Prep by: Dr. James Malce Alo, RN,MAN,MAPsycho.PhD.

1

Nursing C A R E P L A N GRIEF

ASSESSMENT DATA Nursing Diagnosis

EXPECTED OUTCOMES

(or Planning)

IMPLEMENTATION

Nursing Interventions *denotes

collaborative interventions

RATIONALE

EVALUATION

Cognitive Responses

• Questioning and trying to

make sense

of the loss

• Experiencing

disillusionment

• Attempting to make sense

of the loss

Emotional Responses

• Feeling numb

• Experiencing sorrow,

loneliness

• Crying, sobbing

• Having vacillating

emotions including

anger

• Experiencing hopelessness

• Feeling helpless, powerless

Behavioral Responses

• Experiencing great

restlessness;

searching for the deceased

• Seeking and avoiding

places and activities

once shared with the lost

one

• Functioning

“automatically”

Physiologic Responses

• Headaches

• Insomnia

• Lack of energy

➤ Grieving

A normal response

in the human

experience of loss.

The client will

• Identify the loss and its

meaning for self (adequate

perception)

• Express feelings, verbally

and nonverbally

• Establish and maintain

adequate nutrition, hydration,

and elimination (adequate

coping)

• Establish and maintain an

adequate balance of rest,

sleep, and activity (adequate

coping)

• Establish and maintain an

adequate support system

• Verbalize knowledge of the

grief process

• Demonstrate initial

integration of loss into his or

her life (adequate coping)

• Verbalize realistic future

plans integrating loss

(adequate perception)

After establishing rapport with

the client, bring up the loss in a

supportive manner; if the client

refuses to discuss it, withdraw

and state your intention to return.

(“I can understand that you

may not want to talk with me

about this now. I will come to

talk with you again at 11:00.

Maybe we can talk about it

then.”) Return at the stated time,

then continue to be as supportive

as possible rather than

confronting the client.

Talk with the client realistically

about his or her loss; discuss

concrete changes that the client

must now begin to make as a

result of the loss.

Encourage the expression of

feelings in ways the client is

comfortable—for example,

talking, writing, drawing, crying,

wailing, or yelling. Convey your

acceptance of these feelings and

means of expression. Offer the

client verbal support for attempts

to express feelings.

Your presence demonstrates

interest and caring. Telling

the client you will return

conveys your support. The

client may need emotional

support to face and express

uncomfortable or painful

feelings. Confronting the

client or pushing him or her

to express feelings may

increase anxiety and lead to

further denial or avoidance.

Discussing the loss on this

level may help to make it

more real for the client.

Expression of feelings can

help the client to identify,

accept, and work through

his or her feelings even if

these are painful or

otherwise uncomfortable for

the client.