Healthcare providers are trained to absorb loss quietly. Over time, that can come at a cost. Repeated exposure to trauma, sickness, and death changes you, even if you’ve been practicing for a long time. You’re expected to stay composed as you move from one room, one sick patient, one crisis to the next. How can you care deeply for patients without taking the stress and trauma home with you?
Greg Adams, program coordinator for the Arkansas Children’s Hospital Center for Good Mourning and Staff Bereavement, shares insights drawn from his work supporting medical staff who regularly face loss, grief, and emotionally intense situations. While the Center primarily serves children and families, Greg’s role also includes staff bereavement and supporting healthcare professionals as they navigate grief, loss, and emotionally demanding work.
The Hidden Grief of Healthcare Work
Most training and education for healthcare professionals focuses on how to help others in need. But nothing fully prepares you for being exposed to human pain and suffering on a daily basis. While many healthcare systems have begun recognizing the importance of supporting providers, there is still room to grow.
To provide effective care, you have to set your feelings aside in order to act and think clearly. But those feelings don’t disappear. They still need attention and support.
“We need to find opportunities and ways to invite those feelings to filter through us,” Greg says. “If we don’t, we can become numb to intense feelings and distance ourselves from others and from ourselves. Over time, that can increase the risk for PTSD and burnout.”
Grief can also change how we see the world—how fair and predictable it feels, how safe and dependable others seem, and how confident you feel in your own abilities. Losses that feel sudden, preventable, or out of your control can be especially distressing, particularly if you believe you could have done something differently.
The demands, intensity, and pace of healthcare work often make it difficult to pause and reflect. “Too often, healthcare professionals feel that in response to pain and suffering, they just need to avoid it and move on,” Greg says. “Thankfully, that approach is increasingly being seen as too costly.”
Why Holding It Together Isn't the Same as Being Okay
While providing effective, thoughtful care, you also need ways to protect yourself emotionally. According to Greg, those defenses are necessary, but temporary.“The defenses that we put up are best discarded before we go home. Think of workplace stress and trauma as personal protective equipment. We wouldn’t want to wear it or take it home to our friends and family.”
Acknowledging the grief and stress you experience allows those feelings to be supported rather than ignored. When left unaddressed, grief can accumulate and affect your personal life, professional relationships, and overall well-being.
Addressing your own grief doesn’t make you less effective. It makes you sharper. “The more we acknowledge and support our stresses and losses,” Greg says, “the greater potential for posttraumatic growth and compassion satisfaction in our work. When we cope by numbing, we reduce the potential for experiencing the satisfaction that can come from providing excellent care.”
What Support Looks Like After a Loss
So, what can you do moving forward to create a space for processing difficult emotions? According to Greg, what matters most is working toward a culture that openly acknowledges stress and grief and makes room for reflection and support.
“Much of this support is provided informally through conversations with peers,” Greg says. “Those conversations happen more often and are more effective as we develop a more supportive and compassionate work culture.”
Informal conversations are often the starting point, but they aren’t always enough. In some situations, more structured support is needed. Debriefings, for example, have been shown to be very helpful for many providers. These conversations often take place shortly after an event and focus on what went well and what could have gone differently. There are also some helpful guides online that walk healthcare workers through how to cope with grief.
These moments of reflection are important proactively and emotionally. As a result, some teams make debriefings a regular or required practice after certain events, such as when a patient codes.
In other cases, Greg says there may be a need for what he describes as “supportive debriefing,” where the focus shifts from logistics to emotional impact and meaning making. “These supportive debriefings typically occur several days or even weeks after the event,” Greg says. “Participation is voluntary for all who were involved.”
Another option is one-on-one support from a trained peer or support person who was not directly involved in the event. Greg also points to Schwartz Rounds as a valuable resource. “We’ve found that discussing a challenging case in a Schwartz Rounds program months after the event can be a helpful and supportive experience for those who were impacted.” Schwartz Rounds are structured, interdisciplinary forums that allow healthcare staff to reflect on the emotional and social aspects of patient care.
Reconnecting With Purpose When Work Feels Heavy
There’s a delicate balance between caring deeply for your patients and maintaining a healthy emotional distance. Finding that balance requires ongoing awareness of how your work affects and staying connected to the meaning and purpose behind what you do.
“Over the years, I have heard nursing colleagues express this tension,” Greg explains. “If it bothers them too much, they can’t do the job. But if it doesn’t bother them at all, they don’t need to keep doing this job.” What many are seeking, he says, is a balance or sweet spot of patient engagement.
Greg refers to this balance as compassionate detachment. Joan Halifax offers a helpful image: having a strong back and a soft front. When your sense of purpose begins to fade, it may be a sign that you need some distance to reflect and process your experiences. That reflection might happen on your own, or with the support of a peer, mentor, or trusted colleague.
“I remember a time in my practice when I took a day off and journaled for many pages about several patient deaths that had occurred so closely together that I hadn’t had an opportunity to process them otherwise,” Greg says. “That journaling experience was very helpful and led to new insights.”
