Dealing with the Bereaved #caring


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It’s been a tough couple of months. 2 very close friends have lost loved ones and 2 family members have died. 2 of them young woman in their 50’s losing their life to that horrendously awful disease CANCER. Every single one of them leaving behind broken-hearted family and friends.

I have shared their journeys through the caring for their loved ones and it saddens me to hear that they had many battles along the way. Getting much-needed appointments, lack of communication between different organisations and sadly just not enough resources in the NHS to assist them in their caring. But also, the many different positive stories they shared about the many different GP, hospital staff and voluntary organisations that often helped make the day that bit better for their professionalism and caring natures.

Often when someone is ill, especially terminally life is very hard on the people caring for them. They often have very little support or no support at all. One of the carers had to give up their job to care for their wife so he could accompany her to the many appointments for chemotherapy and radiotherapy and to the many visits to A&E and the GP. They had to be the “strong ones” Every single bit of help for them (the carer) goes a very long way in their fight to give their loved one the best possible care that they can………………but they need support from so many other organisations to be able to do this.

The carers often get worn down, quickly feeling low or even getting depressed and often face financial difficulties. Who cares for the patient if the cater gets ill?

Attitude, communication, empathy, time, and listening skills don’t cost a lot but can be invaluable to the carer – and the patient.

If you are aware of such a carer needing a doctor’s appointment please communicate, have empathy and use your listening skills. Try and accommodate an appointment that will allow them to fit in around the caring that they are doing.  They might find a telephone consultation easier. Some carers are worn down by the sheer volume of the day-to-day caring and fighting for their loved one. When it comes to them seeking attention for themselves they just don’t have the fight in them anymore. You need to be their “fight” When someone is watching their loved one suffering in pain, they don’t need any extra pressure.

When I was a Receptionist I was often faced with terminally ill patients. People that were caring for loved ones with terminal illnesses and often them needed to be treated as a patient due to the stress of being a carer.

I still remember the first time I dealt with a family member who had just lost their loved one to cancer. They came into the surgery to collect the death certificate. This was the first time that I had ever come face to face with someone who had just had a death in their family. I was lost for words. I didn’t know what to say, so I said nothing and I felt bad for this afterwards. I just didn’t know what to say. I didn’t want to upset the person.

I also was “surprised” at how some people behaved when then had just lost a loved one. Some would appear to be “happy” even cracking jokes, some would come in and were obviously very upset, some would come in and wanting to blame someone for the death of their loved one, others would just act as if nothing had happened.

I had the opportunity to go on a bereavement training session and this explained so much to me. It taught me why people react to death in many different ways.

The training explained the different emotions that people might be going through immediately after the death.

Shock: It may take you a long time to grasp what has happened. The shock can make you numb, and some people at first carry on as if nothing has happened. It is hard to believe that someone important is not coming back. Many people feel disoriented – as if they have lost their place and purpose in life or are living in a different world.

Pain: Feelings of pain and distress following bereavement can be overwhelming and very frightening.

Anger: Sometimes bereaved people can feel angry. This anger is a completely natural emotion, typical of the grieving process. Death can seem cruel and unfair, especially when you feel someone has died before their time or when you had plans for the future together. We may also feel angry towards the person who has died, or angry at ourselves for things we did or didn’t do or say to the person before their death.

Guilt: Guilt is another common reaction. People who have been bereaved of someone close often say they feel directly or indirectly to blame for the person’s death. You may also feel guilt if you had a difficult or confusing relationship with the person who has died, or if you feel you didn’t do enough to help them when they were alive.

Depression: Many bereaved people experience feelings of depression following the death of someone close. Life can feel like it no longer holds any meaning and some people say they too want to die.

Longing: Thinking you are hearing or seeing someone who has died is a common experience and can happen when you least expect it. You may find that you can’t stop thinking about the events leading up to the death. “Seeing” the person who has died and hearing their voice can happen because the brain is trying to process the death and acknowledge the finality of it.

Other people’s reactions: One of the hardest things to face when we are bereaved is the way other people react to us. They often do not know what to say or how to respond to our loss. Because they don’t know what to say or are worried about saying the wrong thing, people can avoid those who have lost someone. This is hard for us because we may well want to talk about the person who has died. It can become especially hard as time goes on and other people’s memories of the person who has died fade.

The training was excellent and I would really recommend if such a training course becomes available. I understood and was able to deal with bereavement a lot better. I was also able to communicate better, had empathy and my listening skills often came into good use.  I felt I made a difference. I was more confident to talk to people and ask how they were coping and make sure that I did everything in my power to make their visit to the Surgery went as smoothly as possible.

People often appreciated this, and would often say that I would be the first person that day that had acknowledge their loss.

Being recently bereaved can often be a very lonely place.

When I was a manager I instigated a Special Needs Board – this was extremely helpful to Reception staff when it came to identify patients that had just died or were terminally ill.

