I've been in nursing school for a long time and soon I'll be taking the certification exams. There have been a lot of subjects covered... and for every nursing student there is always one subject that they hate dealing with: death. Not catheters or blood or vomit or poop or insanity.... death. It's a horribly uncomfortable subject simply because nobody really knows what exactly is involved with death. It's the great unknown. We've all been sick at some point in our lives, but none of us have ever died so it's always a great difficulty to be with a terminal patient who needs comforting. We always feel out of our depth.
The subject is difficult enough whenever my classmates and I were assigned to nursing homes or skilled nursing facilities (SNiFs) for our clinicals... but what we always abhorred were the pediatric wards or oncology wards where often very young people- children, sometimes- are told that there is nothing more that can be done. Last week I was assigned to pediatrics with a classmate.
I did not envy my classmate because she was assigned a very tragic case of a child with spinal atrophy. The baby was only eight months old and had passed only two hours before we started our shift. My classmate was left with the distraught mother. The mother was just crying and crying even though she had been expecting this outcome for some time. I tried not to listen but my patient (four-year-old with stage 1 Hodgkin's lymphoma... not serious if caught early) had a bed right next to where the other child's parents were standing.
I didn't hear much but apparently the student in the ward tried to comfort the mother by saying "I had a miscarriage once two years ago. I know what it's like to lose a child. It's so painful...." The next thing I heard very clearly as did the rest of the floor because the mother went absolutely ballistic towards the poor student. I couldn't blame the poor woman- she had just lost her baby!- but I was still startled by the insane fury coming from the curtained area beside my patient's bed.
"How DARE you compare a miscarriage to my child!!!! How ****ing DARE you! You never held a child! You never saw the child, knew the child, saw his eyes, heard his laugh, knew what would comfort him and what would make him smile!!!! You just had a ****ing MISCARRIAGE! A ****ing PERIOD, you stupid ****!!! You do NOT know what it's like to lose a child, you stupid ...."
It went on like that for only a few more seconds. The mother literally had to be restrained by her husband and the accompanying doctor while the student nurse was taken out of the room. The student was assigned to another floor for the rest of her shift. After our shift our nursing instructor gathered us around for a special conference. "I don't know if we all heard about what happened today," she said, "But I just would like to go over a few things with you guys. Now, what do you do when a patient is grieving severely." "Comfort them," I said.
"Yes," our instructor replied, "And how do we comfort them?"
There were a few tentative suggestions. "Say 'I understand,'" "Pat them on the back," "Fetch them water," "Say, 'I'm sorry for your loss,'" These were all answered with a "Wrong!" by our instructor. When we finally gave up our instructor said:
"What do you say to a grieving patient? You say NOTHING! You say nothing. You listen. You nod. You let. them. speak. The only person who understands the patient's grief is the patient. No one else. Do you understand?"
We understood. We all remembered. I know that in my profession I will encounter a lot of death and fatality...and that sometimes there will be nothing that can be done. In our own lives though I think it's always best to just listen. Listen and try to understand. Silence is sometimes so comforting and so powerful and so good.
Have you ever had to comfort a grieving friend or relative?
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Comments (27)
I completely & 904870123978% understand how upset that mother is but her behavior was uncalled for. You cant minimize a loss because of your own. I'm 9 weeks pregnant now & even though my baby isnt here, I love him/her SO much already. I'm planning ahead, it already has a crib thanks so someone's generosity & already my mom & friends are buying things for the baby. A loss is a loss whether the baby was a miscarriage or it died, it was still a life. I hope that student didnt get railed for that incident. I think it was just bad timing. Who knows, that mother may have gone crazy if they just asked her if she needed anything.
When a friend of mine had a chemical pregnancy & found out there was no baby, I treated it as a miscarriage because she had started planning & changing her life around. I honestly didnt know what to say so I just offered my support. Good thing too since her mother did all but throw a party over that situation.
