Sometimes I Feel Heartbroken When My Patient Passes Away, I Hope They Know I Cared
I wonder if the mother of the child that drowned 7 years ago knows that I still think of her. Does she know that her guttural sobs and animalistic screams upon holding her lifeless child still echo in my head if I think about it for too long? Would it bring her comfort or sadness to know that her baby would be the same age as my nephew, and I have thought about her boy and all of the moments she has been forced to miss?
Does the son of an elderly man know that I continue to think of his father every Christmas Eve because years ago I held his father’s hand while he took his last breath so he wouldn’t be alone? I remember thinking about how his family would never hear his voice say Merry Christmas again, and how this day will forever hold a memory of an empty phone call.
I’m curious if the parents of a teenager know that I will forever think of them when I hear Taylor Swift’s “Love Story” because it was their daughter’s favorite, and they played all of her most beloved songs on repeat after the doctors declared her brain dead.
My shoulder has been the place where childless mothers and motherless children have shed tears.
Despite this, these are the stories that I don’t share with many people due to the sacred nature and protection I feel around them. Some of the most gut-wrenching and transformative moments in my career occurred in the solitude of my patient’s room and replays in the tenderness of my memory. Unfortunately, the stories that my friends and family most likely remember involve the stupid, sarcastic, and often times mean comments shared by patients and nurses alike. These soft but painful moments have the tendency to be overshadowed by the humorous and often heartless stories we share as a means of self-protection.
With compassion fatigue at an all-time high in the nursing profession, onlookers could easily make the judgment that such high exposure to sadness and grief for an entire career might drive a nurse to develop a heart of stone. But what strangers don’t realize, is that many nurses don’t want to talk about the cases that have deeply affected us. Sometimes it’s because we don’t know if we will be able to tell the story without audibly choking up reliving those experiences. Other times, it might be because those moments feel too sacred and vulnerable to share with people that can’t empathize with us. But for many nurses, the truth is that many of our patient’s stories have woven their way into our outlook and had an impact on our view of the world.
Our hearts only have the capacity to hold room for so much sadness and tragedy.
Hospitals don’t attract people when they are having the best day of their lives, and nurses have had to learn to take on aspects of a counselor and therapist to provide the best care for patients during their heartbreaking moments. In order to keep our personal lives minimally affected by the work we do, many nurses have developed coping mechanisms that involve detaching from patient stories or keeping them at an arm’s length away from our hearts.
When friends or family members ask about our day, we have a tendency to glibly respond by saying how we cared for a patient that had a horrible situation happen to them. And, although we might have deeply cared about this patient and their stories, the way in which we tell our stories might come across as callused and cold. At times, this might be a response to wanting to escape the sadness of the day. At other times it might simply be that once we reach the door of the hospital, we no longer have the capacity to carry our patient’s burdens home with us.
Although the rate that nurses experience burnout has excelled at an exponential rate especially due to COVID and the ongoing nursing shortage, I hope that a positive consequence of the past few years will be normalizing the difficult seasons of nursing. If nurses feel more at ease talking through challenging social aspects of the job with one another, it may lead to a more positive expression of our work to people who do not work in this profession. Similarly, as nurses begin to debrief and build this level of comradery with one another, it might spur on the ability to have more vulnerability in the tender moments with patients.
Sure. There are plenty of nurses in the world that have managed to build strong walls around their hearts and show up to work day after day without being affected. But they are the minority. Many of us care deeply about the joys and trials that our patients face and have come up with individualized methods for creating boundaries between our work and personal lives.
Despite this, that doesn’t mean that we don’t continue to think of these stories for years to come and wonder if the families know how deeply their loved ones have touched our lives.