See blog post:      Special Needs Board http://t.co/wnWKmxHV

As a Receptionist, its important how you react to someone who has just had a bereavement. Knowing that this person might have needs (especially if they are a patient) and how you can make such a great impact on them.

How you treat them can give a lasting impression. Make it a good impression and not a bad one.

Patients With Special Needs (Patients Special Needs Board)


How do you keep staff informed about patients that perhaps need special attention?

What do I mean by “special attention”? Well this could come in many forms but for me as a manager I felt that certain patients needed to be at times “highlighted” to the rest of the staff.

Who would these patients be?

I know a lot of people think that Receptionists ask too many questions – that they are “nosy” or perhaps a barrier to seeing the Doctor – but believe me this is not the case – Receptionists ask these questions on behalf of the Doctors and Nurses and try their very best to ensure than anyone that needs to see the Doctor sooner rather than later does – if everyone was give this priority then the system would be in quite a mess. Then where would that leave the people who are possible at risk and do need urgent medical attention.

For me it was important that these people did not slip through the system without being given any necessary follows ups that were needed.  These people at times needed urgent appointments, urgent prescriptions or just access to the doctors without having to go through the many questions that sometimes a Receptionist has to ask.

Most of your staff will be dealing with these patient and will know of such cases – but what about the staff that work part-time – or those that have been on holiday for 2 weeks – it is amazing what kind of changes can go on in a surgery in this short space of time.

How many times I have seen a Receptionist that has been away ask a patient how their husband/wife/mum/dad are only to be told that they had died. It will happen – but there are ways that you can keep staff updated these issues.

What sort of things would these patients or their families phoning or coming into the surgery about?

An urgent prescription might need to be generated for a terminally ill patient. This could be done almost immediately instead of the usual 48 hours.

An urgent Doctors Visit might be needed for a terminally ill patient.  The visit would be logged without question. And then when the Doctor does his visits he could prioritise this patient if needed.

A patient might need an appointment that day due to a bereavement, or a miscarriage. The patient might be too upset to discuss with the Receptionist and might need to be seen immediately.

A relative of a patient that has recently died might need to see a Doctor. They would not want to wait a few days for this – does your surgery have a policy on patients that have recently been bereaved.

Often if the Doctor is aware that a patient has died he or she will often phone the relatives of the patient – this can be very comforting at this very sad time.

All of the above would mean the patient would need to be dealt with quickly, without fuss or questions and with compassion.

To have their call / query dealt with efficiently without question will no doubly help they already stressful situation.

I decided in creating a “message board” a “specials needs board” or  “patient board” it could be called whatever you like but at the end of the day this is how it worked.

In reception we had a wipe clean board. We used a wipe clean board simply because it was easy to use and update quickly. This would have three sections headed with:

  • Terminally Ill
  • Ante Natal
  • R.I.P. (recently deceased)

At the start of any entry the date that the entry was made should be dated.  This is a way of knowing when the message was written.

TERMINALLY ILL

Any patients that were terminally ill either in hospital in a Nursing home or at home their name would be entered onto the board and the place that they were at.

ANTE NATAL

If we had an expectant mum that was having a difficult pregnancy, had recently had a miscarriage or a still-born their name would be entered onto the board.

R.I.P.

Any patient that had died their name and date that they died would be entered onto the board.

Beside each of their names we would have the patients Date of Birth. This is important to identify the correct patient.

The board would be kept in the Reception Area – but most important not in view to anyone other than staff. This is most important – remember patient confidentiality.

This board would be seen on a daily basis by all staff in the surgery. District Nurses used to come in each morning and have a look to see if any of their patients had died over night.  The health visitors would also check the board on a daily basis. The midwife would look before she started her clinic and the doctors would look before their started their morning and afternoon sessions.

By having the board in Reception it is there for all staff to see – and the good thing about this board is you don’t even think you are looking at it – but when you answer the telephone and one of the names on the board is mentioned you immediately are drawn to the board – the board is almost subliminal you see it without realising it.

You will need to ensure that the board is kept up to-date. You could allocate this job to one Receptionist.

The terminally ill will need to be there until they sadly die and then go onto the R.I.P. (This also highlights those terminally ill that have died)

Your surgery will have to agree on how long you keep the Ante Natal information on there – at our surgery we kept it up there for a month after the entry.

R.I.P – again you will need to agree how long you want to keep the information on there – again we kept it up there for one month.

Try this board system – it really does work and those patients that need special care can get it without having to go through lots of questions to get what they want.

Here is an example of how the board might look.

Terminally Ill

  • Mrs Jessie Jones    DOB 30.03.29   (ca breast)
  • Mr John Smith       DOB 25.06.57  (heart disease)

 Ante Natal

  • Annie White           DOB 26.09.80   (miscarriage)
  • Joan Brown            DOB 25.08.86   (stillborn)

 R.I.P. (recently deceased)

  • Mr Alex Swords       DOB  06.04.75   (died at home)
  • Mrs Susan Bird        DOB 12.12.45    (died in St Marys Nursing home)

You can of course make the board up in any way you think will fit in with your Surgery. But I must stress how important it is that this information is not seen by anyone other than staff.

