Dealing with grief, tragedy and loss as a medical student

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Students on ward rounds at the Regional Hospital When you start medical school, you are probably concerned with studying lecture material and learning how to perform certain medical procedures. You are ready for the workload and think you are prepared for the challenge. What you may not have considered is how you will feel emotionally as you deal with patients who are suffering. You may not be prepared to see someone die or watch a family member grieve but grief and loss is part of the job and learning how to deal with it starts in med school.

 

 

 

Dealing with grieving families

It is almost a guarantee that at some point during your medical school years, a patient you were treating will die. As a med student, you will not be the main person responsible for talking with grieving families and giving them bad news. But you should still pay attention and learn what you can from the situation. One day, you will be in the same situation as your resident or attending physician and will have to deliver heart-breaking news to your patient’s family. 

Whether the news is a poor prognosis or a death, informing families their loved one has died or may die is never easy. In the future, if you find yourself in that situation there are several key things to keep in mind.

Make sure the family has privacy.

You don’t want to speak to a family in the hall or a public location. Ask to speak to them in private.

Be compassionate in your delivery.

You may be giving someone the worst news of their life. That is not something you say in a nonchalant manner. You want to convey compassion and sympathy for their loss.

Avoid using too much medical jargon.

Explaining the situation using technical terms can get confusing. Family members may be emotional and have a hard time understanding things if you use medical terminology.

Ask if they have any questions.

Some families may want to know more than others. Answer their questions honestly and be sure to take the time needed with the family.

Use the right words.

You may want to soften the blow, but avoid using terms, such as “passed away” or “expired”.  If a patient has died, you need to use the words died or dead. It may seem harsh, but you want to provide the information, so it is unmistakably clear.

Have support available.

If possible, have a social worker and a chaplain standing by ready to offer support to the family. Both medical social workers and hospital chaplains are trained to deal with grieving families and may be able to assist.

Give the family some time.

If your patient has died, some family members may want to spend time with their loved one before the person is transferred to the funeral home.

Keep in mind, there is no ‘right’ reaction.

People react differently to bad news. Some people may become angry while others may cry, shout or be in denial. Your job is not to tell someone how to react or grieve appropriately.

Skip the gruesome details.

While you want to be honest about a patient’s death, nothing good comes out of telling the family every gruesome detail. For instance, if a family member asks if the patient suffered, it would not do any good to say yes. That would only cause more upset and grief.

 

Recognize feelings are normal

If you do not have any experience in the medical field, you may not have seen anyone die. In addition, you may not be familiar with how to deal with a family’s grief. Your reaction and feelings to the death of a patient may also surprise you. It is important to realize feeling sad is normal.

Sad things happen in the hospital. People die tragically and unexpectedly. In some cases, family members watch their loved one lose their battle with an illness or die from an injury. Just because you are a medical student does not mean you are immune to feeling sad when something tragic occurs.

Expect that some situations will get to you. Although you don’t want to see any patients die, some situations will stick with you more than others. For example, you may remember the first patient who you saw die long after the event. A patient’s death may stick with you because you have things in common, and you could relate to them. Maybe they remind you of a friend or family member.

Whatever the reason, it is helpful to understand some situations will cause you to get a bit emotional. While you are dealing with family members or other staff, do your best to hold it together. But give yourself a little time when you are alone to work through your emotions.

 

Knowing when you need help

While it is normal to feel bad when a patient dies, if you let it get to you too much, you can run into trouble. You may need help dealing with your feelings if you have any of the following symptoms:

  • Loss of interest in med school  
  • An increase in anxiety
  • A change in sleeping habits
  • Turning to drugs or alcohol to numb feelings

If you find you are having any of the symptoms above after a patient dies, you may want to consider getting help. Some hospitals have a debriefing after a particularly difficult situation. One of the reasons for a debriefing is to allow medical workers the opportunity to talk about how they feel. Talking with others who are dealing with the same situations may be helpful. You may also want to consider counseling to help you deal with negative feelings.

It is important as a med student and later a doctor to strike the right balance between caring and not letting the death of your patients lead to mental health issues. Learning ways to leave work behind and unwind is essential. It is also helpful to find healthy ways to work through bad patient outcomes and move forward trying to be the best physician you can. 

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