Nurses’ hearts and minds are like living libraries of patients’ stories. In the intimate container of trust created in the nurse-patient relationship, a tapestry of memories, confessions, and reflections are woven, and the nurse is privileged to be privy to such soulful sharing.
As nurses, what are we to do when we’re the repositories of so much of the richness of our patient’s lives, including the tragic, the comedic, and the mundane?
Holding the Tapestry
Since patients’ stories are shared in the space of a therapeutic relationship, our first responsibility is to maintain the confidentiality of this sacred information. Throughout a long nursing career, the stories we hold in our hearts naturally accumulate — some blend, some are forgotten, and some are so poignant that they stay with us in almost crystalline clarity for the remainder of our lives.
Working in a psychiatric or mental health milieu, we might be lucky enough to have clinical supervision to unburden ourselves with a mentor or supervisor. There may also be team meetings where patient stories are shared, we compare notes with colleagues, and the puzzle pieces of our patient’s lives are examined for clues as to how we can best serve their healing.
In a busy hospital unit, emergency department, or other settings, stories might be harder to share among colleagues, and we may leave certain shifts feeling as if the weight of our patients’ lives is pressing down upon our shoulders.
Hospice work can sometimes bring opportunities for debriefing, especially when a patient is heading toward death or has already passed away. Hospices, where this practice is the norm, allow nurses, chaplains, aides, and other staff members to laugh, cry, and ponder the deeper meaning of patients’ lives.
Wherever we work, the tapestry is still in our possession, whether it be in a functional, healthy way or a manner in which we are hurt by the suffering we witness and hold.
Unburdening Our Hearts
If you work in an environment where sharing patient stories and unburdening your heart isn’t the cultural norm, you have to find other ways to process what you see, hear, and experience. There are places outside of work where it’s safe to talk, but you’ll need to actively pursue finding the right place to process the tragedy, trauma, and human dramas you hold in your mind and heart.
Employee Assistance Programs
EAPs are workplace-sponsored confidential counseling and mental health services made available at no cost to staff members needing support. Myths about employers having access to EAP counselors’ and therapists’ treatment notes are untrue — your sessions with EAP personnel are entirely confidential. In this setting, you’re free to talk about your patients (leaving out all HIPAA-related identifiers) and receive supportive feedback.
Discussing personal matters that have nothing to do with work is also fair game during EAP sessions. So whether you’re having issues related to your marriage, home life, or anything else, these topics can be addressed.
For many individuals, their faith is an aspect of their lives where they feel safe. If your church, synagogue, mosque, or another place of worship is where you feel you have the greatest chance of finding solace from work stressors, speaking with your faith leader might be the best setting for you to unburden yourself.
Priests, imams, rabbis, and other religious leaders hear countless stories of human suffering and difficulty, and the insights you receive from conversations with such individuals could be the key to understanding your patients while also using their stories in the context of your healing.
Your 12-step sponsor
If you’re involved in a 12-step program, your sponsor may be one of the most trusted people in your life. Patients’ situations and stories can be traumatizing for us, so if you feel particularly triggered or overly burdened by something you heard, this could be appropriate to bring to your sponsor for contemplation and discussion.
Therapist or counselor
Finally, your therapist or counselor can be your go-to as a safe place to discuss what you hear and experience at work. Since your relationship with your therapist is built on trust and complete confidentiality, you can freely share without fear.
The Honor and Privilege
It is both an honor and a privilege to be trusted enough by a vulnerable patient to be on the receiving end of their stories. Patients tend to trust nurses, and that connection can run deep, although we can sometimes suffer our own pain in response to what we witness in the patient.
There’s no shame in experiencing your distress as a caregiving professional. Secondary or vicarious traumatization is no joke; what you feel doesn’t have to make logical sense for it to be altogether real. Emotions are not inherently logical. Thus your reaction is appropriate. However, if your response includes falling into addictive or harmful patterns of behavior or thought, you must seek professional support immediately.
While you can honor the stories patients tell you, you must also take the time to honor the story generated inside of you in response. Seek help and support when and if you need it, and carry this richly woven tapestry of feeling with tenderness and an acknowledgment of its utterly sacred nature.
Minority Nurse is thrilled to feature Keith Carlson, “Nurse Keith,” a well-known nurse career coach and podcaster of The Nurse Keith Show as a guest columnist. Check back every other Thursday for Keith’s column.