Guilt, Self-Blame, and the Weight Providers Carry
Healthcare professionals and suicide loss survivors often share a similar experience of guilt in their grief. Many wonder whether they could have done more to prevent the losses they’ve witnessed or experienced. As caring people, providers may find putting their own actions on trial, asking whether a different choice or response could have changed the outcome.
“Therapist Jack Jordan, who has extensive experience with suicide loss survivors, suggests that, if you must put yourself on trial, you should do your best to make it a fair trial,” Greg says.
One way that a trial becomes unfair is through what Greg calls the “tyranny of hindsight,” where you hold yourself responsible for knowledge you only gained after the event occurred. Another sign of an unfair trial, Greg adds, is when a trusted and honest colleague hears your story and shares that they don’t believe you were responsible for the outcome. “That trusted expert opinion can give us the opportunity to pause and rethink,” Greg says.
Small, Practical Ways to Protect Emotional Well-Being
There are ways to protect your emotional well-being while still caring deeply for your patients. One approach Greg recommends is intentionally incorporating pauses into your workday. While longer pauses, like vacations or time away, are important, small pauses during the day can also make a meaningful difference.
“Some clinicians pause for a few seconds to take a few deep breaths before entering a patient’s room,” Greg says. “They may breathe in compassion for themselves, recognizing that what they are about to do is hard, and breathe out compassion for the person in need of help and support.”\
Some emergency department teams also pause after a code is stopped and a patient has died. Before moving on to other responsibilities, a team member may invite a brief moment to honor the life that ended and acknowledge the efforts made to save it. This practice has been impactful for many teams and provides a short but meaningful opportunity to reflect on what just occurred.
Self-compassion is also another important part of protecting emotional well-being. It isn’t something to master, but rather a practice that improves over time. “Kristin Neff, who studies self-compassion, describes three core components,” Greg says.
- Common Humanity: recognizing that you are not alone and that others experience similar thoughts or feelings.
- Mindfulness: noticing your stress and suffering without exaggerating or minimizing it, and simply acknowledging, I am in a moment of stress or suffering.
- Self-Kindness: treating and speaking to yourself with the same care you would offer a friend or loved one.
With self-compassion, we offer ourselves care not to make the pain disappear, but because it’s hard to be in pain. Greg compares it to comforting a sick child: the illness does not go away, but the child feels comforted simply because someone recognizes how hard it is to be sick.
The Role of Peer Support and Leadership
Peer support is one of the most common—and most powerful—forms of support available to clinicians. You’re often more willing to accept and trust support from colleagues who know you and understand the realities of your work. At its best, peer support focuses more on listening than on offering advice.
“Effective peer support accepts and honors another person’s experience,” Greg says. “Sometimes, it offers alternative ways of thinking about a situation, but only after validating the experience, the feelings involved, and the impact it has had.”
Leadership also plays a critical role in creating safe, supportive, and compassionate work environments. Leaders set the tone through how they respond to team members who are struggling and by how openly they model vulnerability and self-compassion themselves.
“One way leaders demonstrate this is through their handling of mistakes,” Greg says. “While people and systems need accountability, there is a difference between a punitive culture and a culture of restoration and support.”
Leaders can further strengthen a supportive environment by acknowledging difficult situations, recognizing strong effort when outcomes are negative, and arranging additional support, such as supportive debriefings, when needed. By modeling healthy boundaries and taking intentional pauses, leaders signal to their teams that these values are a core part of the workplace culture.
Recognizing When Someone is Struggling and Reaching Out
Everyone is different, but some key indicators that a person is struggling may include:
- Increased absences
- Withdrawal from others
- Changes in composure during stressful times
- Dull mood or reactions
- Becoming easily frustrated
- Statements expressing greater judgment toward others
- Apathy
- Hopelessness/helplessness
These changes shouldn’t be ignored. Greg emphasizes they should be viewed as communication—signs of distress rather than personal or professional failures. Reaching out privately, asking about well-being, sharing observations, and expressing concern are all appropriate and supportive steps.
“It is important to have a tone of support and concern, not judgment or criticism,” Greg says. “If concerns continue or worsen, escalating support through the resources available in your system is appropriate. Addressing these concerns is a matter of safety for those being served and for your team member.”
Caring for Yourself as a Long-Term Practice
Healthcare work is often described as a marathon rather than a sprint, and Greg applies that same metaphor to grief and mental wellness.
“If someone decided to run a marathon and wanted to finish while avoiding injury, they wouldn’t show up on race day in street clothes with no preparation, expecting things to work out,” Greg says. “They would research, consult with others who have run marathons, prepare, and plan.”
Your mental health benefits from the same intentional approach. What would it look like and what would it take to do your work well while remaining healthy and satisfied at the end of the day, week, month, or year? From there, Greg encourages making a plan and revising it as needed, just as you would when training for a marathon.
