By Eileen S. Lenson, MSW, ACSW, BCC
Posted on August 15, 2021
Welcome to Q&A Today, a column designed to answer your questions regarding challenges and concerns in everyday life, from family to coping with current events. A popular topic today revolves around the coronavirus. All questions are fair game. Just send me an email with your questions or concerns, and watch for the answer in upcoming editions of the Tasmanian Times. Q&A Today is published on the first and third Sundays of the month. If your question is printed, only your first name will appear in this column.
Q: I am a nurse, single with no children. Last year I cared for COVID-19 patients in the hospital’s Intensive Care Unit (ICU). Despite the team’s effort to provide the best care possible, some of my patients died. Those were really awful times. I worried about having sufficient protection and unfortunately got sick with COVID-19 during this time frame. Thankfully it was a mild case. I didn’t need to be hospitalised, and was able to return to work after three weeks.
When I returned to work in the ICU one of my patients was sick enough to require being placed on a ventilator. He was a man in his 40’s who had two children and his wife was expecting their third. He was so scared, and I did my best to comfort him. When he died I felt depressed, disgusted and guilty that I had survived COVID-19 but he hadn’t. I wanted to just sit in my car and cry. Or break something. Or yell. But his ICU bed was immediately filled with another COVID-19 patient. What could I do but to suck it up and keep going? Otherwise who was going to be there to help the team take care of all the patients?
I really liked being a nurse but I’ve lost my confidence in myself. I can’t stop wondering why I, who has no children, survived COVID-19 while that man with young children died. Maybe I could have said something that would have given him more peace, or done something different and he would have lived! I quit my job a few weeks after that patient died. I’m working in my family’s business, paying my bills but I’m still not OK. – Suzanna
A: You speak of feeling unworthy of surviving COVID-19 when your patient did not, and that you feel you should have tried harder, done more or something different for the patient. As painful as it is, I’m glad that you’re speaking up about your difficulties, Suzanne. The weight of guilt you are feeling is the hallmark of a phenomenon known as survivor’s guilt. Emotionally it can be crushing. If you don’t attend to these feelings of unworthiness, self-doubt and depression they don’t always resolve naturally over time and can continually have a negative impact on your life.
Survivor’s guilt, a normal and common reaction to horrible situations, was identified as far back as the experiences of Holocaust concentration camp survivors. Some careers place people at greater risk of experiencing survivor’s guilt. It is not an uncommon reaction in occupations that involve unpredictability and human suffering such as law enforcement, medical field, military and firefighters.
While survivor’s guilt is also known to occur in those who survive medical crises such as organ transplants, the trigger doesn’t have to be a life/death situation. Sometimes employees whose jobs are protected when companies downsize experience survivor’s guilt when colleagues lose theirs. So you can see that you’re not alone.
You are in a stressful career with frequent exposure to death and dying, while trying to help relieve physical pain and provide emotional support to patients. ICU beds are not sitting idle with this pandemic. They are in great demand, and when a patient is moved out of an ICU bed it is filled immediately, leaving medical personnel little to no time to process the loss. Additionally, throughout the entire time you worked you were worried about being adequately self-protected from COVID-19. Working with so many concerns and questions and too few answers is a recipe for someone to feel powerless, helpless and hopeless – a lack of control over their life.
It isn’t easy, but with focus and planning you can navigate the guilt and move forward.
Start by thinking how to keep these feelings from distorting your view on life. What thoughts might you have that are irrational? You wonder if you ‘could have done something different’ and if you could have done more, if not to preserve his life then to provide him with emotional comfort when he was dying.
Talk with former colleagues and ask them how they viewed your role as an ICU nurse. Learn more about what you may have exaggerated about your ability to prevent someone’s death or opportunity to make his dying more peaceful.
I think you’ll learn that there may have been nothing more you could have done, that COVID-19 is a modern day plague, and that you did the best that could possibly be done at that time.
You are a caring and compassionate person, Suzanne. I hope that you can learn to take care of yourself or the burdensome emotions you’re feeling may take a toll on your emotional and physical health. Mourn the loss of your patient while also realising the challenges of treating patients while burdened by a modern day plague epidemic. Explore the feelings that exist behind your survivor’s guilt so that they can lose their power and you can finally begin to find a way to let go of them.
Think deeply about what it will take for you to find the ability to be happy again. While you will always feel this deep regret for the loss of lives for whom you provided care, letting go of the self-blame will enable you to find confidence and contentment in life once again. Never forget that you helped this patient of whom you speak as well as a number of others, to the best of your abilities, provided heartfelt care, and that you enjoyed nursing. Your personal and professional experiences with COVID-19 can help you relate to these patients’ needs. Perhaps in time you may wish to consider continuing to help victims of COVID-19 by applying your nursing skills in a different setting, such as physical therapy programs designed for COVID-19 long-haulers, which would allow you the opportunity to work with less critically ill patients.
– Best wishes, Eileen
Eileen S. Lenson, MSW, ACSW, BCC is author of Overcoming Adversity: Conquering Life’s Challenges, by Australian Academic Press. Eileen is a life and business coach and public speaker residing in the United States. She has spent her professional career working in medical and psychiatric hospitals and in her private practice, counselling people experiencing emotionally traumatic events.
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