Elizabeth Kubler Ross in her writings spoke of the five stages of grief. In particular, her studies dealt with the reactions of terminally ill patients and the phases they went through. Pastoral Care Giving involves an intimate connection of communication between care giver and patient. In many cases, the care provider supplies the horrible news that someone will soon die. Within this there will be a multiude of reactions. One such reaction is anger.
So how does a nurse or pastoral care giver deal with the angry patient. Ultimately with love and understanding! The care of a terminally ill patient is more than just caring for his or her physical needs but is a caring for the totality of the human person. In this regard, emotional symptoms must be treated as if physical symptoms.
Kubler Ross asked the question, why is the patient angry? The only way to know is through communication and care. Avoidance and frustration with a patient’s anger will not endear him or her to you nor will it make matters better.
Many patients may be upset over a variety of reasons. Is their death premature or expected? Is the death blamed on God or another doctor or treatment? Is the anger a source of regret of how a person lived his or her life? Is the anger due to the fact you never notice any family members coming to say “goodbye”. Is the anger over a loss of control? Is the anger over how the patient was treated the previous night by a different nurse? Is the anger over the fact the person cannot die at home?
The realm of possiblities is endless and this is again why Kubler Ross insisted one cannot ignore the patient who is angry. Instead, one must discover why the person is angry.
In one case study, Kubler Ross noted that an elderly man simply wished to have his side gate of his bed down so as to move his legs. He feared the casket like formation he had to endure and it reminded him of death. His nurse instead refused for fear of him falling. She was more interested in reading her book by the bedside chair. Maybe it was due to her own fear of facing death that she distanced himself from this poor man. Regardless, the man would be frequently angry.
Another case study was of a man who always controlled his life, whether in his successful business or his command of his family. His anger was a result of the loss of control to the nurses and other health related decisions. Simply by identifying this and giving him options, he became less angry. In fact, he always had a say or input in the course of action directed, but under the guise he had a “control” in the matter.
So as one can see, pastoral care is more than just taking one’s blood pressure or taking checking various readings, but it is also understanding the emotional dynamics that take place within the human mind. Anger is merely a manifestation of something that is deeply wrong; it shoud not affect health care professionals to the extent they ignore the angry patient, but instead push them to finding out why and alleviating it.
If you are interested in Pastoral Thanatology Certifications, please review the program.
Medical Caregivers and Their Own Preconceived Notions About Death
In counseling it is always taught to keep one’s own preconceived notions or past out of the objective judgement during a session with a patient. The same should hold true for medical caregivers. This represents a large portion of doctors, nurses, social workers and even pastoral counselors.
While counselors and social workers recognize the psychology behind death, many doctors are not trained in emotional caregiving. They tend to not treat the emotional symptoms but only the physical ones. Treating the disease overtakes treating the wholeness of the human person.
With these things in mind, doctors need to also look at themselves–and this goes for nurses and counselors as well. What ideas do you have on death or the terminally ill? Do patients suffering in a cancer ward remind you of a lost loved one, or does the scent of death terrify you to such an extent, you cannot face them?
Maybe you feel if you avoid the issue of death with patients, you will not have to discuss it in length with them. Kubler Ross in many of her studies noticed such behaviors from doctors and nurses who confidently felt the patient did not demand long and detailed accounts of their condition. However, upon review, Kubler Ross discovered that the patients sensed the discomfort of the doctors and nurses and decided not to discuss death because of these attitudes.
So the reality was that many patients played off the emotional indifference or fear of the doctors and nurses. These terminally ill patients then lost a critical element of treatment for their own emotional well being. Instead of dealing with their own fears, these doctors and nurses avoided these fears by avoiding the patients they swore to help.
With such lack of pastoral training and difficult fears of their own, many medical caregivers are unable to treat emotional symptoms of grief or simply talk to the patient.
This can only be overcome via education but also facing one’s own fears of death and understanding patients and why they react or do not react to certain things. Anger, indifference, compromise and denial are all reactions or better yet symptoms of grief when someone learns of impending death. Doctors and nurses need to overcome their own fears so they can treat these emotions as well as they treat physical symptoms of a disease.
If you are interested in Pastoral Thanatology Certifications, please reveiw the program.