How Nurses Can Cope With a Patient’s Death

If the COVID-19 pandemic taught us anything, it’s that all nurses encounter patient deaths at some point — no matter which nursing specialty they pursue.

Death affects nurses on a deeply personal level. Caring for a dying patient and their family is complicated, and there’s no right way to handle the situation.

We spoke to an experienced oncology nurse who has cared for many patients at the end of life. Learn her tips for coping with a patient’s death that you can incorporate into your nursing practice.

Mary Buffington is a burnout coach, nurse educator, and nurse entrepreneur. She became experienced with death after years of oncology nursing, but she says it’s always a challenge.

Buffington explains the two types of death nurses may encounter: expected and unexpected. You may care for a patient with a terminal illness whose family had time to prepare and say goodbye. On the other hand, a patient may pass suddenly as a result of an emergency.

Buffington says unexpected deaths are often harder to deal with, especially for new nurses.

“You start doubting yourself, wondering if you’ve done something wrong, what you could have done better. Was there something missed?” she says.

Whether your patient’s death was anticipated or unexpected, it’s good to have coping skills to help process the situation. These tips from Buffington will help you cope with death in your own way, however you choose to grieve.

Often the best way to process death is by talking to someone. After a patient dies, consider leaning on your nursing peers for support. Unlike a friend outside of work, a nurse colleague will understand the situation and may offer objective insight.

Buffington suggests speaking to a mentor such as an experienced nurse on your unit who’s gone through a similar situation. A mentor can suggest coping mechanisms that worked — and didn’t work — for them in the past.

Buffington also recommends using the peer-to-peer app HearMe, which is available 24/7.

“It’s really convenient,” she says. “New nurses can have anonymous, real-time, text-based conversations with experienced nurses about anything.”

You may also consider speaking to trained counselors within your workplace. If a hospital chaplain or social worker was involved in the patient’s care, they probably got to know the patient and family differently than you did.

Their unique perspective may be comforting as you talk through the situation. A hospital chaplain can also help bring you and other nurses closure by leading you in prayer or cleansing the room after a patient passes.

Hospital chaplains and social workers can offer helpful peer support, but if you need more one-on-one discussion, consider working with a therapist.

“Some deaths are extremely traumatic, and that may mean that your normal coping techniques may not be enough,” says Buffington.

Speaking to a therapist allows you to work through emotions while discovering coping methods that work for you. There are many services that connect nurses to free or low-cost therapy.

Caring for a dying patient can take a toll on the bedside nurse. In addition to managing your own emotions, you’re comforting family members who are going through some of the most difficult times of their lives. You may also be providing intense medical interventions on a dying patient before they’re transitioned to comfort care. All of these stressors can lead to nurse caregiver fatigue or burnout.

Here are some signs Buffington says you could be burning out from taking care of a dying patient:

Buffington recognizes it can be hard to maintain boundaries in these situations, so you may need to separate yourself from the patient. She suggests asking for another assignment as a means of coping.

“If this is happening for you, talk with your charge nurse or manager to reassign,” she says.

After a patient dies, you may wonder if the way you’re feeling is normal.

“If you are struggling with grief from caring for a dying patient or the death of a patient, I want to reassure you that you are not alone and that nothing is wrong with you,” Buffington says.

She recommends allowing yourself space to process your feelings and grieve. You can honor your patient by doing something symbolic like planting a flower, lighting a candle, or saying a prayer. It can be healing to honor your patient in a way that aligns with your spiritual values and beliefs.

Nurses are experts at putting the needs of others before their own. Don’t forget to give yourself grace when you’re processing a patient’s death.

“If you are feeling guilty or beating yourself up about a patient’s death, self-compassion can be a powerful tool to help you be forgiving and kind to yourself,” Buffington says.

To develop self-compassion, she recommends following these steps:

Every nurse will have a different response to death, and everyone needs to cope in their own way. It can feel natural to bury your feelings and deal with them later. Instead, consider opening up to someone and sitting with how you feel so you can grow from the situation.

Buffington reflects on her years providing end-of-life care. She says working in death and dying made her a better nurse and a better person.

“While there were challenging moments, there were many beautiful moments caring for these patients,” she says.

On the oncology unit, Buffington coordinated pet visits, helped a patient attend a wedding, and had deep conversations with people about their lives.

“I am grateful and feel honored to have been able to be a part of their death,” she shares.