Grieving is a complex process which can span many disciplines of thought, including psychological, spiritual, and medical. The article “Exploration of nurse practitioner practice with clients who are grieving” (White & Ferszt, 2009) explores the unique clinical challenges and roles of the nurse practitioner in working with patients who are grieving the death of a loved one. The authors chose a qualitative, descriptive, exploratory method to explore the NP’s practice working with grieving clients within a primary care setting. This approach is suitable for the type of information that was being researched, as it leaves more room for undirected answers and an open forum for the participants of the study to share their phenomenological experiences. The dearth of previous research in this area lends itself to qualitative research, as qualitative research is an appropriate way to open up the discourse and to determine what further questions might be worthwhile to investigate in the future (Polit & Beck, 2012). The authors used the purposive sampling method to select nine NP’s with significant experience grief and primary care, also are known for their holistic, comprehensive nursing approach, with the idea that substantive data could be obtained from these clinicians. The research conducted was a retrospective study about the care of particular grieving patients that these NP’s had provided in the past. After receiving three questions one month in advance of the interview, in order to prepare—pertaining to signs and symptoms of grief, strategies of care, and health outcomes— participants were then interviewed, and their answers to these questions were recorded and transcribed verbatim. Each reflected on a particular case that best exemplified his or her work with grieving patients. In addition, to maintain subjectivity, the researcher kept a reflexive journal before and during the span of the study, to provide a forum for documentation of the researcher’s own thoughts, values, and perspective (White & Ferszt, 2009). The data that was collected from the series of interviews proved to be very interesting and informative to an area of interest which had not been well-explored. Key themes that emerged included the somatization of symptoms: six participants noted physical complaints that had no explainable physiological cause. All participants stressed the importance of knowing about the client’s loss and grief prior to the client’s appointment (from health records, family members, or fellow staff). The study provided particularly relevant findings related to the nature of the client’s physical complaints, overall self-care, relationships, work-roles, and emotional well-being and coping. It also described interventions used, including validation, prescriptions for self-care and intentional scuttling of visits, and teaching, referral, and medication (White & Ferszt, 2009). The author acknowledges that the study was limited by its homogeneity, as all NP participants were female, Causation, with at least five years of experience as primary care clinicians. In addition, eight of the nine patients described were female and Causation, which limits the study’s ability to generalize (White & Ferszt, 2009). Overall, the study was valuable in commencing the discourse on the subject and providing much needed information regarding patients with grief in primary care, as often PCP’s are the first healthcare professionals to recognize address these difficult periods in a person’s life.

References:

Polit, D. F., & Beck, C. T. (2012). Nursing research: generating and assessing evidence for nursing practice (9th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

White, P., & Ferszt, G. (2009). Exploration of nurse practitioner practice with clients who are grieving. Journal of the American Academy of Nurse Practitioners, 21(), 231-240. http://dx.doi.org/10.1111/j.1745-7599.2009.00398.x