No Longer at a Loss

For years, nurses relied on their instincts when responding to the death of a patient. From dealing with feelings of loss to lending support to grieving family members, each nurse had his or her own semblance of a system—a dog-eared scrap of paper with the address of a neighborhood church; the scribbled phone number of a funeral home; the memorized name of a good counselor.

Then in 2001, the Children’s Center launched the hospital’s first formal bereavement program for families and caregivers. “The cumulative loss of patients can take a toll on staff,” says program coordinator Elizabeth Reder, “and grieving families need follow-up to complete the circle of comprehensive patient care.”

The program includes regular phone contact with families, bereavement booklets mailed to their homes and support groups for parents and siblings. There’s also an annual tribute for families to honor loved ones, and a candle-lighting service for staff. Caregivers also attend debriefing sessions to share personal and professional responses to the loss of a patient.

Though the bereavement booklet is geared toward pediatric care, it also inspired an adult version that originated on the medical intensive care unit. Nurses there gathered their collective knowledge and practices into one resource. After careful review from nurses on other units, palliative care experts, social workers, clergy and family advocates, the booklet has become the hospital’s official bereavement guide for families of adult patients.

It walks families through the process, from emotional support to practical matters such as wills, insurance policies and death certificates. Bereavement educators teach nurses to initiate a comforting dialog when presenting the booklet, which includes a sympathy card for follow-up in the weeks afterward.

Dana Moore, the clinical nurse specialist who led the project, says that about 1,000 copies will be printed each year to accommodate both grieving families and employees suffering their own losses.

Hopkins is also poised to enter the future of staff bereavement support, thanks to a three-year, $367,500 grant from the Health Services Cost Review Commission. Oncology Nursing, where burnout is often highest, plans to promote staff “resiliency” through unit-based seated massage, quiet rooms, yoga classes, peer support groups and journaling—even flexible scheduling to give nurses time to grieve.

Developing resiliency is a dynamic process that enables employees to maintain and restore personal and professional wellbeing, says Oncology Nursing Director Sharon Krumm. Her proposed program—based on feedback from nursing focus groups and a partnership with social workers, the chaplain’s office and Wellnet—will roll out first to oncology units, then intensive care and eventually, the rest of the hospital.

-From Hopkins Nurse, Fall 2005