Monday, September 14, 2015

When Delayed Grief Affects Work Performance

[Reviewed and updated July 2, 2024]

I tried to shut out the feelings that were hurting my heart with a thousand tiny pinpricks, which was somehow worse than having it broken all at once.  ~ Morgan Matson, in Second Chance Summer

A reader writes: I lost my dad ten months ago, while I was in my last year of nursing school. I had to 'tuck in' the grieving process in order to graduate which was my dad's greatest wish for me. He literally said, "Don't stop school for me." I originally felt rejected by him, but now I see he was protecting me again. He had an 8 month battle with pancreatic cancer that was just horrible.

So, I've graduated from nursing school, passed my state boards, and I wish I could give him a big hug. Now that the stress from school is over, I feel like I need to continue the active grieving.

The problem is that I'm messing up at work, which is not new work for me.

I'm doing the same things I was doing before I became an RN. No med errors, no problems with patient care THAT I'M AWARE OF! I'm messing up on the paperwork, and I seem to have lost my short-term memory. I also feel real confusion. I'm afraid that I will get fired from work. They know about my dad dying, but people who still have their parents are just so unaware.

I'm allergic to many medications, so I'd rather see a therapist. I have new insurance, so I'm going to give it a try. I just feel really scared opening up to someone in person.

I've been writing Dad and God letters and expressing my thoughts and emotions to both of them. I have forgiven myself and my stepmother for the things that happened while Dad was dying. But now, I think I need to forgive Dad for dying, and I'm still pissed off! I want to go stomp on his grave and tell him I don't appreciate him dying (actually, Dad had a great sense of humor, and I think he would get a big kick out of that!)

I need to write another letter to Dad and tell him about the NCLEX, school, problems at work, etc. He's not here physically, but I like to think that spiritually we never end.

My response: First, I want to congratulate you on your graduation from nursing school, passing your state board exams and becoming a registered nurse. That is no easy accomplishment, and to achieve all of that while experiencing the illness and death of your father is nothing short of monumental. Just think of the enormous energy, concentration and discipline it must have taken for you to do all of that!

Frankly, it is not surprising at all to me that now, when you can let down your guard just a bit, this grief is knocking at your door and demanding your attention. That is the way of grief ~ if we cannot or will not pay it the attention it deserves at the time, it simply lies in wait until such time as we are ready, willing and able to deal with it (or it comes out anyway, every which-way but straight, and in ways that we cannot control). The good news is that it's never too late to do the work of grief, and now you have the time and space to deal with it. I applaud your decision to see a grief counselor.

You say that at work you're feeling confused and experiencing some short-term memory loss, although so far this hasn't affected your patient care. For the safety of your patients, however, I think it's important that you have a talk (in complete confidence) with your supervisor to let her know what's going on with you. You can explain your circumstances just as you've explained them to me: that during your schooling, graduation and preparation for state boards you were also grappling with your father's terminal condition and death, that you had no choice but to "put off" your grief work, that you are aware that now it is time to begin doing your grief work, that you intend to seek appropriate help through that process, and that even though you're not functioning at 100% right now, you have every confidence that you will be very soon. If you're so inclined, you may even request that, out of concern for the safety of your patients, a colleague be assigned to "shadow" your work for a time, just to be sure that you've not overlooking something important. Such a conversation will convey to your supervisor that, being the excellent nurse that you are, you are demonstrating accurate self-awareness, you are practicing adequate and appropriate self-care, and you are putting the safety of your patients first.

I like that you've been writing letters to your dad and to God, expressing your thoughts and emotions to both of them. Writing is one of the oldest and most effective methods of self-exploration, self-expression and self-discovery, and it's good to know that you are using it as a tool in your own healing.  

Finally, you said, "I'm allergic to many medications, so I'd rather see a therapist. I have new insurance, so I'm going to give it a try. I just feel really scared opening up to someone in person."

Reluctance to seek counseling is a topic that's come up more than once in our online Grief Healing Discussion Groups, and you might like to read what some of our members had to say about it. See this thread especially ~ and make sure you read all the posts and follow the links you will find embedded there: Can Anyone Tell Me if Therapy Helps?

You sound like one determined young lady, and with your dad's encouragement and love to sustain you, as well as your self-awareness and positive attitude, I've no doubt that you are headed for a successful career in your chosen profession of nursing. I wish you all the very best. 

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