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Dealing with death as a medical student/doctor

When we face a patient’s death, whether as a medical student or a doctor, we may experience a range of emotions, This can include sadness, guilt, anger. There may be associated feelings of self doubt, helplessness, or failure, or the worry of criticism for involvement in the patient’s care. Grief can form when a patient we cared for passes away, along with ideas of ‘I could’ve done more’ or ‘if only I noticed something sooner’.

This can be attributed to the fact that medical students may form closer bonds with patients by spending more time compared to doctors with responsibilities toward greater numbers of patients in wards.

These are natural reactions, since we as healthcare providers are always striving to give the best possible care to whoever walks through the door. When that seemingly does not pan out, it affects us dearly and leaves us with these strong feelings. With the wellbeing of our patients being something we hold so close to our heart , it can be incredibly difficult to try and muddle through the sea of emotions. So how can we grow around grief?


Far from being an event to be 'swept under the rug', it is important to acknowledge the death of a patient in whose care we have been involved, and also to acknowledge the feelings that are evoked within us.

Talk to someone about how you’re feeling, Speak to the family of the patient.


Medical students and doctors may very often wrestle with the feeling of grief, but hide those feelings from others because they may feel that showing emotions can be considered a sign of weakness. The professional taboo around grief can have negative consequences for medics as well as for the quality of care they provide. Any medic can be taken by surprise by how they are affected by a patient’s death and should know that it’s entirely acceptable to feel this way. There is no single way to go through this bereavement, and it will affect different people in their own unique way. But it is okay to seek help if we are struggling to cope with a patient’s death.


Although the grieving of the patient’s loved ones will come first at that moment in time, speaking to them may help you acknowledge and come to terms with your own grief and personal loss. Know that it is acceptable to ask for help. It may be easier to hide from your feelings in the medicalisation of death, but know that it is okay to acknowledge those emotions. It will not make you any less of a medical student/doctor. Reach out to your support system, whilst remembering to maintain the patient’s anonymity if not talking to those already privy to them. Speaking to other medical students/healthcare professionals may prove beneficial, as it is likely they have undergone a similar experience to your own. Receiving bereavement counseling from a professional may be a great aid in your healing process. At the end of the day, remember to treat yourself with the same patience and kindness that you would to a patient who was in a similar position to yours.

Don’t feel pressured to keep working, take some time off if you need it

It can be incredibly difficult to continue working following the death of a patient. If we are battling our emotions whilst taking care of further patients, it can not only lead to the decline of your health, but also increase the risk of unwanted consequences towards the people receiving your care. ​​Speak to your supervisor, consultant, or teaching fellows about taking some time off should you feel it would be beneficial, and check your local rules on Bereavement leave. Within the NHS bereavement is a right from the first day of your employment and is generally paid for.

For further information on Bereavement leave, see the ACAS guide linked here: https://www.acas.org.uk/time-off-for-bereavement

Use the situation to learn for the future

Death is an inevitable part of life and this is particularly true for doctors and medical students who must deal with it on an almost regular basis. Understanding the circumstances that lead to a person's death along with the fact that we are all human is one of the last steps towards dealing with that pain. None of us are omnipotent, and death is a very real experience in life that we cannot always prevent. We can take our grief and associated feelings, and use it to direct our future care, channeling our emotional energy towards the next patient and more.


No matter how resilient we think we are, death can always bring about emotions that we struggle to deal with. No matter the situation, addressing your feelings and seeking help are some of the best ways to manage and move forward.


References:



https://www.rcn.org.uk/get-help/rcn-advice/time-off-work


https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/grief-bereavement-loss/


https://www.bma.org.uk/advice-and-support/your-wellbeing/insight-and-advice/first-times/coping-with-the-death-of-a-patient


https://www.kevinmd.com/blog/2020/03/7-reflections-on-grief-and-personal-loss-as-told-by-a-medical-student.html



https://www.bmj.com/content/355/bmj.i5597


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