Health care workers pride themselves on their ability to be empathetic but professional. Many of us calmly deliver news of adverse outcomes and prognoses to patients and family members every day, then go home to a family or personal life, and try to compartmentalize thoughts of our patients’ diseases, injuries, or deaths.

At least that’s how it may appear to others, even fellow health care professionals. But having worked in pediatric critical care and both adult and pediatric oncology over the course of my nursing career, I know from personal experience what it’s like to witness a child or adult dying, to hear the anguished, helpless cries of family members losing a loved one, to look other human beings in the eye and tell them their mother, father, son, daughter, or sibling isn’t going to live. These aren’t things you just “put out of your mind” when you leave work. They stay with you. And, each time, they take a tiny slice of your soul.

Here’s what other clinicians say about their inner struggles with the unpleasant realities of their jobs:

It should be pretty obvious that what medical workers do isn’t normal. Our constant exposure to human pain, suffering, and death exacts a severe toll over time, even as we are conditioned to greet grief with a stoic calm. Some studies reveal a possible relationship between the effects of cumulative grief in medical workers and profound stress and burnout.

While the impact of grief among oncology workers has been a topic of attention and research, there’s been little focus on the experiences of critical care staff who deal with both anticipated and premature or unexpected death. When a patient is lost, medical workers often feel sad or inadequate, depending on how they died. They also can feel guilt, which can compound grief.

The grief borne by medical professionals is manifested in many ways, including anxiety, fatigue, restlessness, irritability, lack of focus, denial, shock, anger, depression, loss of appetite, nightmares, anhedonia, and substance abuse. And that’s only a partial list of the corrosive effects grief can have on health care workers.

It often is assumed that clinical staff are equipped to deal with the stressful and tragic situations they routinely face on the job. But is there really any adequate preparation for dealing with so much suffering, death, and grief? Medical professionals may feel awkward expressing emotions of grief, so they suffer in silence. Some even start to believe they have selected the wrong profession or question if they are tough enough. It’s regrettable but not surprising that 55% of nurses say they wouldn’t recommend the job to others.

So what can we do to ease the burden of grief on clinical caregivers? How do we take care of one another, and how do we place back the pieces taken out of our souls when we care for others?

Let’s start with ourselves because self-care is the most important and proactive step we can take:

1. Be kind to yourself
2. Recognize that you need to rest, eat, exercise, etc.
3. Spend time on things that bring you joy
4. Talk it out/express yourself to someone you trust
5. LAUGH
6. Make time to acknowledge the work you do day in and day out
7. Breathe
8. Shower
9. Get fresh air
10.  Let light into your life

Given the crushing weight of grief and its relentless presence in the lives of critical care workers, the suggestions above may seem inadequate and even trite. But they’re not. Rather, they are simple but effective ways that medical workers can reconnect with and replenish themselves.

For the families, friends, and colleagues of clinicians struggling with grief, it is important to acknowledge what they are going through and offer support. That support should come in the form of listening and conveying empathy – which has value – rather than sympathy, which can be counterproductive.

Empathy is feeling with people. Sympathy is feeling for them. That may sound like an insignificant difference, but it’s not. While empathy fuels connection, sympathy drives disconnection.

As social worker and author Brené Brown explains, imagine hearing someone shouting from the bottom of a deep well, “It’s dark and scary down here, I’m overwhelmed.” You peer over the edge and say, “I see you,” then climb down, confident that you can get back out. The message of your action is, “I know what it is like down here and you’re not alone.” That’s empathy. Sympathy, in contrast, is looking over the edge of the well and saying, “Oh, that looks terrible. So sorry.” And then you keep walking.

Talking with coworkers who understand your experiences and emotions is one of the most powerful coping strategies for clinicians. Those who don’t talk about what they’re going through typically won’t stay long-term.

Medical workers constantly see other people in pain. Our response is to take care of them. But what do we do for each other?  As health care professionals, our instinct is to “fix it.” But empathy isn’t about fixing. It’s about the courageous choice to be with someone during their darkness, not racing to turn on the light so we “feel better.”

Stephanie Queen has a doctorate in nursing practice.

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