Patients With Special Needs (Patients Special Needs Board)


How do you keep staff informed about patients that perhaps need special attention?

What do I mean by “special attention”? Well this could come in many forms but for me as a manager I felt that certain patients needed to be at times “highlighted” to the rest of the staff.

Who would these patients be?

I know a lot of people think that Receptionists ask too many questions – that they are “nosy” or perhaps a barrier to seeing the Doctor – but believe me this is not the case – Receptionists ask these questions on behalf of the Doctors and Nurses and try their very best to ensure than anyone that needs to see the Doctor sooner rather than later does – if everyone was give this priority then the system would be in quite a mess. Then where would that leave the people who are possible at risk and do need urgent medical attention.

For me it was important that these people did not slip through the system without being given any necessary follows ups that were needed.  These people at times needed urgent appointments, urgent prescriptions or just access to the doctors without having to go through the many questions that sometimes a Receptionist has to ask.

Most of your staff will be dealing with these patient and will know of such cases – but what about the staff that work part-time – or those that have been on holiday for 2 weeks – it is amazing what kind of changes can go on in a surgery in this short space of time.

How many times I have seen a Receptionist that has been away ask a patient how their husband/wife/mum/dad are only to be told that they had died. It will happen – but there are ways that you can keep staff updated these issues.

What sort of things would these patients or their families phoning or coming into the surgery about?

An urgent prescription might need to be generated for a terminally ill patient. This could be done almost immediately instead of the usual 48 hours.

An urgent Doctors Visit might be needed for a terminally ill patient.  The visit would be logged without question. And then when the Doctor does his visits he could prioritise this patient if needed.

A patient might need an appointment that day due to a bereavement, or a miscarriage. The patient might be too upset to discuss with the Receptionist and might need to be seen immediately.

A relative of a patient that has recently died might need to see a Doctor. They would not want to wait a few days for this – does your surgery have a policy on patients that have recently been bereaved.

Often if the Doctor is aware that a patient has died he or she will often phone the relatives of the patient – this can be very comforting at this very sad time.

All of the above would mean the patient would need to be dealt with quickly, without fuss or questions and with compassion.

To have their call / query dealt with efficiently without question will no doubly help they already stressful situation.

I decided in creating a “message board” a “specials needs board” or  “patient board” it could be called whatever you like but at the end of the day this is how it worked.

In reception we had a wipe clean board. We used a wipe clean board simply because it was easy to use and update quickly. This would have three sections headed with:

  • Terminally Ill
  • Ante Natal
  • R.I.P. (recently deceased)

At the start of any entry the date that the entry was made should be dated.  This is a way of knowing when the message was written.

TERMINALLY ILL

Any patients that were terminally ill either in hospital in a Nursing home or at home their name would be entered onto the board and the place that they were at.

ANTE NATAL

If we had an expectant mum that was having a difficult pregnancy, had recently had a miscarriage or a still-born their name would be entered onto the board.

R.I.P.

Any patient that had died their name and date that they died would be entered onto the board.

Beside each of their names we would have the patients Date of Birth. This is important to identify the correct patient.

The board would be kept in the Reception Area – but most important not in view to anyone other than staff. This is most important – remember patient confidentiality.

This board would be seen on a daily basis by all staff in the surgery. District Nurses used to come in each morning and have a look to see if any of their patients had died over night.  The health visitors would also check the board on a daily basis. The midwife would look before she started her clinic and the doctors would look before their started their morning and afternoon sessions.

By having the board in Reception it is there for all staff to see – and the good thing about this board is you don’t even think you are looking at it – but when you answer the telephone and one of the names on the board is mentioned you immediately are drawn to the board – the board is almost subliminal you see it without realising it.

You will need to ensure that the board is kept up to-date. You could allocate this job to one Receptionist.

The terminally ill will need to be there until they sadly die and then go onto the R.I.P. (This also highlights those terminally ill that have died)

Your surgery will have to agree on how long you keep the Ante Natal information on there – at our surgery we kept it up there for a month after the entry.

R.I.P – again you will need to agree how long you want to keep the information on there – again we kept it up there for one month.

Try this board system – it really does work and those patients that need special care can get it without having to go through lots of questions to get what they want.

Here is an example of how the board might look.

Terminally Ill

  • Mrs Jessie Jones    DOB 30.03.29   (ca breast)
  • Mr John Smith       DOB 25.06.57  (heart disease)

 Ante Natal

  • Annie White           DOB 26.09.80   (miscarriage)
  • Joan Brown            DOB 25.08.86   (stillborn)

 R.I.P. (recently deceased)

  • Mr Alex Swords       DOB  06.04.75   (died at home)
  • Mrs Susan Bird        DOB 12.12.45    (died in St Marys Nursing home)

You can of course make the board up in any way you think will fit in with your Surgery. But I must stress how important it is that this information is not seen by anyone other than staff.