Within a period of 6 months, two of the nurses I work with lost their mothers. In both of these cases, they chose to have their mothers on our hospice.
This is a very hard thing to do. It was awkward for a while for all of us at team especially to be referring to and discussing someone in a very clinical manner, yet knowing that this was a team member’s mother. Yet it was also a good reminder for all of us that all of our patients are someone’s mother, father, brother, sister, or even child.
The awkwardness goes away after a brief time. However, when that loss finally happens it can be devastating, not only to the family member but to the whole team.
One of these mothers had a rather traumatic decline and passed away quickly. Her daughter took a week off to recover and to take care of family matters. When I saw her after she returned, she looked exhausted. As we talked, we found that she was going through all of the normal grieving process that we all go through – that is to say, she was in pain. She changed her ring tone on her phone because every time it rang she went into a panic, thinking it was her mom. When she saw an old lady driving by, it looked like her mom. These are all fairly normal experiences, even though they don’t feel normal.
But perhaps the most difficult thing about returning to work in the kind of work we are doing can bring back that loss on a nearly constant basis. Caring for the ill and dying often brings back memories for hospice workers and other health care professionals of their own losses. When those losses are in the past and have gone through some processing they are manageable.
However, dealing with the dying on a daily basis, along with all of the little crises and problems that come along with it (handling medication changes, dealing with grumpy PCP’s, calming emotional family members) can dramatically affect how one handles their own losses.
Compassion fatigue is common among many professional caregivers, and when one is dealing with a personal loss and their personal resources are depleted, it can feel like someone has replaced the match on your ever-burning candle with a blowtorch.
I’ve heard nurses and other hospice staff talk about numbness, panic attacks, and severe depression related to recent losses. Some left hospice for something with a lighter touch or left healthcare completely.
I had a personal experience with this a few years ago. The hospice I worked for at the time took on the case of a young boy who was dying from cancer. I was the chaplain for his family and identified strongly with them because I had a son about his age. I started to become fearful and paranoid concerning my own son’s health. Every headache could have been a tumor, every tired afternoon was leukemia. I struggled with his loss when he died a great deal, not only because it was such a tragic case but also because I could so easily see myself in their shoes.
All of this points to the need for self-care, but it also points us toward being aware of the needs of those working around us on a daily basis. Hospice can be frantic at times, and with our energies directed outward so much we often fail to see that the needs of those we work with are the same as those we are paid to care for. We don’t always handle that well as a team. But we try in our own fumbling way to watch out for each other and give each other space and a listening ear.
This is usually the spot where you read “so here’s five things to do in order to provide care for yourself”. If you want to know that just Google it. I want to say that it’s not always easy. You can’t reduce self-care to a list of things to do or things to look out for. It’s something that is both a necessity but a struggle, much like life itself.
Samuel Blair is a full time Chaplain with Bridges Hospice in Pittsburgh, PA, and has been involved in hospice care since 2003. He writes a lot about his experiences at www.chaplainsreport.com.
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