Distress in nurses following patient death : a local response to the need for debriefing
Bickham, Melanie Ann
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The purpose of this clinical project was to determine if nurses in an acute care setting would report a need for debriefing following a patient death. The review of current literature revealed mixed results regarding the effectiveness of debriefing as an intervention. Literature shows that emotional expression is perceived as cathartic by nurses and is viewed as a positive coping mechanism. However, randomized controlled trials of debriefing models did not demonstrate that participation in debriefing prevented distress symptoms. A survey was created to assess nurses' views regarding debriefing following a patient's death. Surveys were placed in mailboxes of Registered Nurses and Licensed Practical Nurses in a 220 bed hospital in Montana. There were 55 respondents. Demographically, the average participant in the survey was 38 years of age, held a bachelors degree, had been a nurse for 9 years, worked in a critical care unit, and had experienced approximately 15 patient deaths over their career. The majority of nurses surveyed felt that an information-sharing and event processing session among peers (debriefing) would be helpful in coping with their emotions after a patient's death. Thirty of those surveyed reported they would be very likely to participate or would definitely participate in a debriefing session if it were available. The overwhelming majority (n=52, 94.3%) reported experiencing one symptom of distress after a patient death. Comments written on the surveys were grouped into themes. These themes included catharsis/sharing, positive coping, past experiences with debriefing, prevention of death, perceived need for formal debriefing, no perceived need for formal debriefing, emotional distancing, and debriefing only for special circumstances. Surveys revealed that the majority of nurses surveyed felt that debriefing sessions would be helpful in processing their emotions following a patient death. The author wrote a nursing policy regarding the use of debriefing in a hospital setting for nurses following a patient death and made this available to the organization surveyed.