Why nurses need to understand the principles of bereavement theory

Bereavement Needs of Critical Care Nurses: A Qualitative Study

BACKGROUND/INTRODUCTION

Bereavement and grief in critical care nurses remain an understudied phenomenon. As a way of self-protection, nurses may compartmentalize their own feelings and need assistance and support in processing feelings of bereavement. Nurses spend much of their time caring for patients and their family members, while guiding them through the dying process; however, they may not take adequate time to address their own bereavement needs.

OBJECTIVE/AIMS

The aims of this study were to explore the bereavement needs of critical care nurses after experiencing the expected or unexpected death of a patient and, from their lived experiences, gain insight as to how nurses perceive, process, and cope with the death of a patient.

METHODOLOGY

A qualitative, phenomenological focus group was conducted with critical care nurses (N = 10) after gaining institutional review board approval. The group discussion was audio-recorded and transcribed. Content analysis was performed to identify common themes.

RESULTS

Seven themes emerged: (a) emotional distress, leading to compassion fatigue, burnout, and moral distress, (b) empathy, (c) resurfacing personal loss leading to secondary traumatic stress in the workplace, (d) unrealistic expectations placed on the nurse, (e) detachment leading to compartmentalization, (f) lack of formal education, and (g) self-care and available resources.

DISCUSSION/CONCLUSION

More education for nurses in undergraduate and continuing education programs is needed to assist nurses in the bereavement process. More interventional studies are needed to explore programs of nurses' self-care both in the workplace and in nurses' personal lives to more effectively support their emotional needs.

Analysing the role played by district and community nurses in bereavement support

This article explores bereavement support as one of the roles of the district nurse (DN) and community nurse (CN). Bereavement support is considered part of palliative care, which is a major role for all nurses. There is, however, a constant move to increase acute care in the home, questionably placing greater demand on DNs/CNs and primary care provision. Discussion in this article is framed around research into bereavement care in the community, existing guidelines, and policy drivers stressing its importance. Bereavement can result in depression, stress-related disorders, and high mortality; it is therefore imperative to understand the complexities, theoretical aspects, and implications of poor service provision. Palliative care is one of the primary roles of a DN, and it largely involves emotional support. It has been shown that DNs lack confidence and the skills to provide bereavement support to families and carers of palliative care patients. Education, training, and time management are the main determinants of effective bereavement support. The need is to develop a standard collaborative approach to bereavement support and incorporate it into the palliative care role of DNs.