Grief. Understanding the clinical grief model through lived experience.
June 5, 2018
The Stages of Grief. When reading about them in a textbook they seem very cold, clinical, and inapplicable. I wrote down my experiences after a tragic loss and found that they became much more understandable and applicable when relating to patients and their family members.
I recently lost a friend in a tragic accident and went through a time of grieving. When reflecting on the weeks prior to the accident occurring I came to the realization that I was well aware of the grief model in theory but hadn’t truly understood it.
It’s one thing to learn about it in the classroom but as worked through my own grief and met with friends/family I became acutely aware of the differences between my grieving and others in how we processed it.
Let’s take a dive into the grief model commonly referred to as DABDA: Denial, Anger, Bargaining, Depression, and Acceptance. This is called the Kübler-Ross model or five stages of grief.
Please Note: This is how grieving looked and felt for me and is not applicable to everyone (which is one of the motivations for writing this).
Grieving isn’t quite as cut and dry as it is taught.
I awoke on a Saturday morning to a number of missed calls from friends (a number of who are police officers). My first thought was that I had unknowingly caused an patient incident the night before at work (in the emergency department) and was in some trouble!
I was devastated when I found out that the slew of calls was actually due to a good friend passing away as a passenger in a car accident the night before.
Due to the driver of a car being a public figure there was more media attention than is normal for the situation.
Needless to say I was a little stunned when I heard the news. I had just been talking to him the night before on the phone, I was with him in person a few days before that. How could he be gone? This is where my denial began.
I checked the article, which barely had more than a few lines due to how recent the news, and was foolishly expecting the title to be different somehow. I kept hoping to see “Two critically injured” instead of reading “Two fatalities”.
I checked and rechecked my text messages and Snapchat hoping for something to pop-up from my now-deceased friend saying what hospital he was in or making some funny quip about his current situation.
In the following couple of days this pattern of behavior continued as the articles started to contain more information and as I came to terms with it.
This was an interesting stage to experience. It started shortly after hearing the news.
I found that I wasn’t angry at anybody involved in the crash, I found myself angry at things surrounding my friend that didn’t pan out for him.
I was angry at the company that had yet to hire him after multiple applications. I was angry that he would never have the chance to get his dream job. I was angry that someone who was such a genuinely great person would never again be able to tell his jokes or brighten a room with his goofy impressions.
This anger subsided shortly after I realized the absurdity of it and how misplaced it was and found that my anger and frustration was swiftly replaced with sadness.
When reading up on the concept of bargaining I found that this was closely tied with my denial. Part of me believed that if I just opened the article again the title would change and he’d still be alive.
This differs from the textbook definition of bargaining. There was no bargaining with a deity or a doctor for more time or a change of outcome, just a desperate hope to read a different headline.
I have experienced first hand through my line of work the classic bargaining where a patient or family member attempts to bargain their way out of a condition or circumstance.
Depression was an on again off again feeling as I went about my day for the first few weeks after the accident.
It tied in closely with anger as it usually followed my bouts of being upset. I would be angry and frustrated that he would never get to join in another gathering of friends or see his family again with the anger inevitably morphing into sadness.
After a number of weeks the periods of sadness gradually evolved into remembering happier memories which ties right into acceptance.
There were a few things that led to me accepting and coming to terms with the situation.
Going to the scene.
I went by the scene of the accident late at night and walked the area by myself. It was a quiet section of road so I was free to wander and see the spot where the vehicle had come to rest. It was an eerie but necessary experience to begin the process of acceptance.
As much as it hurt to see him in a box I thought that the viewing was a big step in accepting the finality of the situation. After the viewing many of us stayed together for the rest of the day talking about life and our friend.
Putting together a video
I elected to compile as many pictures and videos of my friend as I could and create a video with some of his favorite songs and jokes. Working on a video that I knew I would watch as a reminder and that I was going to give to his family once again helped to cement the finality of what happened.
It remains a strange and surreal feeling that I’ll never again see my friend but I’ve come to accept the events, outcomes, and the fact that I cannot change the past.
He will forever be in our hearts and minds.
This post was a little more personal than normal and was a look into how DABDA is not a linear process but one that can look different for every person that is grieving. It might cycle between stages or even come to a standstill as a person progresses towards acceptance.
If you have any questions or wish to share your own experience please don’t hesitate to email me at NurseNotesorg@gmail.com