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Reflective skills for managing grief as healthcare professionals

We have a lot of tools that can help with different symptoms, but the one thing that we don’t have is a mind reader. So it’s really important to understand where the patient comes from, what their fears are, and what they’re grieving, in order to be able to help them.

Anne Chiang, MD, PhD / medical oncologist

When we encounter death and loss in our professional work, we are often faced with emotions that come from many different places-- the patient, the family, our colleagues, and ourselves. Our patient care (and self-care) improves when we are informed about grief, and how it impacts emotions and behavior in ourselves and others. Here, we offer guidance on maintaining a reflective practice when we find ourselves encountering grief in our professional work.

When a patient dies, we are faced with the family’s feelings, as well as our own

This can be stressful, and using reflective skills can help. By reflection, we mean consideration of our own (and others’) mental states, including thoughts, emotions, wishes, and intentions. Our patient care (and self-care) improves when we can be mindful about how mental states arise, how they impact behavior, and how they interact within relationships. The questions below may make it easier to intuit how to communicate during difficult times.

Reflecting on our own mental states

  • What was that like for me?
  • What is running through my mind?
  • Can I describe what I’m feeling?
  • Did my feelings have an impact on what I did in that situation?
  • What do I think I needed in that moment?
  • What was I wishing for in that moment?

Reflecting on patients' and families' mental states

  • What might their feelings be?
  • How are they making sense of things?
  • What might be running through their minds?
  • What were they needing in that moment?
  • Am I triggering other times when they’ve felt like this?
  • What might they be wishing for?

Reflecting on the interaction between our own and others' mental states

  • Did the family’s feelings impact the way I was feeling?
  • Did that  interaction make me feel frustrated? Anxious? Unsure?
  • Is the family picking up on my feelings? Would it be helpful to share my feelings transparently?
  • Are there other times when I’ve felt like this? Does that match the reality of this situation?
  • What is my behavior communicating to the family? To my colleagues?
  • What was that interaction possibly like for them?
  • How is the care that I am providing to the family impacting the way they feel and behave?
reflective cycle graphic, including the words How am I feeling? What is running through my mind? How is this impacting my behavior at home? At work? The care I am providing? How is the family feeling? What are they thinking? How are they making sense of things?  How is the family's emotions impacting the behavior I am observing?