10 Significant Impacts Of Patient Death On Nurses + How To Deal With It
Written By:
Darby Faubion
Darby Faubion RN, BSN, MBA
Darby Faubion is a nurse and allied health instructor with over 20 years of clinical experience. Darby lives in Louisiana and loves exploring the state’s rich culture and history. Darby has a passion for caring for veterans and a special interest in those affected by post-traumatic stress disorder. In her quest to make a difference for veterans, she founded a non-profit called “Operation Battle Buddy.” Read Full Bio »» RN, BSN, MBA
If you have been a nurse for any time, you know what it is like to lose a patient to death. Although death is a natural part of the life cycle, it can have a significant impact on nurses, some more serious than others. Even though we know to expect the loss of some patients, it is natural to wonder, "What are the impacts of patient death on nurses?”
In this article, I will address that question by sharing 10 significant impacts of patient death on nurses + how to deal with it. Everyone deals with death in their own way, but by taking the information and tips from this article, you will have a starting point to help you find and develop coping mechanisms to deal with patient loss.
What are the Impacts of Patient Death on Nurses?
(The following are the 10 significant impacts of patient death on nurses + how to deal with it.)
IMPACT #1: Feelings of Incompetence
About the Impact:
As nurses, we naturally want to fix things, and losing our patients can sometimes leave us feeling as though we have failed at our jobs. Knowing that patient deaths sometimes come with the job does not mean it is something we take lightly or that it does not impact us. On the contrary, one of the impacts of patient death on nurses is to leave us with feelings of incompetence.
How to Deal With It:
I have been a nurse and healthcare educator for many years, and I can honestly say that no matter how much experience you have dealing with loss, there will still be times when you wonder what more you could have done that could have possibly saved your patient. The simple truth is that you must understand that some patients miraculously pull through situations that we thought they would never survive, and there are times when they do not.
I remember a nursing instructor I had in nursing school told me once, "You hope for the best and prepare for the worst." I thought that was a bit harsh, but I later understood what she meant. We give our best to our patients each day, but at the end of the day, that is all we can do. You must be good to yourself. Treat yourself fairly knowing you did your best and that, even when patients die, you are still competent to do your job. For some patients, they have reached a place where they are ready to die, and we must accept that for them.
IMPACT #2: Compassion Fatigue
About the Impact:
Compassion fatigue in nursing is the physical and emotional distress that results when nurses provide continuous care to patients who are deeply in need. It may also develop in nurses with the death of a patient, especially in situations where there is the loss of multiple patients. Compassion fatigue can leave you feeling overwhelmed, exhausted, and traumatized.
I worked as a hospice administrator and bereavement counselor for quite a long time. Because the patients we cared for were terminally ill, it was "normal" for us to experience patient deaths. No matter how many patients I had who passed away, it never made the next death any easier.
How to Deal With It:
Compassion fatigue is one thing that results as an impact of patient death on nurses, and, although it is hard to avoid, it is something that you can learn to identify, which means you can get ahead of any problems it causes. The most important thing is to keep the lines of communication open between yourself, your team, and your leaders. If you feel overwhelmed by the loss of a patient, you need to understand that you are not alone. All nurses experience loss in one way or another. Reach out to your supervisor or team leader. Also, if your feelings are too much to handle, it is okay to seek professional help to find healthy ways of coping with your grief.
IMPACT #3: Depression
About the Impact:
No matter how many times I experienced having a patient die, it has always left me with a feeling of sadness. Each experience is different, as my sadness may be more because I feel empathy or compassion for the family who have lost a loved one, or perhaps, I feel sadness because I grew an emotional attachment to my patient after caring for them for an extended time.
While it is natural to feel sadness with the loss of a patient, one of the more significant impacts of patient death on nurses is depression. When left unchecked, it can lead to deep-rooted issues that can affect your personal and professional life.
How to Deal With It:
Feeling depressed about someone dying is nothing to be ashamed of. On the contrary, it shows your compassionate side and helps you stay in touch with the reality of what nursing is about. However, you do need to know what to do to handle depression when it occurs.
The first step in dealing with depression related to the loss of a patient is to acknowledge your feelings. Keep in mind that the nurses and other team members have lost their patients, as well. You can all draw strength and encouragement from one another. Talk to your peers about your thoughts and feelings. Also, hospitals and other large healthcare facilities typically have chaplains and social workers on staff to offer support. You could consider talking to them or reaching out to a private counselor or therapist if your depression becomes overwhelming.
IMPACT #4: Feelings of Reduced Professional Accomplishment
About the Impact:
Because nursing is a job of caring and we see ourselves as being instrumental in the healing process, it is understandable that many nurses feel a reduced sense of professional accomplishment when patients die. It is hard to face the fact that just because we know what to do, it does not mean our efforts always get the end results we want. Unfortunately, even when we do everything by the book, sometimes our patients die.
