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Comforting Comes Full Circle

McCroskey, Diane

doi: 10.1097/CNJ.0000000000000516
Feature: practice
Free

ABSTRACT: Nurses' personal grief and loss experiences can enhance their ability to comfort family members of seriously ill and dying patients. Spiritual care in these situations can include empathy, listening, and sharing of Scripture, when appropriate. Additionally, caring for emotional needs of patients in critical care situations also may enable a nurse to resolve personal grief experiences.

Diane McCroskey, MSN, RN, is a full-time instructor of nursing at Lincoln Memorial University, Harrogate, Tennessee. She previously worked in critical care for 25 years.

Accepted by peer-review 1/16/17.

Published Ahead of Print 5/22/18.

The author declares no conflict of interest.

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I had been a critical care nurse in the Intensive Care Unit (ICU) for several years when the phone call came. I was well aware of how lives can change with one phone call, one lab draw, or one X-ray. The Bible reminds us that “You do not even know what will happen tomorrow. What is your life? You are a mist that appears for a little while and then vanishes” (James 4:14, NIV). In the critical care arena, I lived these scenarios daily.

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LOSING MOM

Via phone, it was conveyed that my 58-year-old mother had suffered a cardiac arrest and had not survived. My world was rocked. In the blink of an eye, I became that vulnerable, brokenhearted person I had cared for and walked alongside many times in the ICU.

Emotions, thoughts, and questions consumed me. I had taken pride in being a nurse who paid attention to the most insignificant sign, symptom, or change in a patient. More importantly, I had placed great emphasis on following my intuition and gut feeling. How had I missed the warning signs in my mother? Shouldn't I have known something was wrong? Was I too busy or too close to the situation to notice something wasn't right?

I replayed every detail of the time I had spent with my mother in the days before her death. I could only make sense of one thing—that God is in control of all things. God told his people, “For my thoughts are not your thoughts, neither are your ways my ways, declares the LORD. As the heavens are higher than the earth, so are my ways higher than your ways and my thoughts than your thoughts” (Isaiah 55:8-9, NIV). My head was trying to understand, whereas my heart had difficulty accepting that God's ways are higher than my ways.

I took two weeks off from work and was not sure about going back. Even though I loved serving Christ through serving others, I wondered if I could return to the ICU and be effective. Although I spent a lot of time in prayer and self-reflection, I never asked God why he took my mother. I just acknowledged that my closest confidant and biggest fan went to heaven. I grieved.

What I did question was the lesson I was supposed to glean from this life-altering experience. How could anything positive result? Although my heart was heavy and broken, I felt God's presence sweep across my soul when I read Romans 8:28 (NIV): “And we know that in all things God works for the good of those who love him, who have been called according to his purpose.” This truth enabled me to put one foot in front of the other and report for my first shift back in the ICU.

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LEFT SPEECHLESS

I wept and prayed all the way to work that morning, asking God to allow me to be a blessing and maybe even receive a blessing in the upcoming 12-hour shift. Most of all, I wanted to endure the day and continue to move forward in reaching a better understanding of how my mother's death could result in something good.

As soon as I entered the unit, the charge nurse met me with these familiar words: “We have a patient and family that need you today.” I smiled, knowing that the only way I was going to finish the shift strong was to cling to the truth that Christ would strengthen me (Philippians 4:13).

I was speechless after learning during report that I would be caring for a 58-year-old female who had suffered a cardiac arrest at home. She had been down too long to recover from a brain anoxic injury, but she had survived. I also learned that her daughter was devastated and was having difficulty coping. The charge nurse asked if I was okay taking this patient. I said, “Yes, I think so. I am the best nurse to be with this family today.”

Entering the patient's room, I noticed her daughter at the bedside, holding her mother's hand, softly crying and moving her lips in prayer. She was shaking her head in disbelief. I stood, unmoving for a moment, thinking that this was exactly how I must have looked two weeks before, when I arrived at my parents' home after my mother's collapse.

I introduced myself and saw that familiar look in the daughter's eyes. She said nothing, but her gaze conveyed a desperate search for answers and a plea to make sense out of a hopeless situation. I reassured this woman that I would take good care of both her and her mother. Because I had noticed the daughter praying, I gently noted that God was with us and would help us handle what was coming. She gave a weak smile and thanked me.

