You stand at the doorway and watch your patient’s chest rise and fall. All around him, his family are crying. They look up, waiting for you to tell them what the doctor said. You don’t want to break their hearts but you can feel your own heart breaking inside of you.
How many times has this patient come to hospital?
How many times have you had the opportunity – no, the honour – of taking care of him and his family for the day?
You have looked at family pictures hanging on the wall. You know all about his prized Pekinese at home that he hasn’t seen in eight months because of his illness. You know it all, and now…
You are emotionally involved. That’s what that lump in your throat means.
You need to tell them the truth that he is unlikely to last the night but you are having a hard time accepting the information yourself. You don’t want it to be true.
Tears burn at the corners of your eyes, but you cannot let them fall, not while you wear that uniform.
How do you deal with a patient and his or her family when you have become emotionally involved?
Your Fall Back Plan
As a nurse, you have to fall back on your professional code of conduct. This is the unwritten rule that says you are not to show your emotions to your patients and that you are not to get emotionally involved with them. Only a robot would be able to maintain this code, yet many nurses feel they have to live up to it.
The truth is that nurses are human and they are going to get emotionally involved. Showing some emotion to patients and family is inevitable, but it must not get in the way of proper, safe care.
A Potential Strategy
One suggested strategy (Davies et al. 1996) is simply to learn how to withdraw emotionally from your patients as necessary. This is often something that nurses learn how to do as they progress in their careers after experiencing a particularly hurtful patient’s death at one point or another.
Of course you maintain your cheerfulness and ability to relate to your patient, but you do not allow yourself to be pulled down that road towards learning about them. It sounds cruel, but sometimes you must keep patients at arm’s length to protect yourself emotionally.
Withdrawal is an acceptable strategy for the short-term. It only works to get you out of acute situations because it is basically a tactic of ignoring your feelings.
Talking your feelings out is the best strategy.
Nurses Know Best
No one understands how much it hurts to lose a patient as much as another nurse.
Take the time to talk about your emotional involvement with your peers. Often, they are feeling the same sense of loss and stress that you are feeling. If not, they may have gone through something similar in their career.
Other nurses are a great source of support for you if you are overwhelmed by an incident with a patient, but do not discount speaking with a healthcare provider if the feelings persist.
Sometimes nurses need to put self-care first, in order to take good care of their own patients.
- Davies, B, Clarke, D, Connaughty, S, Cook, K, Mackenzie, B, McCormick, J, O’Loane, M & Stutzer, C 1996, ‘Caring for Dying Children: Nurses’ Experiences’, Pediatric Nursing, vol. 22, no. 6, pp. 500-7, viewed 20 October 2016, https://www.ncbi.nlm.nih.gov/pubmed/9087087