How to Deal With It:
One of the hardest lessons for me to learn in nursing was that a patient's failure to thrive was not my failure as a nurse. I wanted so badly to be the nurse who had the magic touch, the nurse whose words soothed every fear, calmed anxiety, and made everything better. The hard truth was, and remains to be, that I am only human. Whether I am working at a patient's bedside or sitting behind a computer writing articles to educate other nurses, I cannot change the outcome of someone’s health because I wish it to be so.
What I can do, though, and so can you, is come to an understanding that death is part of the life cycle and learn to accept that when it is time for patients to die, it is not a reflection of whether we are professionally competent enough to get a job done. At the end of each day, think about why you are a nurse. Reflect on the positive things that happened in your shift. What did you learn today? What lessons will you take with you to help you become better? Instead of questioning your professional accomplishments when a patient dies, give yourself some credit for being there when they needed you most.
IMPACT #5: Increased Anxiety
About the Impact:
Whether you are preparing to care for a patient who needs to be told about a terminal diagnosis or who is in the process of actively dying, or you need to discuss a patient's status with their family or loved one, talking about a patient's death can cause significant anxiety. It is hard to tell how someone will respond to the news of a terminal diagnosis or how someone who knows they are dying will act from one day to the next. The stress and grief they feel are often projected onto nurses, which can lead to anxiety even in the calmest nurses.
How to Deal With It:
There have been times when I sat with patients who were dying, and I felt at peace because I knew they were at peace. There have been other times when I sat at a patient's bedside, and it took everything in me not to run from the room because I felt so nervous and anxious, knowing there was nothing I could do to ease their pain or suffering or to make their families feel less anguish about their coming loss. It is a normal process as a nurse caring for patients who are dying.
The important thing when dealing with increased anxiety in these situations is to be honest with yourself about how severe your anxiety really is. If you are a little nervous and can take a deep breath and get through the assessment or conversation, that's great.
However, if you feel completely overwhelmed, it may be best to ask to be excused and find your charge nurse. Explain to them what is going on and ask for help. We have all been there and know that there are some cases that hit us harder than others. That is why teamwork in nursing is so important. Reach out when you need help. You may just need someone to accompany you in the room for a little moral support. Whatever you need, it is best to ask for help than to stay and be so overwhelmed that you make matters worse for your patient and yourself.
IMPACT #6: Compromised Physical Health
About the Impact:
I don't know about you, but I am one of those people who tends to internalize things. If I am stressed or worried about something, I often bottle it up, and if I am not careful, it begins to affect my physical health. Anxiety and depression can lead to high blood pressure, digestive problems, sleeplessness, irritability, restlessness, and difficulty concentrating. If we are not careful, the emotional toll that the impact of patient death on nurses takes can lead to issues of compromised physical health.
How to Deal With It:
One thing I try to stress to every nurse I work with, whether it is as a preceptor, instructor, leader, or peer, is that the best way for us to take care of our patients is to first take care of ourselves. Even when we are caring for the most fragile patients, those who are on the brink of death, if we are not in a state of wellness or balance, it is nearly impossible for us to provide high-quality care to them.
Does that mean everything in your life has to be perfect or that you will get everything right every time? Of course not! What I do mean, though, is that we must be aware enough of what is going on within ourselves to know when we need help. Whether you need a break, a day off, a schedule or routine change, whatever it takes to help you find balance so that you can be the best version of yourself, that is what you need to do.
Practicing self-care is essential. Eat a well-balanced diet and get plenty of exercise and rest. Most of all, know your limits and set healthy boundaries personally and professionally.
IMPACT #7: Poor Job Performance
About the Impact:
When nurses fail to cope with the challenges related to patient deaths, it causes feelings of low job satisfaction, which leads to poor job performance, another major impact of patient death on nurses. This situation is something of utmost concern because, if it is not handled quickly, it can result in poor patient outcomes for other patients in the nurse's care, poor job reviews, being reprimanded on the job, or even loss of a job.
How to Deal With It:
Having worked in a supervisory position, I can assure you that a good nurse manager does not want to lose you just because you may be having trouble dealing with the death of a patient. It is important, though, for you to be transparent with your nurse leaders and let them know what is going on with you. Let them know you are having trouble coping and ask for input on how to deal with nurse grief. You may be surprised to know how supportive they can be in helping you find ways to work through the loss of patients.
IMPACT #8: Burnout
About the Impact:
One of the most difficult deaths in my nursing career occurred related to a patient in a pediatric emergency department. The child was initially brought into emergency services by her mother, who told us the child was walking and kept falling over. The doctor who initially examined her said she needed a few tests and sent her to radiology. While there, the child began seizing and died. The death was difficult to me for a few reasons. First, the death was difficult because it was a child. Second, it was so sudden that we didn't get a clear diagnosis, and I felt unable to process my own thoughts about what was wrong with the child, let alone be able to help the family. It all happened so quickly.
