- Words are not always necessary; a light
 touch on the elbow, shoulder, or hand or just
 being there indicates caring.
- Respect the client’s unique process of grieving.
- Respect the client’s personal beliefs.
- Be honest, dependable, consistent, and wor-
 thy of the client’s trust.
 A welcoming smile and eye contact from the client
 during intimate conversations indicate the nurse’s
 trustworthiness.
Evaluation
Evaluation of progress depends on the goals estab-
lished for the client. A review of the tasks and phases
of grieving (discussed earlier in the chapter) can be
useful in making a statement about the client’s sta-
tus at any given moment. We could say that while
Margaret, in the vignette, still misses James, she is
in the reorganization phase of grieving. She has a
sense of independence and confidence and has ac-
complished several tasks of grieving: creating new
ties, developing a new sense of self, pursuing new
activities, and integrating the loss into her life.
SELF-AWARENESS ISSUES
Clients who are grieving need more than
someone who is equipped with skills and basic knowl-
edge; they need the support of someone they can trust
with their emotions and thoughts. For clients to see
nurses as trustworthy, nurses must be willing to ex-
amine their personal attitudes about loss and the
grieving process. Taking a self-awareness inventory
means periodic reflection on questions such as:- What are the losses in my life, and how do
 they affect me?
- Am I currently grieving for a significant loss?
 How does my loss affect my ability to be pre-
 sent to my client?
- Who is there for me as I grieve?
- How am I coping with my loss?
- Is the pain of my personal grief spilling over
 as I listen and watch for cues of the client’s
 grieving?
- Am I making assumptions about the client’s
 experience based on my own process?
- Can I keep appropriate nurse–client bound-
 aries as I attend to the client’s needs?
- Do I have the strength to be present and to
 facilitate the client’s grief?
- What does my supervisor or a trusted col-
 league observe about my current ability to
 support a client in the grief process?
 Ongoing self-examination is an effective method
 of keeping the therapeutic relationship goal-directed
 and acutely attentive to the client’s needs.
➤ KEY POINTS
- Grief refers to the subjective emotions and
 affect that are normal responses to the expe-
 rience of loss.
- Grieving is the process through which a per-
 son travels as he or she experiences grief.
256 Unit 3 CURRENTSOCIAL ANDEMOTIONALCONCERNS
I NTERNET R ESOURCES
Resource Internet Address
◗Bereavement, grief, and trauma
educational resources http://www.therapeuticresources.com/grief.html
◗Sites devoted to grief and bereavement http://www.growthhouse.org
◗Adult bereavement resources http://rivendell.org/resources/hospice_sponsored.html
◗What Can I Say? What Can I Do? http://members.aol.com/Jeri10/Death.html
◗Poems about the loss of a child http://www.thelaboroflove.com/prose/loss.html
◗Grief and healing http://www.webhealing.com/cgi-bin/main.pl