Nurse's Pocket Guide

GRIEVING
Making meaning of the loss; personal growth
Experiencing relief
OBJECTIVE
Detachment; disorganization; psychological distress; panic
behavior
Maintaining the connection to the deceased
Alterations in immune/neuroendocrine function
Desired Outcomes/Evaluation
Criteria—Client Will:
• Identify and express feelings (e.g., sadness, guilt, fear) freely/
effectively.
• Acknowledge impact/effect of the grieving process (e.g., physical
problems of eating, sleeping) and seek appropriate help.
• Look toward/plan for future, one day at a time.
Community Will:
• Recognize needs of citizens, including underserved population.
• Activate/develop plan to address identified needs.
Actions/Interventions
NURSING PRIORITY NO.1.To identify causative/contributing factors:
• Determine circumstances of current situation (e.g., sudden
death, prolonged fatal illness, loved one kept alive by extreme
medical interventions). Grief can be anticipatory (mourning
the loss of loved one’s former self before actual death), or
actual. Both types of grief can provoke a wide range of
intense and often conflicting feelings. Grief also follows
losses other than death (e.g., traumatic loss of a limb, or loss
of home by a tornado, loss of known self due to brain
injury).
• Evaluate client’s perception of anticipated/actual loss and
meaning to him or her: “What are your concerns?” “What
are your fears?” “Your greatest fear?” “How do you see this
affecting you/your lifestyle?”
• Identify cultural/religious beliefs that may impact sense of
loss.
• Ascertain response of family/SO(s) to client’s situation/
concerns.
• Determine significance of loss to community (e.g., school
bus accident with loss of life, major tornado damage to
infrastructure, financial failure of major employer).
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
346 Cultural Collaborative Community/Home Care