Serious surgeons waiting in the corridor in hospital

Loss on the job

How to acknowledge job-related grief

By Andrea Bodie
Wednesday, April 10, 2013

Loss is a part of delivering health care services. Regardless of what setting you work in - acute care, a personal care home, the community or even corporate - loss happens. Whether that loss takes place because of a transition or whether we actually lose a patient, client, resident, or  co-worker the fact remains: loss needs to be acknowledged and completed.

Why? Because health care providers are at risk for an unavoidable occupational hazard: vicarious trauma. Seeing and working with traumatized people everyday through the course of our work has physical, emotional, behavioural, cognitive and spiritual impacts. The empathic openness that can make health care delivery so meaningful can also put health care providers at risk as secondary victims of trauma.  This empathy and our capacity to be compassionate depends on our capacity to be self compassionate.  This ability - to be mindfully self compassionate - is perhaps our greatest source of strength and resiliency when confronted by loss.

In spite of its inevitability, we often have difficulty acknowledging the pain and suffering it can bring. "Don't fight and resist those feelings but acknowledge and be present with them. These are natural feelings. It is in fact unnatural to deny them and resist them," says Tim Wall, Director of Counselling at Klinic Community Health Centre. "We have a responsibility to each other in our work settings to build in opportunities where people can talk about what it is that they're feeling without being judged as less professional or incompetent."

This ability to acknowledge and be with our own suffering requires an ability to know how to sooth ourselves and manage these difficult emotions. We need to first develop these skills, to calm, be comfortable with our own emotions and confident in our ability to soothe them (see pullouts on mindfulness and self-compassion for more information). A wise old adage states, "Never take down a wall until you know why it has been put there." This includes the walls we have built within ourselves, there often there for a reason.

Wall recommends building in processes that allow people to recognize and cope with their feelings in the workplace. Why? Left unattended, the cumulative effects of suppressed emotion and secondary trauma can dramatically impact our lives, our ability to function, be happy and healthy.

"We need to be aware of our grief, our sadness and take time to be present with it," he explains. "We may have to then find ways to sometimes put it off for awhile because we have other tasks to do but we can allow ourselves the opportunity to come back to those feelings at some time later in the day, or even at home and where and when it feels safe."

If finding expression for these feelings at work feels like a radical shift because we've been told about the need for professional, clinical detachment, consider how powerful making a paradigm shift might be for the delivery of health care services. And it could help build our relationships with colleagues.

"Traditional health care has sometimes nurtured the separation of acknowledging emotions and health care delivery and I don't think that's a good idea. The simple acts of kindness, of recognizing somebody else's suffering - that's what compassion is all about, being present with the suffering, even just for a moment and with an intention to help alleviate that suffering," he says. "We have a responsibility to look out for each other, to recognize when someone may be struggling or grieving. It's important to take a moment to acknowledge what others are experiencing. It's crazy making when we act like nothing has happened and that people are not affected by those events."

Wall says this acknowledgement doesn't need to be complicated. In fact, the simple and most obvious things can make a big difference. Extending compassion to our colleagues may be as simple as a hand on someone's shoulder or recognizing that things aren't okay and that something horrible happened.

"Our health care system expects people delivering services to be empathic. But just expecting people to be empathic doesn't make them that way. We need to help everyone develop those abilities and skills," says Wall. "In mental health, we realize that genuine, authentic and caring relationship is really central to helping people recover from things like trauma, to deal with crisis situations, to improve their mental health and even be physically well. Primary health care can benefit from the knowledge that's been gained and research that's been done in mental health." After all there is a mind, body, spirit connection.

That's where the concept of trauma-informed care is important. Trauma informed care makes an important shift from viewing trauma and loss as a sickness or pathology to seeing trauma as an injury and event. Trauma impacts people in a myriad of ways.  Given every person in their lifetime has likely experienced a traumatic event, we need to be familiar with the signs and symptoms of trauma.

"Trauma is pervasive. We need to assume that every person we are providing services to, regardless of the setting, has been affected by trauma in one way or another. That is a safe and healthy assumption to make," he says. "Trauma informed care is also an important and critical shift from 'what is wrong with you?' to 'what has happened to you?' This is another step in becoming more compassionate."

Trauma impacts a person's physical health, their immune system and their brain. Research has shown that toxic stress can lead to chronic health problems - that include cardiac health issues and diabetes. Trauma informed care can also help boost health.

"We have all this evidence that talks about the neurobiology of trauma and how trauma and toxic stress affect health and wellness - and resiliency and a person's ability to cope with life and illness," says Wall. "Trauma informed care is providing every one with a basic understanding of trauma so that we are all more sensitive to people's vulnerabilities and more knowledgeable about how to better support people and our relationships."

That's holistic care at its best - allowing the personal and professional to coexist. Wall says trauma-informed care has the potential to revolutionize our health care system by helping health care providers be happier, healthier and more effective.


Every person's guide to self-compassion

Trauma Toolkit

Trauma Informed Care

Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness

Dan Siegel


Trauma Informed Care Workshop

Becoming Trauma Informed

Trauma Informed Care for Managers and Policy Makers

Vicarious Trauma