Healthcare, Grief, and Personal Wellness
Understanding Common Experiences in Healthcare
While grief is a universal human experience, healthcare professionals may encounter it more frequently, more intensely, and in a wider range of contexts than many people outside of healthcare.
The Many Layers of Grief in Healthcare Settings
Grief can be an ongoing presence in healthcare, shaped by patient deaths, witnessing supporter distress, supporting colleagues, and navigating moral distress. These overlapping experiences can accumulate over time, influencing emotional well-being, team dynamics, and the way care is delivered.
Research suggests that more than two-thirds of healthcare professionals experience high levels of secondary traumatic stress, with similarly elevated rates of burnout and compassion fatigue. These data reflect the emotional demands of healthcare work and reinforce the importance of proactive, institutional support.
Losing a Patient
The death of a patient can have a significant emotional impact on healthcare professionals. Grief can be present across roles and specialties.
The potential for grief reactions and trauma-related responses may be heightened when strong therapeutic relationships have formed, when deaths are sudden or particularly distressing, and in workplace cultures that discourage emotional expression or lack adequate support.
In some specialties, such as pediatric oncology, patient death is consistently described as one of the most emotionally challenging aspects of clinical work.
There are patients that you become emotionally invested in... and then the grief is very profound. You feel like you’ve lost a friend.
Healthcare professionals often use coping strategies such as emotional suppression, compartmentalization, or seeking support from peers, team members, family, or faith communities. While these strategies may be helpful in the moment, they may not be sufficient on their own. Without institutional recognition and support, grief can accumulate over time, contributing to emotional exhaustion, burnout, and reduced capacity for connection with patients and their supporters.
Grief is not a single emotion. Healthcare professionals commonly report a range of responses following a patient’s death, including sadness, guilt, helplessness, and regret. These reactions are normal and understandable. The intensity of grief may be influenced by factors such as patient age, length of the therapeutic relationship, and the circumstances of the death.
Sometimes you feel like you failed them. Even if rationally you know you did everything, the feeling of failure is there.
A patient’s death can also evoke feelings of failure, guilt, or shame. Even when clinicians know they did everything possible, it can be difficult to internalize that reality emotionally.
Losing a Colleague
Losing a Colleague
The death of a colleague can deeply affect both individuals and care teams. These losses are often sudden, traumatic, and personally meaningful.
A colleague's death sets the team on a path that transforms people and changes the group dynamics.
Colleagues are often more than coworkers. They are part of daily routines, shared responsibilities, and informal support systems. Their absence can be disorienting and isolating, and it may alter how teams experience connection, safety, and support in the workplace.
Qualitative research examining COVID-19–related deaths of team members describes intense and varied grief responses among healthcare professionals. Participants reported shock, anxiety, sadness, reduced motivation, and ongoing distress at work. Some noted that the loss affected their sense of professional sustainability, while others described persistent helplessness and emotional strain that carried into daily clinical practice:
The news of his death brought tears to my eyes, and when I received the news from the virtual group, I cried uncontrollably.
No one could believe our colleague died… because he was so young… it was very hard for us.
His death affected me both professionally and mentally and I am looking for the first opportunity to actually quit this job by writing a letter of resignation.
I often wait for him to come to shift, I can't accept that he has left us and is no longer with us.
Workplace Rituals
Just as with patient loss, grief for a colleague deserves acknowledgment. Group rituals like lighting a candle, creating a shared memory board, or attending a memorial can help teams process the loss together and honor their connection.
These acts don’t “fix” the pain, but they offer needed pause, reflection, and communal support that can begin to restore a sense of emotional safety. This emotional grounding is needed to continue to come to work with a sense of hope and purpose.
When Personal Loss Is Activated at Work
When Personal Loss Is Activated at Work
Grief does not remain confined to personal life. Experiences of loss can resurface in clinical settings, sometimes suddenly and with emotional intensity.
These moments are often described as Sudden Temporary Upsurges of Grief (STUGs), a term introduced by Therese Rando to describe brief, acute grief responses that may be prompted by reminders in the environment. These responses are time-limited and expected within the broader course of grief.
Unlike the language of being “triggered,” STUGs reflect the natural, episodic nature of grief and may occur even long after a loss, particularly in environments where illness, injury, and death are regularly present.
In healthcare settings, a STUG may arise while caring for a patient with a similar diagnosis, hearing a familiar phrase, or approaching a meaningful date connected to a personal loss. These responses do not indicate dysfunction. They reflect the ongoing significance of a meaningful relationship and loss.
When a Sudden Temporary Upsurge of Grief occurs, small, intentional steps may help support regulation and allow you to continue your work without suppressing your experience.
- Pause and ground. Take a few slow breaths, notice your feet on the floor, or use a brief intentional ritual, such as hand-washing with awareness, to help your body settle.
- Connect with a trusted colleague. A quick check-in or informal debrief can reduce isolation and help normalize your response.
- Allow emotion in a supportive space. Tears or emotional release in a private or safe setting are not signs of unprofessionalism. They can be healthy responses to loss.
These practices are not about eliminating grief. They are about acknowledging it, supporting yourself in the moment, and sustaining your capacity to care for others.
In the moment, I'm okay. As soon as [the patient is] gone, then it's like, ‘Whoof, I have to then make sure that I'm processing it for myself because it can be activating of my own lived experience.’
Recognizing STUGs as a normal part of grief can help reduce shame and support emotional regulation. Simple grounding strategies or micro-boundaries, such as briefly stepping away, using a sensory reset, or naming what is happening with a trusted colleague, may help in the moment.
Acknowledging these experiences as valid supports a healthcare culture where compassion extends to clinicians as well as patients and their supporters.
Non-Death Loss
Non-Death Loss
Grief is often understood primarily in relation to death, which can make it harder to recognize how frequently healthcare professionals are exposed to grief related to loss and change that do not involve death.
Supporting patients through life-altering diagnoses, functional losses, or major transitions, such as transitioning a long-term patient to hospice, often involves witnessing significant suffering even when no one has died.
Because these experiences may not always be labeled as grief, their emotional impact can be overlooked. Over time, repeated exposure to non-death loss may contribute to emotional fatigue and cumulative stress.
Recognizing non-death loss as a valid source of grief can support emotional awareness and reflective practice.
Recognizing Common Emotional and Professional Experiences in Healthcare
The emotional impact of healthcare work does not present in a single way. Healthcare professionals may experience different, overlapping responses to loss, trauma, and ethical challenges. Recognizing these common experiences can help contextualize responses and guide selection of appropriate support strategies.
Moral Injury
Moral injury may occur when healthcare professionals are involved in, witness, or feel unable to prevent actions that conflict with their ethical or professional values. Unlike burnout, which is often linked to chronic stress, moral injury is rooted in perceived violations of conscience and professional integrity.
Examples in healthcare may include:
- Being required to follow protocols that result in patient suffering
- Feeling unable to advocate for a patient due to systemic or institutional constraints
- Providing treatment that feels misaligned with a patient’s goals or prognosis
- Working in understaffed conditions that compromise quality of care
- Bearing witness to inequities or preventable harm without the ability to intervene
These experiences may be accompanied by guilt, anger, shame, or a sense of betrayal. These responses can reflect deep ethical commitment rather than personal weakness. Recognizing moral injury can support access to ethics consultation, peer support, and psychologically safe spaces for reflection and healing.
Vicarious Trauma
Vicarious trauma (VT) refers to internal changes that may occur when healthcare professionals are repeatedly exposed to the trauma or suffering of others.
Examples in healthcare may include:
- Repeated exposure to patients with severe injuries related to interpersonal violence, which may influence a clinician’s sense of safety or trust.
- Long-term work in pediatric oncology or palliative care, where ongoing exposure to serious illness and suffering may affect a provider’s sense of meaning or hope.
- Caring for patients impacted by systemic inequities, which may contribute to feelings of helplessness or cynicism about the healthcare system.
Over time, this exposure can influence worldview, sense of safety, and meaning systems, even when the trauma is not directly experienced.
How it may show up:
- Shifts in beliefs, such as feeling the world is unsafe
- Emotional withdrawal or numbing
- Irritability
- Difficulty experiencing joy
- Intrusive thoughts or imagery related to patient stories
Vicarious trauma is often cumulative. Awareness and proactive attention to well-being can support long-term resilience and sustained capacity to care.
Secondary Traumatic Stress
Secondary traumatic stress refers to emotional responses that may arise from hearing about or witnessing another person’s trauma, particularly when there is a strong empathic connection. Unlike vicarious trauma, which tends to develop over time, STS may emerge more acutely and can resemble post-traumatic stress symptoms.
Examples in healthcare may include:
- Caring for a pediatric abuse survivor, where repeated exposure to detailed accounts of harm may lead to intrusive mental images outside of work.
- Supporting patients following a mass casualty event, with repeated exposure to intense emotional distress.
- Providing end-of-life care to a patient who shares traumatic life experiences, which may leave a provider feeling emotionally overwhelmed.
How it may show up:
- Intrusive memories
- Heightened vigilance
- Emotional reactivity
- Avoidance of reminders
- Difficulty sleeping or concentrating
Although often used interchangeably, vicarious trauma and secondary traumatic stress describe related but distinct experiences.
Secondary traumatic stress is typically more acute and may resemble post-traumatic stress responses, such as intrusive thoughts, nightmares, or heightened vigilance. It often reflects a short-term reaction to exposure to another person’s trauma.
