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?