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As nursing staff, we learn that compassion is the cornerstone of nursing, but when it comes to the death of a patient, where is the compassion for us?

Surely, it’s only reasonable to expect that health care staff may feel some form of grief or bereavement when one of their patients dies. But from my experience as a student, there’s little support directly related to self-care after death. This needs to change. 

Caring for a patient at the end of life and performing “last offices” – the care given to a body after death – can be a highly emotional experience. 

I’ve been lucky to have a brilliant support network, but I know it’s not like this for everyone

But the stigma of talking about it – and the feeling that as nursing staff we should just rally around and “get on with it” – is very real. The pandemic has exacerbated this.

From washing a patient to supporting the family, our role is key. And as nursing staff that can become very normal. Then it starts to become treated as an  everyday task – when actually it’s far from it.  

A ton of bricks

I’ve had the experience of performing last offices and then going on to care for a living patient thinking I’m absolutely fine. It’s only when I get home that it hits me like a ton of bricks. I’ve been lucky to have a brilliant support network, but I know it’s not like this for everyone.

It’s become clearer to me that nurturing the mental health of staff at this stage in patient care is absolutely paramount, not only for the wellbeing of the staff member but also because it directly affects the quality of care we provide to patients who are living. 

There is no huge change that can be implemented right now – it won’t be an overnight fix. We all know how stoic the nursing profession can be. We don’t always like to talk about how we’re feeling. But burnout is a real issue and we need to look at small changes we could make to stop the ball rolling in that direction in the future.

I’d like to see better signposting introduced in staff-only areas to support those involved in last offices. Ideally it would be alongside a small flyer or card integrated into the care after death process that simply reads: “If you require further support, please contact…”. This would provide a discreet, anonymous way for students and staff to access help if needed. 

Just because something is the norm, it doesn’t mean it should stay that way

It’s not a big change but would make a huge impact by acknowledging that dealing with death can be hard and it’s OK to feel that way about it. It would help to validate what people are going through by recognising the magnitude of it all and help them to feel supported and listened to.

Reduce the stigma

But what else can we do right now as students and newly qualified nurses to help shift the culture around death? Together we can start opening up conversations with our peers about improved support for our mental wellbeing.

We can keep talking, and we can keep asking questions. Just because something is the norm, it doesn’t mean it should stay that way. Importantly, we can make sure we reach out for help if we’re struggling – it’s a strength to recognise this and to take a step back if that’s what’s needed. 

Finally, we can continue to look out for each other. Surround ourselves with supportive people and don’t continue the stigma by not talking. Voicing things little by little helps prevent them turning into something more overwhelming so we can progress through our nursing career with more strength and resilience.

Megan Sutherland has recently completed her studies in Scotland.

Picture of Megan by Chris Sutherland

Supporting you

The RCN offers a free confidential counselling service over the telephone for members, including trauma-focused therapy.

Get further information online or to book an appointment call RCN Direct on 0345 772 6100.

The RCN has a number of resources on end of life care including a wellbeing programme for nursing staff.

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