I had two friends who lost their children and all I did was listen to them and give them a hug
I truly believe that losing a child is one of the most if not the most tragic event that could happen to a person. My boyfriend died 3 months ago and while I was completely heart-broken I also knew that his parents were probablt suffering even more than me. He was there baby even though he was 32 and as much as I hurt for myself my heart also ached for them. I didn't know what to say to them and I stayed up tossing and turning the night before his funeral agonizing over what to write in the condolence card and what to say to them when I saw them. When I got to his Mom that day I didn't say anything, we just looked at each other and embraced and sobbed.
I guess saying nothing is better but that mother was so out of line. So out of line. The girl was just trying to say I've been there, I feel your pain, you're not alone. What a slap in the face. It's sad she lost all self-control. Ugh.
You know what, I guess I'm going to be unpopular for this but I'm saying it anyways. I totally agree with the OP's instructor.
When my father died, I was 20. It made me so upset when people said crap like "I understand." Unless your story was just like mine, no you don't. There is no good reason to say that, it is almost like story one-upmanship. And wtf?
I don't think the woman was out of line because I agree with her. Was her cursing and venom necessary, probably not. But grief takes many forms, and if that is what SHE needed at the time, then so be it. That student nurse was in the wrong to *compare* life stories at the time of this woman's acute loss.
Is a miscarriage a loss? No doubt, I am not minimizing it. But comparing grief is ... oh my god it is so painful and unnecessary. What is the point?
This is one of the best tutorials for how to help those going through serious and close loss that I've ever seen. Thank you for writing it.
I had to re-read the post to see you were given the briefing/debriefing after the situation. Maybe the mother was out of line as some of the other posters have said, but you can't tell anyone how to grieve. I doubt the woman was in control of her emotions when she lashed out. I doubt that it was deliberate. I doubt she meant to belittle the pain the nursing student felt from having a miscarriage.
I am all for on the job training for nursing and pre-service teachers (etc) because that is how you will get your best training. However, in this situation, if I were in charge, you friend would have been reassigned when she arrived or she would have not had to handle that situation alone. She would have at least got a briefing about how to handle grief when she arrived. Your instructor is right, you shouldn't say anything unless the patient asks. This is something you all should have discussed before this happened. I understand knowing in theory is, not the same thing as knowing in practice. However, say nothing, should have been something that popped into her mind.
I am sorry that your friend and the mother had to go through that.
@sarahsmurfette@xanga - Thanks a bunch
And personally I agree with everything you say
"Comparing" experiences is a natural way for people to try to relate to others.
However, the instinct to do so needs to be shut down when dealing with grieving people, especially when it is your job. I feel bad for the student, because she made a mistake. But, it was definitely a mistake. You'd think that is something you'd be taught thoroughly before entering a situation like that, because it doesn't come naturally to all people.
@sarahsmurfette@xanga - I completely agree with everything you've said and you said it so well.
I, too, lost my father at 19 and nothing was worst than people who tried to "comfort" me by just saying something. It's almost like a club you join that really no one understands unless they've been through almost the exact same situation.
I was a hospice nurse for 14 years, and yes, you do say things. You can't just assume you know what the dying patient is going through, or thinking, and sometimes very softly asking what you can do for them, or gently rubbing a part of the body not in pain is helpful. Sometimes they have a favorite book at the bedside, and reading them a chapter is nice. And sometimes, the family has been fractured for decades, and you can help by talking with them, reminding them to just be there for the person, and frequently just reminding them to tell the patient they love him. If they don't, so beit. The support system from family and friends is just as important as the nurse pumping meds through his veins, and you can forge a relationship with them, learning about your patient, the things he enjoyed doing, etc. It was my favorite type of nursing because it is so broad, and so many things come into play. I remember my own mother's cancer death, and a friend showed up one day and bitched constantly about her own health. We told her not to come back.
I understand that the student was trying to help, but I cringed when I read the story. I think that may have been one of the worst possible things that she could have said in that situation. It's understandable because she was still learning, but it's sad that a person in such a horrible state of grief had had to be on the receiving end of her mistake.
