to step outside of their comfort zone. It then becomes a part of the "culture" of their dept, which allows for more openness and reflection.

Other efforts I have made didn't work out simply due to timing...hard to ask folks to come in on their day off to "process", and hard to ask folks to stay late or come in early. So, trying to find a way to incorporate this much needed time into the regular workday is my best advice.
Re:supporting grieving nurses (by tpond on 09/28/2009)
There are a few things I have done that I have recieved positive feedback from nurses or nursing supervisors. The first has to do with memories and similarities. If the death has aspects that are familiar to the nurse(s) it hits a little closer to home. For instance, if the patient was older, asking if the nurse's parents are still living may open a door for them to explore their emotions. If it is a child and the nurses have children I sometimes ask if they have called home yet. This is often met with a smile and a tear at the same time. Our hunches are valuable, just ask.
Another is ice cream. After a particularly agonizing death of a young mother with two small children, I returned in a short while with sundaes (hot fudge) and if offered the opportunity for some very productive emotional release.
One more that has brought no small number of tears to the eyes of nurses, particularly in the unit areas,is the question, "Have you known the patient long?" No explaination for it, it just seems to be a question that helps them release emotion.
+ Re:supporting grieving nurses (by Tim_Ford on 09/29/2009)
I will second the point that George made in that I have found 'face time' to be by far the most effective use of my time in supporting my staff. By that I mean simply being available. For me it is sitting at the team room table sipping tea and listening. If a nurse or staff need private time, most feel comfortable asking and we step into an empty room to talk. Formal debriefings and support groups around here have not been well received, my staff views it as 'one more thing I have to do'. About half of the staff get a lot out of our annual memorials and about half find it impossibly hard to attend.
Hope this helps.

Tim Ford
Palliative Care Chaplain
VCU Massey Cancer Center
Richmond, Virginia

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