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Healthcare, Grief, and Personal Wellness

Types of Coping

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How healthcare professionals cope with traumatic exposure can influence both psychological distress and opportunities for growth. Focusing on adaptive coping strategies may be a practical, evidence-informed way to support personal well-being.

Coping Strategies as a Protective Practice

coping strategy refers to ways stress, emotional discomfort, or challenging situations may be managed. In healthcare settings, cultivating intentional and sustainable coping strategies may be protective, supporting regulation of thoughts, emotions, and responses in the context of ongoing exposure to grief, trauma, and high-stakes decision-making.

Types of Coping Strategies

There are different types of coping strategies:

  • Avoidant coping 
  • Emotion-focused 
  • Problem-focused 

Avoidant Coping

Avoidant coping refers to strategies that focus on minimizing, escaping, or numbing emotional discomfort rather than addressing or processing it. While these responses may feel protective in the short term, over time they have been associated with increased emotional strain and reduced emotional connection with self and others.

I don’t want to be numb. That’s not why I went into medicine. But feeling everything is exhausting.

Pediatric Oncologists’ Coping Strategies for Dealing with Patient Death / (Granek et al., 2016)

These strategies may look different depending on context and role. 

On the job
  • Emotional detachment from patients or supporters — Creating distance to limit exposure to grief, sadness, or helplessness, such as referring to patients by room number rather than name or avoiding eye contact during difficult conversations.
  • Overworking or taking extra shifts — Using constant busyness as a way to avoid sitting with grief, stress, or unresolved emotional impact.
  • Suppressing emotional responses during distressing cases — “Powering through” emotionally charged situations without acknowledging internal impact or returning later to process the experience.

Avoiding reflective supervision or team debriefs — Skipping opportunities to process difficult events due to discomfort, concerns about vulnerability, or the belief that there is not enough time.

When Compartmentalizing Is a Short-Term Necessity

In healthcare, there are moments when temporarily setting aside emotional responses is necessary to focus on patient safety and complex care tasks. Challenges may arise when there is no opportunity to return later to process what was set aside, allowing emotional impact to accumulate over time. Recognizing the difference between short-term, functional compartmentalization and ongoing avoidance can support more sustainable coping.

Outside of Work
  • Disengaging from loved ones — Withdrawing emotionally, feeling numb, or avoiding conversations about work because it feels overwhelming or exhausting to explain.
    Relying on substances or excessive screen time — Using alcohol, medications, food, or prolonged screen use as a way to avoid sitting with work-related distress or difficult emotions.
  • Avoiding grief-related reminders — Steering clear of music, places, or situations that bring up memories of patient loss, rather than identifying safe ways to process.
  • Downplaying stress or declining support — Saying “I’m fine” when not, or turning down offers of help due to concerns about burdening others or appearing vulnerable.
Overwork as a Form of Coping

Working longer hours, picking up extra shifts, or staying constantly busy may be interpreted as commitment in healthcare settings, where productivity is often reinforced. In some cases, however, overwork may also function as a way to avoid processing grief or emotional pain. While this may feel effective in the short term, sustained overwork as a coping strategy has been associated with increased risk for burnout, emotional exhaustion, and reduced capacity for sustained care. Recognizing when busyness is serving as emotional avoidance may support more balanced and sustainable coping.

Two people standing in a hallway; one person stands with head lowered and hand covering part of their face, suggesting emotional distress, while another person is turned away, creating a sense of tension or emotional distance.

Any behavior that pushes our feelings and thoughts of grief out of our awareness likely means we are also not aware of the impact on our physical self.

The Grieving Body (p.107) / Mary Frances O’Connor

The Impact of Avoidance

Avoidant coping strategies, such as denial, distraction, or emotional withdrawal, may be common in high-stress healthcare settings. Research has linked reliance on avoidant or maladaptive coping with higher secondary traumatic stress and ongoing emotional strain among healthcare professionals. In work environments where emotional expression is discouraged or unsupported, emotional suppression has been associated with emotional distress, burnout, and emotional disconnection.

Emotion-focused Coping

Emotion-focused coping refers to strategies that support regulation of emotional responses to stress, rather than changing the stressor itself. These approaches may help restore emotional balance, reduce overwhelm, and support longer-term resilience, particularly in situations that cannot be changed.

