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Author’s note: I believe many people misunderstood what I meant by I can’t cry with you. I think many assumed that I was trying to communicate that I am not allowed to cry, rather than I emotionally cannot handle your pain right now and therefore must distance myself.  Please check out my follow-up post, Why I Can’t Cry With You if you have a knee-jerk “did she just say she can’t cry with her patients!?” reaction. I have cried with many patients. This post discusses the emotional challenges of working with people in the midst of death and dying.

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I just saw the doctor walk out of the room…the room of your husband on a ventilator, who after 12 days of no improvements, has had set back after set back. I talked to the doctor before he walked into the room. I know what he told you.

Forgive me. I have to avoid you for a short time. I’m going to go do something else for a little while.

You see, I’ve seen that look before, that look on someone’s face where they are about to sob uncontrollably and throw up from the sheer emotional pain. People usually put on a strong face when the doctor delivers the news. And as soon as the physician has vacated the area, they allow themselves to break down.

But guess who is still in the room?

The nurse.

Through their tears, they ask us the questions they were either too shocked or too scared to ask the doctor. Somehow, what we say stings even more.

Shift after shift, we see lives permanently altered. We see people walk into the hospital with hope and we see them walk out with despair.

It never gets easier to do this. You just get used to it. You figure out how to do it.

So, I’m sorry. I’m sorry to the wife who needs me right now. I know you have questions you want to ask me. Questions you didn’t think to ask the doctor. Questions you didn’t want to ask him because you didn’t want him to think you were stupid. Things you want me to explain. I know you want my honest opinion.

I need to collect myself first before I walk into your husband’s hospital room. I need to put up my wall. I need to mentally prepare myself to not compare you and your husband to my mother and father. I need to disconnect the dots.

I have to do that because as soon as I’m done being there for you, I have to go see my other patient. My patient that will probably recover from the massive stroke he suffered, but is a little down today. I have to go in with a smile on my face and tell him that he’s doing great. I have to be happy for him. I have to motivate him. I have to inspire him.

So, please forgive me. I know that because I’m not emotionally upset with you right now, I may look cold and heartless. I promise I’m not. It is out of self-preservation that I am not going into that deep, dark pit of despair with you right now. I’m going to get as close as I can without losing it. I’m going to take a ladder down into that pit with you, but I’m going to stay on that last step. I’m going to stay on that step because I have to be able to quickly climb out on a moment’s notice for the man in the room next door.

You see, I’ve gotten pretty good at that. I’ve gotten really good at lowering myself into that pit and getting as close as I can to your pain, but not quite there. And I’ve got even better at running up that ladder and out as fast as I can.

I’ve gotten good at that because I’ve had to. If I take that last step, I cannot continue on. I cannot do my job. I cannot be there for any other patients. I cannot talk to physicians and coordinate your husband’s care or the care of any others. I cannot hold myself up. All I will think about is my husband dying. Or my father.  Or my mother.

So, I put up my wall. My boundary of empathy. I will get as close as I possibly can for you. I want to support you. I want to be there for you. I want you to feel cared for. So I will give you as much as I can bear. I pray that will do, for I have no more left.

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I am hosting a free 1-hr webinar with Nurse.com entitled Empathy 101 for Nurses: How to Care for Yourself While Emotionally Supporting Others. You can get a free CE for the 60 minute course. Sign up here. 

Here are a few great books that discuss empathy, compassion, death, and the human experience:

More posts on FreshRN about death and dying:

• When Your Patient Starts Crying
• Episode 010 of the FreshRN Podcast: Dealing with Patient Deaths
• Something You’re Dying to Talk About
• Comfort Care Conversations

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