6 Ways to Cope With Grief as an Oncology Nurse
By Laura Winzeler, contributor
The transitory nature of life is in daily focus when you're an oncology nurse. This challenging specialty chosen by those with an extra ration of compassion supports patients dealing with the many uncertainties of a cancer diagnosis while also offering comfort to their families and caregivers.
Oncology nurses often act as coaches, helping patients manage symptoms and side effects while navigating complex treatment protocols. Lidia Schapira, MD, FASCO, points out that an individual's treatment often passes through many phases and includes care from several medical professionals from different specializations. Frequently, it's the oncology nurse who provides consistent information and guidance across the treatment plan.
Sometimes the bonds formed with patients and their families last years, long after treatment is over. If the patient becomes palliative, the focus shifts to optimizing quality of life and mitigating suffering. The deep familiarity oncology nurses form with cancer patients can lead to a profound sense of grief when the patient dies. But there's frequently no time to process the grief because other patients need urgent care.
The following are six strategies oncology nurses find helpful for dealing with job-related bereavement. See if any of them make your load lighter.
1. Advocate for workplace support
A positive work environment is essential for nurses' health, well-being and satisfaction, according to a study published in Oncology Nursing Forum. The most supportive workplaces have policies and guidelines in place to make a variety of grief-resolution strategies available to their nurses regularly. Examples include:
- Supporting outward displays of grief and mourning by nurses
- Assigning each oncology nurse a mentor who offers guidance and support
- Debriefing sessions with a psychiatric liaison nurse or the pastoral care team
- Creating meditation or quiet time-out rooms on nursing units
- Holding a service of remembrance for patients who died on the unit
- Ensuring nurses have a regular opportunity to leave the floor and take a break outside the facility
2. Process grief with colleagues
Team debriefings lighten the burden of sadness oncology nurses can feel. A literature review on grief resolution coping strategies published in the Clinical Journal of Oncology Nursing found the following had a cathartic effect on oncology nurses:
- Peer-supported storytelling
- Workplace psychosocial wellness retreats
- Listening to others' stories of grief experiences
Even just checking on a colleague in the break room after a patient dies or getting together with other oncology nurses for a meal outside of work can ease the stress.
3. Acknowledge all the emotions that arise
Lisa C. Barbour, BN, RN, BSC, used her own experiences to explore the impact of grief on oncology nurses. Her self-study, published in the Asia-Pacific Journal of Oncology Nursing, contains numerous insightful observations regarding the broad range of emotions she experienced.
In addition to grief, bereaved nurses often feel anger, depression, frustration, helplessness, hopelessness and overwhelm. Barbour also observed that she experienced patient-related grief at times other than the moment of death, such as when a patient experienced a recurrence or upon viewing photos of a healthy, vital patient before the onset of cancer.
4. Try to leave work at work
In a study on professional bereavement, nurses from inpatient and outpatient adult and pediatric oncology units reported that limiting the amount of time spent talking about work at home was an effective strategy for coping with grief and loss. Ideas offered include:
- Calling a friend when leaving the hospital at the end of a shift
- Sitting in the car for 10 minutes listening to the radio and decompressing before heading for home
- Riding a bike to and from the hospital to transition from work to private life
Oncology nurse Theresa Brown shares that the 2-mile uphill bike ride home "can be a killer after a 12-hour shift," but when she gets home, she's mentally reviewed the events of the day and begun to digest the sadder occurrences "that weigh on me over time."
5. Maintain a grief journal
Nurse Lisa C. Barbour found that journaling her thoughts and feelings after a patient's death was a therapeutic way of debriefing. She advises other nurses to do the same. This could be helpful for a travel oncology nurse who might not have a close connection with colleagues.
6. Create a supportive self-care environment in your daily life
Several studies have found that nurses can prevent or limit grief by maintaining a healthy work-life balance. This includes:
- Getting adequate sleep
- Prioritizing healthy nutrition
- Engaging in physical activity
- Performing enjoyable activities
- Asking for help when needed
Compassion fatigue is more likely to occur when stress is experienced over time and caregivers don't focus on their own emotional needs.
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