As a psychiatric nurse, I had been taught not to cry in front of patients or families. I always heard it would be too difficult for the patient to cope with a nurse crying. It just wouldn't be therapeutic. But I now work in geropsychiatry instead of general psychiatry. The nurses here do lots of things differently. We are big on giving patients hugs and allowing them in the nurses' station, among other things. All things I never would have done in general psychiatry.
I never really saw myself as a big-time crier, but a personal experience probably set me up for being closer to crying than usual. My youngest sister and her husband had been trying to have a baby for some time. She was 12 weeks pregnant and then lost the baby. I was feeling sad for them and had become very teary several times at home.
The first crying experience at work happened when the charge nurse and I needed to talk to the wife of a patient with advanced dementia. This was no ordinary patient. Ron had been an outstanding nursing assistant and an all-around nice guy who I worked with more than 15 years ago. Now he could not say my name or put together a complete sentence and needed 24-hour supervision. We had spoken with his wife many times about his prognosis and abilities, but because of his young age, the change in his personality, and massiveness of the disease, she had trouble comprehending all of the consequences of his condition. The charge nurse and I sat down with Ron's wife and discussed how Ron was no longer worried about his appearance or able to appreciate what she was doing for him. Basically, he was no longer Ron. The three of us cried as we talked about their losses and the tough decisions before her.
The next time I cried at work that week was when I received a phone call from the wife of one of our liveliest patients. This woman and her husband would come in for outpatient appointments, joking and laughing the entire time. They obviously loved each other and life in general. Usually, the wife would call with a question about side effects or when they ran out of medications. This time was different. She called to tell me that while they were on vacation, her husband had a stroke and died 3 days later. I cried; she cried. She and their son came in to see me later that week and talked about their wonderful relationship and how her husband lived life to its fullest. We cried together.
The last time I cried was approximately 4 p.m. that Friday afternoon. I was talking to the daughter and caregiver of one of our patients with dementia who attends the day treatment program. She had been through a difficult time with her father, but after some interventions, things were looking up. She related a story that happened after a particularly frustrating day of care when her father was resistant to do anything. After she got him tucked into bed, he looked at her and said he didn't mean to give her a hard time. She said she knew that and loved him. He told her, "You are my sunshine," and broke into a robust rendition of the song. She said she broke into tears. I did, too.
These caregivers and wives touched me, and I'd like to think that I their lives. Looking over the three experiences, I would not have changed anything. I think that my crying let these women know that I had a good idea of what they were going through, and perhaps allowed them to express their grief. In this way, they truly were therapeutic interactions. Even though there are many difficult issues surrounding caring for geropsychiatric patients and their families, I wouldn't trade the experience for anything.