Thursday, September 02, 2004

Learning to Cope with the Grief of Others

How do you cope with witnessing the grief of others regularly in your work? This was another question posed in the comments section of one of my previous posts that I thought deserved a posting of its own.

Grief feels like a well deep inside me. The smallest sadness can blow off the lid on that well and it's like there is a bottomless hole filled with tears that is suddenly exposed and all my old grief is reawakened. The more I let myself cry freely, without trying to hold it in, and the more I take that lid off, however, the less traumatizing it is when I am sad again. I watch Six Feet Under and cry almost every other episode. I cry at the endings of happy movies. Perhaps this is why I am so addicted to watching DVD's every night off. They let me feel safe accessing the sadness.

Through my job, I have witnessed people coping in various ways with their grief - from directing anger towards me (in one instance in particular) to dramatic displays of loud wailing by mothers and wives. Their grief could be heard throughout the entire hospital ward. Then there is the silent but heavy weight of some loved ones' grief as they stand quietly at the patient's bedside. However, some people seem to be either at peace with their loss or in the denial stage of grief.

Are you familiar with the five stages of grief? Of course, the stages are not necessarily experienced one at a time nor in any particular order.

1. denial
2. anger
3. bargaining
4. depression
5. acceptance

In my job, I have seen all five. When that one family was angry with me, that was the most difficult. I knew on an intellectual level that their anger was a normal and healthy part of processing their grief. But I was also having a hard time with the loss of that particular patient and a part of me was blaming myself for her death (though I knew if she hadn't died during my shift, she would have died within the next few days). So when the family member's grief is complicated by my own personal feelings, coping with the grief of others can be especially difficult.

However, most of the time, I see working with these patients and these families as a form of meditation in a way. Before walking into the room, I focus on bringing my mind and spirit into a state of peace so that I may be stable within myself to serve as a source of strength and stability for them in their time of vulnerability and need. And perhaps by bringing that peace within myself into the room, I hope that it may be contagious and have a calming effect on the grieving.

The first time I cried while at work was during a visit to a family in their home (I was doing clinicals with a home hospice program). I was on my way out the door. I knew the patient would die in the next day or so. The patient's husband walked me to the door. I wanted to say something, anything to support him. I knew it was likely I wouldn't see him again, as I wouldn't be back until the next week and I was certain his wife would have passed before then.

"I want you to know you are doing an amazing job taking care of your wife." And he was. He was very loving in looking after her and giving her medication. Everyone should be so lucky as to be surrounded with such love in their final hours.

He looked at me and almost shrugged, "She's my life."

The tears welled up in my eyes immediately and I threw on my sunglasses to cover them up as I walked out the door. I met my preceptor back at the car.

"How do you do it without crying all of the time?" I asked her.

"Oh, I cry. Some patients affect me more than others. It's okay to cry. It shows them that you care."

I have never forgotten those words. Tears have come to my eyes again in certain situations with specific families. Crying is not bad, however, you may not fall apart. You don't want the family to feel the need to comfort YOU. So although, I feel a sense of inner calm, I do not try to deny my feelings as they come up. I was worried if I cried at all, I would fall into a sobbing puddle.

The only time I cried that hard was the time the family was angry with me and I was blaming myself for the patient's death. But I didn't fall apart in front of that family. I went to the bathroom and cried until it all came out. Then I went for a long walk outside to pull myself back together before I went back in that family's room. In this case, I hid my feelings a little too much. By covering up my feelings after falling apart, they likely got the sense that I didn't care, which probably enabled them to continue directing their anger toward me. Though I did go back into the room and offered my condolances, I think they needed something more. More solid evidence that I cared and their mother wasn't just an everyday occurrence in my job.

Obviously, coping with other's grief is not something I have mastered yet. I am still learning.

I welcome your stories on learning to cope with other's grief.

No comments: