The issue with tissues

The issue with tissues

May 8, 2024 | Reflective practice

How do we deal with tears as health professionals?

I have recently become more aware of how tissues are used when patients begin to cry. Often as nurses we don’t like it when we see a patient or family member cry. We may feel upset by this or we may feel uncomfortable by the tears. It’s important for each of us to reflect on this; how we are with the tears of another, and if possible, why and how we use and provide tissues as a result.

I was working in a hospital recently on a medical round with a consultant, registrar and specialist nurse. Later in the day we went to see a patient who had distressing pain overnight. We didn’t see them in the morning as they were sleeping and we wanted to support them by allowing them to rest. This in itself is amazing and showed how we were not governed by our own time frame or agenda. It was very much about the patient.

One of my colleagues began to explore with the patient what had happened in the evening and early morning prior. Their pain had started to build until it became a crisis situation for them, making their pain difficult to manage for the night staff. At one point the patient began to cry, sobbing that they thought they were going to die from the pain. My colleague reached for the tissues placing them on the bed. At that time the patient made no attempt to reach for a tissue. My colleague then took two tissues from the box and placed the tissues directly into the hand of the patient. With that, the patient immediately wiped their eyes and stopped crying and they also stopped their processing of the events of the night before. 

This may seem like nothing much, but from what I was observing it was huge. The patient had touched some real fears they were facing and in their moment of tears they were being very vulnerable. There is no criticism of my colleagues in this situation, for it is a clear moment that presented a real opportunity to learn and understand ourselves more as health professionals and the reasons why we do things in practice.

People, our patients and their families can become emotional for many reasons and they often cry – we even cry from time to time too. How we respond or react to this is important both for us but also the person who is crying.

Something that I am learning is to be ok with feeling uncomfortable with something that a patient is sharing. It’s ok to feel uncomfortable at the time when someone is crying and with that, not go into ‘trying to fix’ that something. Often patients share things with us that bring up things for us to look at in our own life. This is life and constantly happens with every interaction we have, day in day out, this is no different in healthcare.

It’s not something we are taught in nursing or medical schools. The focus is more on fixing, repairing or managing whatever is going on for the person. When someone is crying, they are expressing, often a sadness they have been carrying, sometimes for a very long time. We are not able to fix this and it’s important that we allow the person to be, so they can feel the sadness and release it. What I observed in this situation was that handing someone a tissue too early can stop this process for the person, thereby stopping that release. This is a very important consideration. 

There is absolutely nothing wrong with using tissues. How we use them is important for a patient, family member or even a colleague who may be crying. Why we use them is also important for us to reflect on. There is no right or wrong, simply moments to learn from and observe why we make the choices we do. In this way we come to see that we are offered a greater understanding not only of what is going on for those in our care but also ourselves in the work we do in healthcare.

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