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Pam McMillan a native to the Texas Panhandle is a registered nurse, wife and mother. During her career she has developed a passion for serving those suffering from cancer. Her current role is leading the survivorship program on behalf of the Harrington Cancer and Health Foundation. She continues to serve those individuals and families across the region that are affected by cancer. Follow her on Twitter @pammo10

Can You Just Listen to Me?

Is saying "sorry" enough when someone is grieving? As a nurse, how can you help a grieving patient or family?
PUBLISHED: 7:00 AM, FRI MARCH 3, 2017
Talk about this article with nurses and others in the oncology community in the General Discussions Oncology Nursing News discussion group.
I am sorry.

How do you react when someone says this to you? Sometimes "sorry" is just not enough to fix the pain. Over the last year, I have lost five extended family members – that’s more than I wanted, and each of them from different circumstances. Every time I was lost for words to say to the immediate family. The first thing that comes to my mind is “I am sorry” and that probably is the last thing they want to hear. Or is it enough? How do you respond to people grieving?
 
I can remember one of my patients telling me “I am going to die of this cancer, but I am not going to let this cancer live for me.” I was taken back because I didn’t know how to respond. I didn’t want to acknowledge that yes, the cancer would probably take her life since it was stage IV, but at the same time I didn’t want to lie to her. I remember just sitting there with her and saying, “I am sorry”. Her response was “Honey there is nothing to be sorry about.” Thinking about it makes me emotional because that was probably not what she wanted to hear from me. Was she just looking for a safe person to talk to? Did she just want someone to understand her?
 
How can we prepare ourselves when we are thrown into these types of situations and taken by surprise? Can we even mentally prepare ourselves? Just because we work in a healthcare environment does not guarantee that we know what to say or how to respond to people who are grieving. We as humans have the same fears and helpless feelings when it comes to people we care about that are grieving. We sometimes avoid people because we don’t know what to say. I was talking with a hospice nurse the other day and I was telling her that I was having such a hard time finding the perfect thing to say in these types of situations. She said to me there is rarely a time when someone we know is not facing grief. We grieve because we lost our car keys, we lost our dog, we lost our phone, our body image changed due to surgery, or we lose a loved one – it is all some form of grief. No matter what type of grief someone is facing we all want to be understood. We want them to acknowledge how bad or hurtful that event was.
 
She also told me about a seminar that she went to where the speaker spoke about how we all have our own buckets. For a minute, I want you to think of my patient. Imagine that she is holding a bucket in her hand and in this bucket, she has all her feelings that she has experienced because of her situation. In her bucket she might have anger, fear, guilt, blame, resentment, worry and maybe even despair. Now picture your bucket in front of you. What type of feeling would you have in your bucket because of her situation? I think for me I was afraid, because I didn’t know what to say and maybe I thought if I said something I would be in a sink hole that I couldn’t get out of.  What I didn’t realize is her bucket was FULL! No matter what I said or did, she didn’t have room in her bucket for my feelings. What I should have done was get in her bucket and listen to her. People that are grieving need a safe person, someone that will allow them to talk out their situation and just listen. 
 
I hear from patients that have gone through surgery that has caused body image issues that they were not prepared for the outcome. They tend not to see themselves the same as before the surgery. Losing something that is part of us can do more to our mental status than we know. I don’t think that these patients want someone to say, “I understand”, when we ourselves haven’t gone through what they have been through. These patients just want someone to acknowledge their pain. Something as simple as “that must really hurt” could help them cope. What they don’t need is explanations thrown at them. 
 
So, next time you find yourself in any of these situations remember that there is a healing process. Give each patient comfort – just listen! Don’t try to pour your feelings into their bucket. Focus – focus on what they are saying before you try to talk to them. Timing – it’s not the words you say, but the timing of your words. We all have our own buckets and let’s not just pour everything out onto others, but learn to have a listening ear.

Talk about this article with nurses and others in the oncology community in the General Discussions Oncology Nursing News discussion group.
More from Pam McMillan, RN, OCN
Understanding the effects of chemotherapy-induced peripheral neuropathy (CIPN) is imperative to be able to care for our patients better. 
PUBLISHED: Tue October 17 2017
Many patients complain of feeling so tired. What can we do to help those suffering from fatigue?
PUBLISHED: Tue August 29 2017
What milestones do you celebrate with your oncology patients?
PUBLISHED: Thu June 15 2017
As a young adult with cancer you may feel like a prisoner in your own world. How can nurses help this age group?
PUBLISHED: Wed May 31 2017
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