Nurse's Pocket Guide

• Assess status of relationships/marital difficulties and
adjustments to loss.
NURSING PRIORITY NO. 2.To assist client to deal appropriately
with loss:
• Discuss meaning of loss to client, active-listen responses without
judgment.
• Encourage expression of feelings, including anger/fear and
anxiety. Let client know that all feelings are OK while setting
limits on destructive behavior.
• Respect client’s desire for quiet, privacy, talking, or silence.
• Acknowledge client’s sense of relief/guilt at feeling relief when
death follows a long and debilitating course. Sadness and loss
are still there, but the death may be a release; or, client may
feel guilty about having a sense of relief.
• Discuss the circumstances surrounding the death of a
fetus/child. Was it sudden or expected? Have other children
been lost (multiple miscarriages)? Was a congenital anomaly
present? Repeated losses increase sense of futility and compromise
resolution of grieving process.
• Meet with both members of the couple to determine how
they are dealing with the loss.
• Encourage client/SOs to honor cultural practices through
funerals, wakes, or sitting shiva, and so forth.
• Assist SO(s)/family to understand and be tolerant of client’s
feelings and behavior.
NURSING PRIORITY NO. 3. To promote wellness (Teaching/
Discharge Considerations):
• Encourage client/SO(s) to identify healthy coping skills they
have used in the past. These can be used in current situation
to facilitate dealing with grief.
• Assist in setting goals for meeting needs of client and family
members to move beyond the grieving process.
• Suggest resuming involvement in usual activities, exercise,
and socialization within physical and psychological abilities.
• Discuss planning for the future, as appropriate to individual
situation (e.g., staying in own home after death of spouse,
returning to sporting activities following traumatic amputation,
choice to have another child or to adopt, rebuilding
home following a disaster).
• Refer to other resources, as needed, such as counseling, psychotherapy,
religious references/pastor, grief support group.
Depending upon meaning of the loss, individual may
require ongoing support to work through grief.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
Diagnostic Studies Pediatric/Geriatric/Lifespan Medications 355
risk for complicated GRIEVING