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When a patient dies, healthcare workers may experience grief that they barely acknowledge because they know their role is to move on to the next patient. But over time, such grief can build up and contribute to stress and burnout.
There are different dimensions of burnout, including the state in which someone becomes “detached” and is no longer able to communicate in a normal, personable way. This is known as depersonalization, says Jennifer Gray, PhD, MPP, associate professor of public health in the School of Health Studies at Northern Illinois University.
Younger staff in particular might need mentorship opportunities that discuss grief and bereavement. Without support and some training, they might lack skills that help them cope with losing patients, Gray says.
A focus on handling grief and patients’ deaths should be part of any healthcare organization, but it is especially important in nursing homes and other settings where staff will lose many patients to death, she adds.
Healthcare organizations can help their staff cope with grief and prevent workplace burnout by ensuring policies acknowledge the emotional needs of staff. This could include allowing staff time off to attend patient funerals or memorial services. “Give them time to attend a service so they do not have to use one of their vacation days,” Gray says. Employees who spent a lot of time with the deceased patient and are having difficulty with their grief might need a few days off, she adds.
One simple change is to provide staff with as-needed resources, such as grief support and counseling. Sometimes, a healthcare professional grieving over a patient’s death can be helped by co-worker support. Organizations can encourage this natural support network by teaching staff a few skills in communication and listening.
“Gauge whether that person needs more time, and be a good listener,” suggests Eboni Green, RN, PhD, co-founder of Caregiver Support Services in Omaha. “Let that person express sadness.”
Co-workers who show major changes in mood and attitude could be in pain and do not know how to tell anyone about it. Ask them what is going on, she suggests. “Ask, ‘Why are you so angry?’ And then it will start flooding out,” Green says. “It’s not that these are not loving and kind people; it’s just that there is a compiling of these losses.”
An organization can help encourage staff grief support by providing an in-house memorial service for recently deceased patients. “It would be good if they offer it at least annually,” Green says.
Self-care for healthcare workers might include taking breaks during the work day, practicing mindfulness or meditation, deep breathing, listening to relaxing music, exercising, eating well, and getting enough sleep.
“You have to learn how to establish good emotional boundaries so you’re not taking so much of the emotional overload on yourself,” Gray says. “You need to separate yourself emotionally from that patient’s life and have your own life that you go back to at the end of the day.”
One way to view this is to think of emotional well-being as a bank. Stress reduction activities increase the emotional bank funds. But when a patient dies or some other stressor occurs, the emotional bank dips, Gray explains.
“As a healthcare professional, you are drawing on those emotional resources to support people who might not be emotionally stable themselves,” she says. “What kind of tools do you have in your toolkit that can help you put money into your own emotional bank?”
Healthcare leaders might view adding grief resources as yet another task that they do not have time to perform. They are focused on mandated training requirements and finding time for all of those, Gray notes.
“Trying to fit in grief and bereavement as a training topic can be challenging,” she says. “But it’s also in some cases raising awareness that the emotional health of staff and families is really important. The organization needs to put resources into that if they want to do well as an organization and be successful on all fronts.”
Financial Disclosure: Nurse Planner Kay Ball, PhD, RN, CNOR, FAAN, reports she is a consultant for Ethicon USA and Mobile Instrument Service and Repair. Medical Writer Gary Evans, Editor Jill Drachenberg, Editor Jonathan Springston, Editorial Group Manager Leslie Coplin, and Accreditations Manager Amy M. Johnson, MSN, RN, CPN, report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.