Nursing Grief Discussion

Nursing Grief Discussion

Nursing Grief Discussion

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I received the report from ED that I was receiving an intoxicated and suicidal female patient. A typical report followed for a common admission. The patient arrived to ICU. She was calm, polite, well dressed, and clean. When she did speak, which was not often, she appeared educated and articulate. Nursing Grief Discussion

The patient responded to my admission assessment questions with a flat affect and minimal eye contact. When questioned if anything triggered her drinking, the patient stated her fiancé had committed suicide, and she had discovered his body. She stated they both had been attorneys in a successful law firm at that time. After his death, she began to drink alcohol to cope with her loss. She became an alcoholic. Her alcoholism caused her work to become impaired, and she began losing cases at her law firm. She was fired. She eventually lost her home and had no other choice but to return to her childhood home with her mother. Her mother took her to the Emergency Department in hopes of getting her the help that she needed. Nursing Grief Discussion

The patient had been at a high point in her life. She had a successful career. She had been planning a future and wedding with a loved one. Suddenly, her entire world irreversibly changed. She began to spiral out of control. This depression and addiction may not have been caused by a suspicious illness or from a physical injury, but what she experienced caused her emotional injury to become a type of physical injury. It also put her at significant risk for self-harm.

The patient and I established an excellent rapport. By the end of my two shifts as her nurse, her flat affect remained, but she began to make eye contact with me. I empathized with her. I told her that she was not alone and that she did not have to fight alone. She was not the only person to endure unimaginable struggles, and she would not be the last. I encouraged her that this darkness would not last forever and that better days were ahead.

The patient was assigned to a hospitalist that was not known for compassion, patience, or empathy. I approached him and explained what the patient had gone through. I notified him of her professional success and the level of education she had accomplished, hoping he would not stereotype her as he often did with several patients. I expressed my belief that with the correct type of assistance, the patient could be reached. He disagreed with me and stated, “No, she was successful. She is just a drunk now.” I was persistent with my rehab suggestions and expressed my disappointment in his stereotyping. I also reached out to Case Management. She was discharged to one of the rehab facilities. Unfortunately, I do not know her outcome. I wish I did.

Complicated grief is a “prolonged, bereavement-specific disorder” (Parisi, 2019). Complicated grief is defined as a “persistent, intense, and impairing grief reaction” (Goetter, 2019). When one struggles with the strong yearning for the deceased, persistent thoughts of their loved one, and avoiding reminders that the loss they are experiencing is permanent and lasts more than 6 months indicates a diagnosis of complicated grief (Goetter, 2019). Complicated grief can cause significant psychological and physical consequences. Prolonged bereavement may lead to increases in substance abuse. Complicated grief predicts increases in smoking and alcohol dependence. Grief assessments and grief interventions were found to be effective in reducing symptoms of complicated grief as well as substance abuse (Parisi, 2019).

The challenges nurses face are not only just patient and family-oriented. Sometimes, we fight challenges within our own circle. We must always remember to advocate for our patients regardless of who our fight is against. Nursing Grief Discussion

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