Living with Dying
In an article published in The Guardian, Australian oncologist and author, Dr. Ranjana Srivastava stated frankly, “some patients die. As a doctor, I have to live with this inevitable fact,” (Srivastava, R., 2015). Although healthcare professionals working in an array of specialties have different training and protocols for treatment, the reality is that most have one thing in common—the death of a patient.
Despite how common the death of a patient is, healthcare professionals don’t tend to openly speak about the toll it takes on them emotionally, as Dr. Srivastava describes when stating, “’I lost a patient today’ attracted a unique brand of awkwardness among doctors,” (Srivastava, R., 2015). Unfortunately, physicians are not trained in dealing with loss. Unlike the loved ones of a patient, healthcare professionals often are not provided access to grief counseling, and furthermore, they sometimes do not even have the time to reflect on their feelings regarding the death of their patient(s). The need to grieve is extremely disparaged, as the following common misconceptions of healthcare professionals reveal:
- “As a professional, I am trained not to be affected.”
- “Grieving is unprofessional.”
- “Just move on, there are other patients to serve.”
- “My work is not personal.”
- “I can’t do my work if I let myself grieve.”
Dr. Srivastava described the concept very vividly saying, “the consolations of fulfilling a doctor’s obligations were familiar, but so were the exquisite and fragile emotions that accompanied the loss of a patient. It was as if a bit of grief always lurked in the corridors, springing out to hijack the unsuspecting soul. Sometimes you swiped it away, other times it overpowered you,” (Srivastava, R., 2015).
Within the last 40 years, research has identified potential adverse consequences that affect the health and wellness of healthcare professionals who are unable to cope with their emotions associated with the death of a patient. These consequences include stress, problems with physical health, depression, burnout and “compassion fatigue.” The theme of balancing emotional boundaries emerged from the research, where a healthcare provider is able to grow close enough to care about the patient while creating enough distance to avoid the pain of loss. Unfortunately, few professionals that were surveyed felt they had been able to do this successfully.
Some of the recommended strategies for coping with a patient’s death are self-explanatory, such as exercising, eating a healthy diet, learning how to set boundaries, and setting aside time for yourself. Others are not as typical, but all can show to be beneficial for medical professionals and their teams to remain healthy during emotionally stressful times.
- Seek the guidance of a trusted senior healthcare provider—Most providers have had this experience at some point in their career, and they may be willing to offer their own insight and/or coping strategies.
- Be introspective and thoughtful—Determine what lessons can be learned that will help you and your team grow, and be open to feedback.
- Provide support to your team—Review the case with your team and allow everyone to have a voice in expressing what occurred. Also being there for the family is still the priority. No matter how you or your staff are feeling, they have lost a loved one.
- Seek the support of your family/friends—Allow yourself to mourn, and seek comfort from family, friends, clergy, and/or peers.
- Consider attending the funeral or memorial services—This will be based on the relationship that you have cultivated with the patient and the family. Some professionals will find closure from the process, and families appreciate the presence of providers.
- Write a personal note to the family.
- Reach out to a colleague who has lost a patient—Opening and maintaining lines of communication can benefit you and your colleague(s).
- Seek professional help—A patient’s death can lead to extreme stress. If a case deeply troubles you, consider discussing it with a counselor or therapist.
Medical professionals are responsible for their own care. Therefore an honest assessment of your ability to cope with loss, and of the toll it may have already taken, can help determine the best next steps for you.
Srivastava, R. (2015). Some patients die. As a doctor I have to live with this inevitable fact. The Guardian. Retrieved from https://www.theguardian.com/commentisfree/2015/mar/20/patients-die-doctor-grief