Grief, Loss, Death
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| Identify the nurses role when caring for patients who are experiencing loss, grief, or death | Advocate, counselor, teacher, caregiver
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| What are the types of loss experienced throughout life | Body parts of function, self-esteem, friendships, confidence, income
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| Describe Kubler Ross's theory concerning the Stages of Dying | Ross says individuals experience 5 different stages of grief/dying: Denial, Anger, Bargaining, Depression, Acceptance
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| What are the four phases of Bowsb's attachment theory | Numbing, Yearning and seeking, disorganization and despair, reorganization
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| Describe Numbing stage of attachment theory | Last a few hrs- few weeks, shortest stage, protects person from full impact of the loss, "stunned" or "unreal" stage
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| Describe the yearning and seeking stage of the attachment theory | Lasts months-years, tearing, sobbing, acute distress occurs, common physical symptoms of this stage include tightening of chest and throat, shortness of breath, feeling of lethargy, insomnia, loss of appetite, internal yearning for lost person
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| Describe the disorganization and despair stage of the attachment theory | Person exams loss and expresses anger towards anyone who may be responsible for the loss, person retells story again and again until realization sets in
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| Describe the reorganization stage of the attachment theory | Usually takes a year or more, person begins to accept change, assume unfamiliar roles, acquire new skills, build new relationships, separate themselves from the lost person
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| Describe Warden's Grief Task Model | Task I: Accept reality of loss; Task II: Experience pain of grief; Task III: Adjust to a world in which the deceased is missing; Task IV: Emotionally Relocate Deceased and move on with life
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| Describe Rando's "R" process model | grief as a series of processes instead of stages or tasks. They recognize the losses, reacting to the pain of separation, reminiscing, relinquishing old attachments, readjusting to life after loss, reminiscence important activity of grief/mourning
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| What are the different types of grief | Normal grief, Anticipatory grief, Disenfranchised Grief, Complicated Grief (exaggerated grief, delayed grief, masked grief)
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| Describe characteristics of a person experiencing grief | Withdraw, anger, depression, loss of appetite, lack of concentration, short attention span, fatigue, disorganization, forgetfulness, problems with decision making, loss interest/motivation
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| What are some interventions for symptom management in patients at the end of life? | pain meds PRN, keep mouth moist, ice chips, oral care, modify environment to conserve patient energy, offer small portions of pt preferred food, identify underlying cause to anxiety and provide active listening
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| Discuss the criteria for hospice care | Usually have less than 6-12 months to live, must have a family caregiver to provide care when the patient is no longer able to function alone, pt may be hospitalized to stabilize symptoms (they must be out of control) must return home 24 hrs after stab.
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| Describe care of body after death | Federal and state laws require institutions to: request organ/tissue donation, perform autopsy, certify and document occurrence of death, provide safe and appropriate post mortem care (RN pronounces death)
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| Discuss the nurse's own grief experience when caring for dying patients | Nurses often become attached to their patients, loss is experienced with them too, Before recovering from grief from loss of one patient oftentimes nurses encounter another death, feelings of frustration, guilt, sadness or anxiety may ensue
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| Identify methods for nurse self-care in grief and loss | healthy self, compassion fatigue, maintaining balance (self reflection, talking, creative strategies, stress management techniques)
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