The emotional toll that patient death has on nurses is one of the major stressors that leads to burnout in nurses. Some nurses have trouble coming to grips with the fact that not all patients live. It is crucial for you to realize that, even on our best days, we may lose patients, and it is no one's fault.
How to Deal With It:
Unfortunately, burnout happens for lots of reasons. When patient deaths occur often, such as in high-risk settings like critical care or hospice, it can make matters worse. I advise being honest with yourself about the type of setting you feel you can work in most comfortably. Are you mentally prepared to work in a setting where there are critical or terminally ill patients? Do you have enough experience managing the roller coaster of emotions that come with dealing with grieving patients, families, and staff? If you do, you may not be as much at risk of developing burnout related to patient deaths.
However, if you are unsure, for your sake, the sake of the patients you care for, and the staff you work with, you should consider talking with a charge nurse about the best way to handle patient deaths. Express your concerns and ask how they learned to cope and what they recommend doing when you feel overwhelmed. Just because you do not have experience in this area does not mean you should not try it. Just set yourself up for success by preparing beforehand.
IMPACT #9: High Rate of Job Turnover
About the Impact:
Another significant impact of patient death on nurses is that there tends to be a high rate of job turnover, especially among nurses who work in areas where death rates are higher. As nurses, we understand that death is part of the life cycle and, as much as possible, prepare to handle those situations when they arise. However, when high death rates occur, the anxiety, stress, depression, and feelings of hopelessness that come with it often lead to nurses leaving their jobs. Some nurses even leave the profession altogether.
How to Deal With It:
The stark reality is that some people get to a point where they feel they cannot handle it anymore, and leaving their jobs feels like the only option. If you work with a nurse in that situation, you deal with it by being supportive. Being a nurse is hard, and not everyone is cut out for positions that deal with death day in and day out.
If you are a nurse who feels the job is too much for you, do not neglect your feelings. Instead, be true to yourself. Talk to your supervisor, your spouse, or loved ones. Let them know how you feel and why you feel time away from the job or moving to a different position may be the best option for you. One of the awesome things about nursing is that there are endless opportunities for jobs. So, if one job is too much, another may be a better fit.
IMPACT #10: Strained Relationships
About the Impact:
I am one of those nurses who always seemed to take my work home with me. If a patient was upset or a family member needed someone to talk to, they always had my phone number, and I answered when they called. While there is nothing wrong with being there for patients, if I was not careful, it was easy to blur the line where personal and professional boundaries began and ended. In much the same way, depending on how often death occurs, the impact of patient death on nurses can reach beyond a regular shift at work and begin to affect other aspects of a nurse's life.
For example, I remember when I first began working as an admissions coordinator and bereavement counselor at a hospice agency. I not only verified that patients met the criteria for admission, but I had to coordinate their care with the rest of the staff. Also, as the bereavement counselor, I spent time with the patients and their loved ones to prepare them and help them through the grieving process. Because the grief process is such a roller coaster of emotions and everyone experiences it differently, there were days when it seemed as though my phone rang constantly. It was not long before I began to feel the strain of my workload affecting my personal relationships, and I had to make decisions to hand off responsibilities to appropriate staff and make sure I had designated professional boundaries.
How to Deal With It:
The most important step you can take to deal with or prevent strained relationships related to the impact of patients on nurses is to designate boundaries for yourself. Know what is acceptable contact and communication between you, your patients, and their families. Do not give out your personal phone number or contact information. Also, if things begin to get overwhelming, reach out to a person in authority at work to help you get a grip on things at work before the tension spills over into your personal life.
My Final Thoughts
Nursing is an amazing career, but we also face some challenges. One of the things nurses face is negative impacts related to patient deaths. In this article, I addressed the question, "What are the impacts of patient death on nurses?" It is important to understand how patient deaths affect nurses and know how to handle difficult situations when they arise. The 10 significant impacts of patient death on nurses + how to deal with it featured in this article are some of the most common impacts nurses experience because of patient deaths. If you follow the tips on how to deal with them, you can find ways of coping and have a rewarding career, even in the face of death and loss.
List Of Sources Used For This Article
1.
“What is Compassion Fatigue? 24 Causes & Symptoms Explained” (
positivepsychology.com)
2.
“Self-Care for Nurses- 25 Prove Strategies to Take Better Care of Yourself” (
nursingprocess.org)
Darby Faubion, RN, BSN, MBA
Darby Faubion is a nurse and allied health instructor with over 20 years of clinical experience. Her work history includes clinical experience in pediatrics, mental health, addiction and behavioral disorders, geriatrics, wound management, and communicable disease. Darby has worked in hospitals, long-term care facilities, and home health and hospice agencies. Darby also has experience as a nursing and allied health educator at both community college and university levels. Her love for nursing and nursing education led to her becoming a test-taking strategist and NCLEX prep coach.