coping with reality. The nurse used communication
skills to encourage Ms. Morrison to examine her ex-
perience and behavior as possible ways in which she
might be coping with the news of loss. Margaret and
James’s logical approach to life allowed them to cope
by continuing to have fun together while attending
to medical regimens as they faced the reality of his
impending death.
Intervention involves giving the client the op-
portunity to compare and contrast ways in which he
or she has coped with significant loss in the past and
helping him or her to review strengths and renew a
sense of personal power. Remembering and practic-
ing old behaviors in a new situation may lead to ex-
perimentation with new methods and self-discovery.
Having an historical perspective helps the person’s
grief work by allowing shifts in thinking about him-
self or herself, the loss, and perhaps the meaning of
the loss. Margaret’s religious practices of prayer and
spiritual reading helped her to discover new depths
of meaning and purpose in her life.
Encouraging the client to care for himself or her-
self is another intervention that helps the client cope.
The nurse can offer food without pressuring the client
to eat. Being careful to eat, sleep well, exercise, and
take time for comforting activities are ways that the
client can nourish himself or herself. Just as the tired
hiker needs to stop, rest, and replenish himself or her-
self, so must the bereaved person take a break from
the exhausting process of grieving. Going back to a
routine of work or focusing on other members of the
family may provide that respite. Volunteer activities—
volunteering at a hospice or botanical garden, tak-
ing part in church activities, or speaking to bereave-
ment education groups, for example—can affirm the
client’s talents and abilities and can renew feelings
of self-worth.
Communication and interpersonal skills are tools
of the effective nurse, just like a stethoscope, scissors,
and gloves. The client trusts that the nurse will have
what it takes to assist him or her in grieving. In addi-
tion to previously mentioned skills, these tools include
the following:- Use simple, nonjudgmental statements to
acknowledge loss: “I want you to know I’m
thinking of you.” - Refer to a loved one or object of loss by name
(if acceptable in the client’s culture).
12 GRIEF ANDLOSS 255
◗ INTERVENTIONS FOR THECLIENT
WHO ISGRIEVING
Explore client’s perception and meaning of his or
her loss.
Allow adaptive denial.
Encourage or assist client to reach out for and
accept support.
Encourage client to examine patterns of coping in
past and present situation of loss.
Encourage client to review personal strengths
and personal power.
Encourage client to care for himself or herself.
Offer client food without pressure to eat.
Use effective communication:- Offer presence and give broad openings.
- Use open-ended questions.
- Encourage description.
- Share observations.
- Use reflection.
- Seek validation of perceptions.
- Provide information.
- Voice doubt.
- Use focusing.
- Attempt to translate into feelings or verbalize
the implied.
Establish rapport and maintain interpersonal skills
such as - Attentive presence
- Respect for client’s unique grieving process
- Respect for client’s personal beliefs
- Being trustworthy: honest, dependable,
consistent - Periodic self-inventory of attitudes and issues
related to loss
Nurses’ tools