I find that acknowledging my grief when a patient dies helps keep me centered in the midst of caring for my patients.

Cynda Hylton Rushton, PhD, MSN, RN, FAAN / Professor of Clinical Ethics at the Johns Hopkins Berman Institute of Bioethics

This type of coping may involve practices such as reflection, movement, or connection. These strategies may look different depending on role, setting, and personal preferences. 

On the Job
  • Pausing to breathe or ground between patients — Using brief breathing practices, body awareness, or small rituals (such as intentional hand-washing) to support emotional regulation in high-pressure moments.
  • Connecting with a trusted colleague after a difficult case — Informal check-ins or debriefing with someone who understands the emotional demands of the work.
  • Allowing emotional expression after a loss — Creating space to acknowledge and release emotional responses, whether privately or in a supportive environment.
  • Engaging in reflective writing or case journaling — Using writing to process emotional impact, support insight, and create a sense of closure.
     
Outside of Work
  • Spending quiet time in nature or with animals — Using calming environments or companionship to support emotional decompression.
  • Engaging in creative expression — Activities such as art, music, movement, or storytelling to process complex emotions when words feel insufficient.
  • Seeking emotional support — Connecting with a partner, friend, therapist, or spiritual leader to feel seen, understood, and supported.
  • Practicing mindfulness, prayer, or other grounding practices — Using reflective or spiritual practices to support presence and reconnect with meaning or purpose.
Person sitting outdoors wearing a hat and sunglasses, holding a dog that is looking up at them affectionately.

Research suggests that these strategies may help reduce emotional exhaustion, support mental health, and sustain empathy, even in high-stress environments such as emergency and critical care settings. 

Allowing Grief in Caregiving

Rather than resisting grief and saying, ‘It's just too hard to think about these issues,’ I can choose a different perspective as I accept the inevitable fact that I will be affected by grief.

Hui-wen Sato, MSN, MPH, RN, CCRN / PICU Nurse at Children's Hospital Los Angeles

PICU nurse Hui-wen Sato, MSN, MPH, RN, CCRN, describes how allowing and working with grief supported her emotional endurance and caregiving in her TED talk, How Grief Made Me a Better Caregiver.

Problem-focused Coping

Problem-focused coping refers to strategies that aim to address the source of stress through actionable steps, such as setting boundaries, seeking support, or adjusting workflow. These approaches may be most helpful when stressors are changeable and may look different depending on role, setting, and available resources.

On the Job
  • Requesting schedule or assignment adjustments — Advocating for shifts or duties that allow time to recover after recent losses or emotionally intense cases.
  • Clarifying roles or limits after difficult events — Asking for support, delegation, or protected time following patient death, moral distress, or vicarious trauma exposure.
  • Structuring tasks to reduce overwhelm — Using prioritization tools, team huddles, or delegation to ease cognitive and emotional load during heavy shifts.
  • Pursuing training in grief- and trauma-informed care — Engaging in professional development to build confidence and preparedness for emotionally complex situations.
  • Contributing to grief-informed practices at the organizational level — Sharing feedback with leadership or participating in wellness, peer support, or quality improvement efforts related to loss and trauma exposure.
Outside of Work
  • Seeking support for grief or trauma — Connecting with a colleague, therapist, counselor, coach, or spiritual care provider to process loss and reduce emotional burden.
  • Setting boundaries around work-related re-exposure — Limiting work-related conversations outside of shifts, declining certain case types when possible, or protecting time off for restoration.
  • Creating a personal grief-informed routine — Building in regular practices (such as journaling, movement, or grounding rituals) to support emotional processing and reduce cumulative stress.
  • Addressing secondary stressors — Taking steps to reduce external strain (such as childcare, financial stress, or sleep disruption) that may compound emotional fatigue.

Problem-focused coping can help healthcare professionals address sources of grief and stress through practical, actionable changes that support both well-being and capacity for care.

Active Coping for Sustainability

Research suggests that active coping and planning are associated with post-traumatic growth, including strong positive relationships observed in analyses of frontline clinicians. These strategies have also been linked to lower burnout and psychological distress, particularly when healthcare professionals feel supported and empowered to take action. Identifying and addressing needs, both within and outside of work, may help create space for healing and support more sustainable practice.