Vicarious trauma tends to develop more gradually. It reflects cumulative exposure to trauma and suffering and may involve shifts in worldview, beliefs about safety or trust, and sense of meaning or professional identity.
A helpful way to think about the distinction:
- Secondary Traumatic Stress: “I can’t stop thinking about that one traumatic story.”
- Vicarious Trauma: “After hearing so many of these stories, I no longer see the world the same way.”
Both are understandable responses to empathic healthcare work and benefit from recognition and support.
Compassion Fatigue
Compassion fatigue refers to emotional and physical exhaustion associated with prolonged exposure to others’ suffering. It is often described as the depletion that can occur when sustained empathic engagement is not balanced with adequate opportunities for recovery and support.
Examples in healthcare may include:
- A palliative care team member supporting multiple patients at end of life and their supporters with limited time to process between losses.
- A NICU nurse caring for medically fragile infants experiencing ongoing distress and uncertainty.
- A case manager working long hours with patients facing housing instability and complex trauma histories.
- A rehabilitation therapist repeatedly supporting patients through life-altering injuries, such as paralysis or amputation.
How it may show up:
- Emotional numbing
- Irritability
- Cynicism
- Withdrawal
- Diminished empathy
- Reduced motivation
- Questioning one’s sense of value or purpose
Compassion fatigue is often cumulative. Over time, it can affect emotional capacity, sense of purpose, and ability to remain fully present and connected in caregiving roles.
Burnout
Burnout refers to a state of chronic workplace stress characterized by emotional exhaustion, depersonalization (emotional distancing from work or others), and a reduced sense of professional efficacy or accomplishment.
Examples in healthcare may include:
- A primary care provider managing high patient volumes alongside extensive EHR and administrative demands.
- A nurse regularly mandated to work overtime, with limited opportunities for rest, meals, or recovery.
- A therapist in a community clinic carrying high caseloads with long waitlists and limited referral options.
- A resident rotating across services with little protected time for rest, learning, or reflection.
How it may show up:
- Persistent fatigue
- Loss of interest or satisfaction in work
- Dread related to work
- Low motivation
- Disengagement
- Increased absenteeism
Burnout is an occupational risk in environments that require sustained output without adequate support, recovery, or recognition. When unaddressed, burnout can affect both clinician well-being and quality of patient care.
Anticipatory Grief
Anticipatory Grief
Anticipatory grief is the emotional distress that arises for a loss that is expected but has not yet occurred. For healthcare professionals, especially those working in palliative or critical care, this form of grief can emerge when caring for terminally ill patients.
Examples include:
- A palliative care nurse who has supported a patient and their family through a long illness.
- An ICU physician anticipating the death of a young patient despite exhausting every possible intervention, and quietly mourning the life that won’t be lived.
- A provider caring for a terminal patient who reminds them of a loved one, making the situation more emotionally charged and personally resonant.
Manifestations may include:
- Emotional exhaustion or compassion fatigue
- Difficulty focusing or making clinical decisions
- Increased attachment or over-identification with the patient
- Subtle withdrawal or dread around upcoming shifts
Recognizing anticipatory grief as a valid and human response can support proactive attention to emotional well-being and reflective practice.
Collective Grief
Collective grief refers to shared sorrow experienced by a community or group in response to losses that affect collective identity, safety, or a sense of justice. For healthcare professionals, this grief may be especially impactful when clinicians personally identify with the communities affected.
Examples in healthcare may include:
- A Black clinician caring for a patient harmed by police violence, where professional empathy intersects with personal and historical racial trauma.
- A Jewish healthcare professional treating patients injured in an antisemitic hate crime, activating fears for personal and community safety and intergenerational trauma.
- An LGBTQ+ clinician caring for someone targeted due to gender identity or sexual orientation, where care may activate personal experiences of marginalization or threat.
- A clinician from an immigrant background supporting patients affected by xenophobic violence or restrictive policies, with emotional impact shaped by shared histories of displacement or exclusion.
- A neurodivergent clinician caring for a patient harmed by misdiagnosis or stigma related to neurodivergence, which may activate personal experiences of invalidation or systemic bias.
In these situations, professional roles intersect with personal and cultural identity, intensifying emotional impact.
How it may show up:
- Heightened emotional responses during or after patient encounters
- Feelings of helplessness, hypervigilance, or cultural exhaustion
- Tension or disconnection with colleagues who do not share the same lived experience
Recognizing collective grief is an important component of trauma-informed and culturally responsive care. Peer affinity groups, culturally attuned supervision, and grief-informed organizational practices may offer meaningful support.
Collective Grief: A COVID-19 Example
During the COVID-19 pandemic, many healthcare teams experienced grief not only for patient deaths, but also for colleagues, disrupted routines, and a shared loss of safety and predictability.
Repeated losses often became a collective experience within units.
