1. Ferrell, Betty R. PhD, CHPN, FAAN, FPCN

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Nurses who have chosen palliative care as their professional specialty are very familiar with death and bereavement. Over years of practice, we witness many deaths and offer bereavement support to many, often having developed deep relationships with patients and families in our care.


And then a call comes-not to notify us of a patient's death, but rather to inform us about the death of a colleague. Whether the death comes suddenly from an accident or acute illness or is the result of a prolonged illness, the death of a colleague may seem to stop time and to render us, as nurses who specialize in loss and grief, immobilized, as we become those who grieve.


The loss of a colleague is, of course, an individual experience and, just as with the grief of patients and families, does not fit into a single response. Yet, I have observed some common threads in the loss of beloved colleagues, including my own losses of nurse colleagues.


An initial response I have felt and witnessed in others is that this can't be true. "We" are nurses who care for "them," other people who are dying or grieving. That very thin veil that separates us seems to fail as we become the grieving person. There may even be anger or a sense of injustice. Shouldn't we who comfort so many be excluded from losing the people we love?


When a nurse colleague dies, we are also reminded of our own mortality. Perhaps because we have seen death so many times, held those left behind, and bathed the bodies of the deceased, we have denied that it will happen in our own lives. We also may have a stark reality that this person I have called my colleague, coworker, or fellow nurse has actually become much more-he/she is my dear friend. In hearing of a colleague's death, we also recognize that our colleague was not only a nurse but also a spouse, sister, grandmother, or a son.


The death of a colleague may also cause us to pause and reflect on our own professional lives. Early in my career, I experienced the loss of my mentor, Jean, who died in an auto accident. She was just completing her doctorate and launching a career in nursing administration. Her death caused me to think about my own life-should I work harder to achieve things she would never have the opportunity to do or should I work less now that I was reminded of the fragility of life? The American journalist Mignon McLaughlin wrote that "The death of someone we know always reminds us that we are still alive-perhaps for some purpose which we ought to reexamine."


I was reminded of the profound shock of such a loss recently with the death of a friend and colleague, Debra Wiegand, president of Hospice and Palliative Nurses Association. I had known Debra for about 10 years and greatly admired her stellar career in critical care, as she led many efforts to advance palliative care in hospital settings. Debra was an esteemed faculty member, researcher, and clinician. She was radiant in teaching, and I had personally witnessed her enthusiasm for palliative nursing, as she served as faculty for our End-of-Life Nursing Education Consortium project teaching critical care nurses, including a trip to South Korea where she delighted in sharing her expertise.


As news of Debra's death began to be shared over the following days, I received several separate emails from colleagues in all parts of the country, and I noticed that several people had made almost identical comments in their messages, as they wrote "she always made me laugh." What better tribute than to know that you brought such joy to others.


I have no words to make the death of a colleague easier. I only know that the best response to grief is to grieve-step across that thin veil that separates us in life and death and grieve for our colleagues, celebrate their lives, and remember to hold tightly to our other colleagues as they also grieve. As Khalil Gibran wrote, "When you are sorrowful, look again in your heart, and you shall see that in truth you are weeping for that which has been your delight."


We are very privileged as nurses to know death well-to see it come to those we care for and to perhaps know more intensely than others may, that life is precious and finite. And times come when we also grieve because we have lost our colleagues whom we also call friends.



Betty R. Ferrell, PhD, CHPN, FAAN, FPCN




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