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26). Two other writers note, "Nurses must be aware that there is no one right way for a patient to respond to dying. Nurses must adapt their care based on patients' current responses and needs and not expect them to always progress through defined stages" (Craven & Hirnle, 2009, p. 1327). Thus, nurses need to be attentive to their dying patients and their moods, and need to take the time to get to know these patients so they can help them through their grieving and make the process a little less painful.
The nurse plays a critical role in the grieving process, because she is often the representative between the family and the dying patient, and she should be able to act as a facilitator between the two, especially if the family has been estranged. She can also learn to recognize the symptoms of grief in patients and families, such as loss of appetite, loss of sleep, depression, lack of interest, loss of sex drive, and other symptoms, to help treat the depression and anxiety with some form of physical or medical treatment, if necessary. If left untreated, grief can turn into dysfunctional grief and literally ruin a person's life, so the nurse plays a key role in helping the patient and family members manage their grief.
It is also important to remember that the grieving process is different according to the details of the death. A sudden, traumatic death can elicit more grief from friends and family as it was not expected and accepted. A group of writers note, "When a family member dies as a result of sudden traumatic death, the immediate shock...
In this case, the nurse can be invaluable at helping to console the family and friends, but also to watch for signs of distress or health-related problems related to the grief, because sudden, traumatic deaths can sometimes trigger health-related reactions in the mourners, such as heart attacks, etc.
In conclusion, the nurse is a primary figure in the grieving process, and she has to watch for signs of grieving in the terminally ill patient, the family, and friends, as well. If she is empathetic and understanding, she can gain information that can help her understand the overall physical and mental health of the patient and family during the grieving process, and she can make this difficult time pass a little easier, as well. It is crucial for her to understand and recognize the grieving process, and to recognize that grief is managed differently in different cultures, so she can be aware of patients' specific needs and wants.
References
Clements, P.T., Deranieri, J.T., Vigil, G.J., & Benasutti, K.M. (2004). Life after death: Grief therapy after the sudden traumatic death of a family member. Perspectives in Psychiatric Care, 40(4), 149+.
Craven, R.F. Hirnle, C.J. (2009). Fundamentals of nursing: Human health and function. Philadelphia, PA: Wolters Kluwer Health.
Tedeschi, R.G., & Calhoun, L.G. (2004). Helping bereaved parents: A clinician's guide. New York: Brunner-Routledge.
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