'Grief Rounds' help students cope

Even as a seasoned veteran in the Medical Intensive Care unit at the Hospital of the University of Pennsylvania, professor of pulmonary and critical care Horace DeLisser said he still “struggles with the death of patients.”

To help others cope with the same, DeLisser has initiated and runs Grief Rounds, a support group that aims to help students and residents cope with the large number of patient deaths in the MICU.

Since it was founded in fall 2007, the group has discussed everything from ending patients’ life support to organ donation and unexpected death.

House staff and medical students are invited to attend Grief Rounds during their month-long clerkships in the MICU. In addition to DeLisser, a physician, chaplain and grief and bereavement specialist are at each one-hour session.

The sessions aim to provide trainees with an opportunity to process the intensely emotional experience of caring for and treating critically-ill patients at the end of their lives, DeLisser explained.

Through discussion of specific patients, group members work to enhance communication and listening skills, peer support and coping mechanisms.

“[Grief Rounds] is a formal way to debrief, find support among peers and to explore self-care as one way to decrease emotional fatigue and possible burnout,” said Florence Gelo, the program’s bereavement coordinator.

Each session begins with a brief introduction or description of the purpose of the session and is followed by a 45-minute discussion of two or three patients who have died in the previous four weeks, DeLisser explained.

The session concludes with a short review of suggestions for dealing with death.

“The facilitators follow the lead of the students and house staff during each session,” DeLisser said, “helping them to acknowledge, name and describe the emotions they have and are experiencing.”

He said students and staff have described “frustration and anger at having to aggressively treat obviously-dying patients with unnecessary interventions.”

They also describe being overwhelmed by patients’ families’ demands, disappointed by an inability to do more to help patients and saddened by the death of a patient to whom they have grown close.

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