I agree with your instructor 100%, especially when you're a medical professional who doesn't know the individual personally. There isn't usually much we can say that will give any true comfort or consolation during a time of intense grief. No body on the outside really "understands" and, to the grieving person, it really won't "be okay." If the grieving person is your friend, I think the best you can do is be willing to listen and remind them that you're there for them and that they can call you for anything at anytime.
That poor mother had just lost her child and people are criticizing her for lashing out at the student? I would probably have done the same thing. In all honesty, most of the anger might not even have actually been directed at the student, but she was there and she ended up in the line of fire (thought IMO she still should have just kept quiet).
I've lost people I love, Ive watched someone I cared deeply for die in a hospital.. and its beyond heartbreaking. And in my experience "I know what you are going through" and "ive been there" are two of the worst things you can say to someone who just lost a loved one. Don't say anything, just be there.
I think the instructor did the right thing. But that student should not have been there in the first place.
Eek that was a dumb thing for her to say. But I feel bad for her. I'm sure she instantly regretted it and was just nervous. My cousin had a miscarriage right before I did this year. She said "It felt like I lost my daughter (who was 1 1/2 at the time). I had a 9 month old when I miscarried. I was shocked that my cousin said that. As tragic and upsetting as a miscarriage is, it is NOTHING compared to losing your child. I healed and moved on from my miscarriage. If I lost my daughter, my world would end.
People said dumb things to me too. "Well it was meant to happen." "Something was wrong." "You should go out and try to do normal things." "You can try again." I'd prefer they just ask me how I am and be sympathetic. I tried to not get upset because I'm sure it is just awkward for them. Really a hug and silence is just the best response to someone grieving.
A girl I work with just lost her father AND 18 month old daughter at the same time. I'm glad I read this, to have some perspective on how to handle seeing her.
My son died when he was a month old. I know how that mom felt and if you can not relate (and I pray that you can not) then don't say anything about how what she said was uncalled for or that it was dumb. You may think you can try to put yourself in her position but you can not. When you lose a child, especially in those first few weeks there is no what is called for and uncalled for or inappropriate. All these societal lines that we have painted for our lives are gone.
Later in her grief she may not even remember that moment but if she does I am sure it isn't something she will be super proud of.
Your instructor is 100% right. Do not say anything. Nothing you say can make it better and most people say the wrong things. Things that would seem comforting to other people just don't work. When my son died the doctor working on him came in and gave me a hug and cried with me. She didn't say anything other than "I did everything I could". She just gave me a hug and cried. And I thank her for that. Her emotion with out words was what I needed and it showed me that she really meant she did everything she could.
@Pollypinks@xanga - Wow, that's amazing that you've been a hospice nurse for so long! I've known a couple of instructors who were hospice nurses and they ended up switching to another nursing facility after only a few months on the job. They just couldn't take it emotionally. "My heart got too full."
I think if you're an experienced nurse who's been in Hospice a long time you can say something comforting.... but if you're inexperienced or only a nursing student it might be better to say nothing IMO. I don't know personally, I've never worked in hospice. Heck, I'm not even a nurse yet
What a stupid move on your friend's part. And I would probably react much the same way as that mother did. Maybe not with so much venom, but....you really can't compare a miscarriage and a child's death. I've had two miscarriages, and I've got a healthy four-year-old. I know for a fact that there is a difference. The miscarriages were hard to deal with, yes,but the pain passed quickly. If my boy were to pass away I think I would just kill myself right there.
.......She had no right to react with such venom to the student. It's a STUDENT who was learning to deal with how to appropriately address such a loss. I'm sorry, but you don't have a right no matter what is going on in your life to lash out like that. You just don't.
Miscarriages is pretty much you losing a child. A child you WANTED. A child you probably couldn't wait to hold, kiss & cuddle. At least this woman had that opportunity. The student was only trying to comfort her, to let her know she had lost a chance to be a parent as well. Obviously, not all people want to see it that way, but still the woman shouldn't have lashed out in such a manner.
