¶ … GRIEF & THE NURSE'S ROLE Nursing

Comparative Experiences with Grief & the Nurse's Role

Comparative Experiences with Grief & the Nurse's Role

I have been friends with a certain young woman for most of my life. She was very close to her elderly cousin. With respect to the family tree, the young lady and her elderly male cousin were not close. They were, however, very close in spirit. Her cousin led a very active lifestyle and even had somewhat of a professional career as a musician. Sharing experiences with music made my friend and her cousin quite close. She is an aspiring songwriter with talent, though she has yet to have her "big break." They would discuss the creative process with respect to music. They would share they favorite music with one another. They also just simply enjoyed each other's company. Even in his elder years, the young woman's cousin was still quite active. There came a point, though, where it was necessary for her cousin to have home care because though most of his grown children lived in the same city as him, they were not around very much to take care of him in his final years.

The elderly cousin suffered a mild stroke. He recovered quite well for his age, in his latter eighties. While he was hospitalized, his eldest daughter sold his home, in which he had lived for the past thirty years and moved him into another residence. The move made him very upset and disoriented. Shortly thereafter, the elderly cousin was moved in a long-term residence and health care facility far away from his friends and family, though still in the area. It was quite inaccessible. Even still, the young woman made the time to visit her cousin. He stopped talking so much, and his mind was not as active as it had once been.

During her final visit to him, she asked him if he would like to go out with her for a day trip soon. To go see some jazz, to get a haircut and his favorite barbershop, and to have a nice dinner. Her cousin died less than a week after her final visit. She was devastated. My friend was shocked and stunned for a few weeks. At the time, I was investigating schools with graduate programs. I encouraged her to attend school and study music -- to channel the grief she felt for her cousin and her loss into something positive -- a decision he would have supported if he had still been alive.

There is a family that lives in my building named the Bridges. Mr. And Mrs. Bridges were married for fifty years. Their granddaughter, Tiffany also lives with them because her mother has a substance abuse problem and has not been a part of Tiffany's life. Tiffany's father is the son of Mr. And Mrs. Bridges. He has a reputation for promiscuity and reckless spending. He is not a dependable source of a support in Tiffany's life.

Mr. Bridges knew everyone in the neighborhood very well. He had a positive influence on the whole building, for which he was the superintendent, the street, and the neighborhood. One could often find Mr. Bridges having positive conversations with other older and elderly males who were his peers. He supported the youth in the community. He knew many of their names, parents, and activities. He offered his support and congratulations on achievements in a timely way. Mr. And Mrs. Bridges have been smokers for decades.

Mr. Bridges developed cancer in his lungs, which continued to spread into his lymph nodes and liver. By the time the cancer had been properly diagnosed, the cancer was in Stage 4. Many people attended Mr. Bridges funeral and offered their support to his family. Since his death, the Bridges family argues very often and very loudly. His son has returned and continues to upset his mother and daughter. Some other family members such as cousins, and uncles have had to come to their home to break up arguments that may escalate into fights. Mrs. Bridges is actually smoking more than usual since his death, though his death was primarily caused by smoking. She and Tiffany keep very strange hours. Tiffany got her shifts/schedule changed at her job and keeps very odd hours, so as to avoid her father coming and going.

The son is drunk more often, and starts arguments with his mother and daughter loudly. Even the family dog, Diamond, has changed her behavior. She kicks...

Neighbors can hear the Bridges yelling at Diamond for kicking the door and not following directions in general. Ever since Mr. Bridges died, the rest of his family has had a hard time coping. It is as if they are not coping at all. His son took his death as an opportunity to gain sympathy from friends and to vent about his father's shortcomings. Recently, some of these behaviors had subsided, yet there are still present.
There is a consensus regarding grief. It is that it takes place over several stages. Some professionals argue there are five stages; some contend there are seven. With respect to my friend and her cousin, I definitely saw the first stage, which was shock and denial. This lasted for a few weeks with her. She also felt pain, and some guilty for not having had the visit they had planned before he died. My friend was angry at his children, for the ways she perceived they treated him in his final years. She absolutely felt depressed and felt a loneliness without him. There are not many people in her family that she shared that kind of connection with.

During this reflective stage, she began her upward turn toward happiness and hope because most of her memories of him and them together were very happy. Once I told her about my intentions to return to school and my encouragement for her to return to school and study music, she definitely worked through her grief gaining acceptance of his death, and hope for the future -- to make music in his memory and honor. Her grief, to me, seemed like normal grief. She was lucky to have processed the trauma of the loss of her cousin so well. She is doing quite well now and excelling in a program of audio production and music composition.

The Bridges family is a far more complex set of circumstances, stages, and types of grief. I am not privy to as much detail about their grief as my friend, as they are simply my neighbors, but to some extent I am aware of what is going on, as I do engage them in pleasant, everyday conversation, and sometimes chat with Tiffany, as she is close to my age. Out of the three primary family members, I would guess that Mrs. Bridges has come along the farthest in her stages of grief. She is the most direct and upfront about her feelings. She is not in denial about the loss of her husband, and she continues to remember him fondly. I think she had a case of anticipatory grief. She was the closest to him, as his loving wife. She probably had a greater sense of how ill he was more than his progeny and peers. This may explain why and how she has moved through the stages of grief more so than her son, granddaughter and others.

His son's grief is complicated. At first his grief seemed to be inhibited or absent, and then it was delayed. It came, but much later than his other family members. He also shows signs of distorted and chronic grief. Tiffany is somewhere in the middle. She is around her grandmother, who seems to have a much healthier reaction to the loss of Mr. Bridges, but now she is subject to the emotional instability of her father. Though she is an adult, people often revert or remain in the initial relationship dynamics, especially with respect to familial relationships. Her resolution with her loss is somewhat stunted due to exposure and confrontation with her father and his distorted grief. His substance abuse of alcohol hinders his and his daughter's recovery from the loss.

All health care professionals have some kind of responsibility toward helping people develop coping mechanisms for loss. The nurse's role may be particularly critical because of the amount of contact nurses have with patients and their family members. Physicians and other doctors may perform more complex procedures and deliver news, yet nurses also deliver results and are often there before, during, and after the trauma or procedure. Nurses will also encounter a great variety of patients. Grieving has different manifestations that are often culturally determined and/or influenced. In short, different people handle death and express grieving in various ways. Nurses should be educated regarding the various ways grief is expressed. They should be able to recognize signs and stages of grief in many different types of people.

Nursing care…