Letting go of patients is inevitable

Just recently I have been introduced into an ICU setting and shockingly enough, even though patients are comatose, it is still very possible to become attached. I have been seeing a patient for the last 3 weeks in ICU. And I have, unfortunately, become attached. Thiedke (2000) expresses how important it is to show your patients that you are not just there to perform a duty, but that you truly do care and want to be there for them. Last week, doctors informed the family that he was not going to be waking up. Family was in and out all day saying their goodbyes and passing messages along from family members that could not be there in person. I have never felt such emptiness and sympathetic loss as I did when I was watching a Mother beg her son to open his eyes just one last time. Needless to say, I was emotional and tearful for the remainder of that day.

There are upsides and downsides to the situation. A positive outlook would be that at least this patient’s family were able to say goodbye and spend some last moments with him. It provides closure, and that is seldom allowed when dealing with death. Negatively, someone is dying…and there is nothing I, or anyone else, can do about it.

I am new to witnessing death so frequently (he was not the first patient I have lost within these last 3 weeks), and I suppose I need to become accustomed to it and work on accepting that all I can do is comfort the family and do my best to make his last days as comfortable as possible.

When I am faced with a situation like this again, I will make more of an effort to distance myself, but still be there for the patient and family members if need be. Wolf (2008) describes a term known as “compassion fatigue” which occurs when a health care practioner becomes too close to a patient and feels the need to play the “hero” role. What Wolf (2008) implies is that there needs to be professional boundaries and to remember you are there to do a job; “be friendly, but not friends”.

Thiedke, C. C. (2000). Grieving the Death of a Patient. Family Practice Management. Vol 7(5): 78.

Wolf, K. (2008). Maintaining Professional Boundaries in Interpersonal Work. Professional Boundaries: A Nurse’s Guide to the Importance of Professional Boundaries. Retrieved from: www.ncsbn.org/Professional-Boundaries-2007-Web.pdf

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3 Replies to “Letting go of patients is inevitable”

  1. Great read- I can definitely relate to this!

    I’m not sure if i agree wholeheartedly with the idea of keeping distance from a patient and setting clear boundaries. I have found that sometimes just listening to, spending time with and speaking to a patient it can have significant clinical benefits. That said I don’t have the “answers” for dealing with death….I believe it is something that will always be difficult to understand and overcome. Perhaps speak to a clinician, who you believe is a role-model in terms of dealing with death, to see what their views and advice is.

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  2. I enjoyed reading this.

    I think that if caring and showing deep compassion for your patients is something that happens naturally for you, then distancing yourself will be quite difficult. Maybe following your narural instincts is what makes your practice special or unique?
    At the same time, I understand “compassion fatigue”, experiencing a loss so regularly can take its toll but I think we should all rather be a human before anything else. Don’t change who you are just yet!

    This was well written and your references seem interesting.

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  3. Hi blogger, This was an interesting blog-post and i can totally relate to this, I would like to highlight to you that sometimes we cannot help but be compassionate towards our patient and we really want to see them get better and we would do anything to make them feel better, distancing ourselves from them might give us an extra burden as your kind-hearted soul will always be crying deep inside of you asking many questions regarding what could have been different if maybe you were a little more caring to them but i understand where you coming from with this post, it is not always easy to lose someone even if you just knew them for a day or two.

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