The ventilator, intravenous pumps, and monitoring equipment mesmerized and overwhelmed the patient's daughter so I spent much of the morning explaining, answering questions, and building rapport. My heart warmed, as the patient's daughter described the relationship she and her mother shared. She reminisced about growing up in a loving Christian household, where her mother led by example and believed that God was in control of all things. The similarities in our beliefs and upbringing were remarkable. Recalling those difficult days of my mother's recent death stirred my emotions. I felt a deep trust and connection develop with the daughter, as often happens when we care for people in such critical moments.

To a large degree, I understood what she was experiencing. I thought it would help the daughter to know I had recently lost my mother and could relate to her pain, so I told her without going into a lot of details. I reminded myself and the daughter that God can meet our needs when we are suffering. The Bible reiterates this truth in 2 Corinthians 12:9 (NIV), “My grace is sufficient for you, for my power is made perfect in weakness. Therefore, I will boast all the more gladly about my weaknesses, so that Christ's power may rest on me.”

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LETTING GO

As the day progressed, the patient's condition continued to deteriorate. The physicians were forthright about her poor prognosis, saying that death was imminent. As comfort measures and withdrawing of life support were suggested, I saw how this intensified the daughter's grief and brought another dimension of uncertainty about how to proceed.

The patient's daughter wanted to speak to me alone for a moment. She asked me to help her sort through what would come next and to be a part of the decision-making process for her mother's care. One of the most amazing blessings a nurse can receive is to be respected and trusted enough to be invited into the lives of patients and family members, especially under these circumstances. Such moments are priceless.

I asked God to lead, guide, and direct me with a servant's heart and a nurse's knowledge, while helping the patient's daughter through this storm. Remembering that God promises to instruct us in the way we should go (Psalm 32:8, NIV), I trusted him for the right words, as I explained what to anticipate and the plan of care surrounding end of life.

The daughter and I prayed together at her mother's bedside. I then allowed her time alone to embrace the information presented. Reentering the room later, I expected a bombardment of medical questions and concerns. How long does she have? Will she go quickly or struggle when we invoke comfort measures and withdraw life support? Is she in pain? Can she hear me? But these questions never came. With tears streaming down her face, she asked only those questions that truly mattered and burdened her heart.

“Does anyone understand what this woman means to me and the vital part she plays in my life?”

“How do I say goodbye?”

“How do I let go and move forward? What could I possibly learn in this dark, lonely valley?”

My answers came without hesitation. Tearfully, I reminded her that God cares and understands all that we endure and experience, remembering Hebrews 4:15 (NIV): “For we do not have a high priest who is unable to empathize with our weaknesses.”

I empathized and shared that things happen in our lives that we may not choose, like, or even want to accept, but the God we believe in makes no mistakes. If we trust him completely and look with eyes of faith, these experiences ultimately will be for our good and for his glory. These were not just words, they were the truth I was learning to trust and believe in wholeheartedly. Being in such a similar situation and struggling with the very same thoughts, questions, and concerns allowed me to speak from my heart to hers.

I reminded her of the strength we find in the relationship we share in Christ and the promises of hope found in his Word. Isaiah 41:10 (NIV) states, “So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand.”

In the valley of this loss, I was reminded that God never leaves or forsakes us. During times of grief and despair, trusting God enriches our relationship with him and enables us to obtain the peace that passes understanding. “And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus” (Philippians 4:7, NIV). Talking with someone like me, who had experienced what she was dealing with, seemed to make it easier to proceed with the prescribed plan of care.

Once comfort measures were initiated and life support withdrawn, it was only minutes until the mother drew her last breath. It was a time of sorrow, but also a time of celebration. After the finality of the moment sank in, the daughter turned to me and said, “I will never be able to repay you for making an unbearable situation more bearable.” I was grateful that God allowed me to be a source of comfort, caring for both the patient and her daughter.

Driving home that night after my shift, I realized God had revealed the response to the question I had longed to have answered. Not only are we comforted in our trials, but our trials can equip us to comfort others. Our main goal should be to glean all we can from what we are called to endure so that we can comfort others.

Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves have received from God. 2 Corinthians 1:3-4

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Additional Resources

Keywords:

compassion; critical care; end of life; grief; nursing; spiritual care

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