1. ACKNOWLEDGING THE WORK OF UMHS STAFF

2. Between 1000-1100 deaths every year of hospital patients Countless other patients die at home Colleagues suffer losses of family and friends Colleagues also develop terminal illnesses or can die suddenly

3. Everyone who works here is a caregiver. Staff develop caring and compassionate attitudes towards patients and families. Staff learn about hope and resiliency of our patients and their families This is our reward.

4. What does that mean to each of us? Professional means this is not my loss but one of many I will deal with Professional means I get to come back and do this again. Professional means I have to find a way to handle my own feelings in a respectful and dignified way. I have to work at it Need to develop the right blend of compassion and self- protection Professionals often hide their grief but postponed grief needs expression Familiarity with death does not make it easier to accept.

5. Line can blur between professionalism and allowing oneself to feel the others pain and express our own feelings Confidence in ones own ability to look at death Whether one views death as an enemy The expectations of the Michigan Difference are high. We bump up against our ethics all the time. Feelings of Helplessness

6. Compassion Fatigue is the cost of caring Is related to the compassion we feel and is unique to caregivers We do this work and sometimes it hurts We cant always take the time to process what we are experiencing with our colleagues or friends.

7. When we experience our own losses it is a compounding factor Shouldnt we have immunity-we gave at the office We are quicker to see the end point We are not sure how to support each other in the work place

8. I cant go in that room anymore. That poor woman is just dying I wasnt prepared to have to transport a patient to the viewing room who was all dressed with make up on. That really bothered me. I dont like seeing the dead bodies being wheeled off the units. It feels like a failure Can someone else take the next dying patient? I cant take one more right now.

9. I got so close to my patient. She was here for months. Its hard to believe shes gone. I kept trying out new therapies but then had to admit that all I could do was help him have the least worse death There was so much suffering at the end. It was hard to watch that. I couldnt help but remember what my mother went through when she was fighting Alzheimers. I feel for that family

10. Talk to other people who understand Take time out Give ourselves permission to grieve Create our own rituals to make a transition from one patient to the next, one loss to the next. Become acquainted with the process of normal grief Dont stop caring! Take care of our physical, emotional and spiritual selves.

11. From PICU social worker to ODA Learning to be present and witness pain Making it better so families do not get stuck here Helping staff cope and being a resource Becoming the transplant center cummulative grief coordinator

12. Acknowledge staff losses across the health system Focus on activities that renew the head, heart and spirit. Acknowledge the cumulative effect of losing patients, colleagues, family and friends We do this work and sometimes it hurts

13. Over 1000 deaths per year in the Medical Center Many more deaths of UM patients in home or hospice settings. Often no time for staff to mourn losses or acknowledge the emotional impact of losing a patient, colleague or loved one. Unrecognized effects of cumulative grief can lead to burnout, stress, loss of productivity and low morale.

14. Unrecognized grievers need to acknowledge cummulative losses Has not been institutional recognition of these losses (occasional unit-based activities.) Have not had a memorial service focused on staff.

15. Coordinator of the Office of Decedent Affairs teamed up with the Coordinator of the Transplant Center Cummulative Grief committee. Idea to have a grief week for staff inclusive of all areas and disciplines

16. Planning members include: Social workTransporter Services Spiritual CareEnvironmental Services MedicineChild life NursingUnit hosts interpreter servicesGift of Arts Transplant ServicesGift of Life Home care services Physician Assistants Public Information Office Employee Assistance Program

17. Committees formed to plan events of grief week. Each group is multidisciplinary Events supported financially by a variety of hospital units and outside grants. Off-site units may be able to participate with the art project, and webstreaming.

18. Schwartz Rounds: Creativity and Grief- A Showcase Sister Susanne: Looking for Laughter in the Midst of Loss Memorial Service for staff (offered twice) Keynote speaker: Dr. Alan Wolfelt : Grief in the Workplace-Companioning Yourself while You Companion patients, families and staff. Family Panel: Gratitude and Grief Ongoing: Art Project Ongoing: Grief Wall in UH

19. Ongoing: Information Table Tips of the day on the internal home page Evening event open to all professional staff interested in grief and loss. Wolfelt seminar: Beyond Therapy: the Art of Companioning the Bereaved Registration required Evaluation will be conducted after Grief Week to solicit ideas for improvement for next year.

21. Please plan on attending as many of the activities as possible and encouraging all of your staff to do the same! Thank You.