For some clinicians, particularly those from communities disproportionately affected by COVID-19, clinical losses intersected with personal and community losses, intensifying emotional impact.
Over time, this shared grief showed up as team exhaustion, heightened emotional responses, and withdrawal.
Naming COVID-19–related loss as collective grief helped some organizations shift from expectations to “push through” toward creating space for shared acknowledgment, peer support, and collective healing.
Disenfranchised Grief
Disenfranchised Grief
Disenfranchised grief refers to grief that is not openly acknowledged, socially validated, or supported.
In healthcare settings, the death of a patient can evoke meaningful emotional responses, yet these responses may be minimized or left unspoken within workplace culture, particularly when environments implicitly or explicitly suggest that grieving a patient is unprofessional or that emotional distance reflects competence. This can create pressure to suppress grief, which may contribute to isolation.
Examples may include:
- A nurse who formed a close bond with a long-term patient and avoids sharing their feelings because emotional reflection is discouraged.
- A healthcare professional who feels ashamed for being “too affected” by a patient death.
- A resident who is impacted by a first patient death and worries that speaking up will be seen as a lack of resilience.
Disenfranchised grief may show up as:
- Withdrawal from colleagues or patients
- Irritability
- Emotional numbness or detachment
- Changes in sleep
- Increased emotional fatigue
Without opportunities to acknowledge and process patient loss, disenfranchised grief may accumulate, increasing emotional burden and contributing to longer-term stress and burnout risk.
Suffocated Grief
Suffocated Grief
Suffocated grief, a term introduced by Dr. Tashel Bordere, refers to grief that is silenced, invalidated, or punished, particularly among individuals from marginalized communities. Grief responses may be pathologized instead of supported, increasing emotional burden and limiting access to appropriate care and accommodation.
Examples may include:
- A nurse who cries after the sudden death of a long-term patient and is reprimanded for being “unprofessional.”
- A healthcare professional whose request for bereavement leave is framed as a reliability issue rather than a legitimate need for support.
- A physician who requests short-term support after a personal loss and is met with disciplinary responses rather than accommodation.
Suffocated grief may show up as:
- Withdrawal or hypervigilance in professional settings
- Suppression of cultural or personal mourning practices
- Internalized shame related to grief expression
- Ongoing emotional and psychological distress
When suffocated grief is not addressed, healthcare professionals may experience increased emotional distress, reduced psychological safety, and greater barriers to seeking support, which can reinforce inequities within the workplace.
An ER nurse whose parents immigrated from the Philippines cares for a patient who was assaulted in a hate crime targeting immigrants, leading to collective grief tied to broader community harm and personal identity. Later in the shift, the nurse learns that a long-term patient is transitioning to hospice, contributing to anticipatory grief. Ongoing staffing shortages have been adding workload pressures, and the nurse has been experiencing burnout.
During shift huddle, the nurse seems uncharacteristically irritable. When asked to clarify whether a patient has already received pain medication, the nurse responds, “It’s in the chart,” in a sharper tone than usual. The charge nurse reprimands her in front of colleagues for having an “attitude problem,” rather than considering a possible grief response. The nurse is then informally labeled as “difficult” during charge nurse handoffs, affecting future scheduling and access to support. In this context, the nurse’s grief becomes suffocated, as emotional responses are reframed as performance problems rather than signals of cumulative strain.
The Weight of the Work
The Weight of the Work
Grief and trauma are part of healthcare work. Without tools, time, or support to process repeated exposure to loss and suffering, the emotional cost can be significant.
Systemic factors such as time pressure, staffing shortages, productivity expectations, and workplace norms that discourage emotional expression may contribute to healthcare professionals defaulting to emotional suppression. While understandable, this response has been associated with reduced empathy, increased psychological distress, and challenges in sustaining emotional presence in care.
Over time, this can contribute to clinical environments that may feel emotionally distant or invalidating for patients and supporters, while also increasing risk for emotional exhaustion, burnout, and declines in healthcare professionals’ own well-being.
Grief-Informed Wellness to Support Care
Personal wellness is a core component of grief-sensitive care and may contribute to more psychologically safe and compassionate workplace cultures, supporting both healthcare professionals’ well-being and the quality of care they provide. Acknowledging grief and practicing self-compassion may help reduce risk for burnout, secondary traumatic stress, and moral distress by supporting emotional processing and reducing internal conflict. Reflective practices, such as mindfulness, can support more grounded, patient-centered decision-making under pressure.
Caring for others in the face of grief and trauma requires more than clinical skill, it demands emotional sustainability. By acknowledging the emotional toll of healthcare and integrating grief-informed wellness practices, you can protect both your own well-being and the quality of care you deliver.
Medicine has become so busy… I think that it is really important to acknowledge that it is a hard field, and there are big feelings that come with it, and that it's okay to feel that, and that it's important to acknowledge that as a field, and to give doctors space to deal with it.