Nurse Experiences of Grief and Coping in the Intensive Care Unit

Background: Intensive care unit (ICU) nurses may experience cumulative loss as they are routinely exposed to traumatic situations, patient suffering, and death. They must also deal with personal grief and grief of patients' family in a time of uncertain crisis. Currently, there is minimal literature that acknowledges grieving and coping in the ICU. The grief and coping experiences of medical intensive care unit (MICU) nurses is little understood. Purpose: Explore grief and coping amongst registered nurses working in the MICU at a major metropolitan hospital in Hawaii. Method: A qualitative descriptive approach was used. Open-ended interviews and a brief demographic questionnaire were used to collect data from five registered nurses who work in the MICU. A pragmatic approach to qualitative data analysis was used. Results: The findings of this study are presented in two main categories: grief and coping. Subthemes of grief are further described in the following categories: 1) circumstance of death; 2) keeping professional boundaries; 3) being supported; and 4) learning from experience. Coping is addressed by describing the main methods used by the nurse participants. Coping includes: 1) talking and being heard; 2) finding a support system; 3) using humor; and 4) spirituality. Findings suggest that MICU nurses have unique grief experiences and their coping is individualized. The nurses are aware of the effects grief has on their personal and professional lives. Additionally, they all seem to have developed effective coping habits to manage grief. Conclusion: There is no single method to manage grief responses. However, there is a level of mutual understanding of experiencing death in the MICU, which yields support and camaraderie amongst MICU nurses. Further research is needed to explore differences in other ICUs