While my heart goes out for the woman who lost her baby, I don't agree with her anger & animosity she showed the student, she should have excused herself. You shouldn't treat people like that. End of story.
I've never known what to say to those grieving and I'm glad read this so I don't make this mistake because I hadn't prepared what I'd say/do if the situation arose. I feel bad for both parties in this story though...
I was going to say, "You don't talk. You listen." If it's someone you know, you offer to be there for them if they need you to be.
I almost wish I'd had the nerve to speak back against some of the idiotic things that were said to me when I miscarried (mostly after the first one). "You'll just have to pray." "Everything happens for a reason." I'm an atheist, for one. For two, if your god is killing my children, then you're worshiping the wrong deity.
Shortly after I lost the first one, I heard a coworker (she didn't know) say, "the hardest thing about losing a child is you're not supposed to have to bury a child". I really wanted to go off on her for that. No, bitch. Funeral expenses should be the least of your concerns. Ugh. I can't stand that woman.
I have a friend who had an ectopic pregnancy. She has a friend who lost her premie. The three of us lost our children within a span of just a couple months. I'm not stupid enough to try to say that any of us "know exactly" what the other is going through. We've lost children. We hurt like hell. It does no good to try to say we have the same pain or argue who hurts more. Even if you've lost your father and you're talking with someone who has just lost theirs... you aren't the same people and you didn't have the same relationship.
I totally agree with what your instructor said. Nothing is more comforting than someone saying,"I know how you feel," or," They are in a better place." Because really someone that is grieving is going to tell that person to go f*&% themselves. My grandma passed away recently who was the world to me and I hated the people that came up to me and just kept talking and making it seemed like they "knew" what I was going through. But the ones that just held me and let me cry and didn't say anything but I'm so sorry were the ones that helped me the most.
I never had to tell someone their loved one has died but , as a Psychology student, I study death and how to approach it. And I would approach it just like you were told to
@syringesofglitter_x@xanga - LOL "I'm sorry you lost your child but please watch the potty mouth." I think any nurse being caught saying that to a patient's relative would have her behind booted out of a hospital pretty quick!
I know that a lot of times, people don't know what to say so they use these tired old platitudes that no one really wants to hear anyway. "I know how you feel," "They're in a better place," etc. NO ONE wants to hear it, but still people say it.
When I was doing infertility treatments I had to hear things like that all the time. "Maybe it wasn't meant to be," "Everything happens for a reason," "Something was wrong with your baby, Nature/God spared you the trouble of a baby with disabilities," "Just relax and it'll happen," "You should just enjoy not having kids and go on vacations and sleep in!"
If people can't cut the canned bullshit, the best thing to do is just listen. When my daughter died, that's all I wanted. I didn't need words of comfort, just a shoulder to lean on.
@phoebester - Did I say that is what the student nurse should have said to the grieving mom? No I didn't. Please don't "put words in my mouth" thank you. I simply expressed my opinion that no matter what is going on in your life, you don't have the right to lash out like that to someone who 1. is a student, learning what to say or what not to say & 2. to anyone who is trying to comfort you.
I don't think the mother was out of line, she had JUST lost her baby. Not a day ago, a week ago or a month ago...but a few minutes ago. I think it's fair to say she truly could not even begin to think about the discomfort of a student nurse.
The student nurse did the what she thought best, turned out it was a bad call, but was wisely turned into a learning experience for all.
There is no one right way, or one right thing to say or do in these situations. There is no way to know how the other person will take or hear our words and actions. I do think that it's wiser to listen than to speak, and to keep it all about THEM.
I heard some wise words on a radio show yesterday, about being the kind of friend who invites others to talk out their thoughts. Rather than saying "I know" and sharing our own parallel experience or feelings, we say only things that communicate that we are hearing them and honoring their thoughts, feelings and words. Never make it seem like we want them to comfort US, just keep it on them.
I've had friends who have experienced the loss of a child. The only thing I had to offer, and it is true to the bone is "my heart is broken for you."