Loss of a Loved One: Managing Grief as a Nurse

• Elisabeth Kubler-Ross established the five stages of grief, but not everyone’s process is the same for addressing the loss of a loved one. 
• Nurses can struggle to balance their grief with their role as caregivers.  
• Within the industry, nurses believe their grief is interrupted to care for family and friends.  

I have so often wanted to sit down and try to understand why there might be a disconnect — not for everyone but for some — when they lose a loved one, such as a parent or sibling. I have questions, such as, “Where did the grief go?” and “Why was it so hard to let the grief process start?”   

These were questions I had when my mother passed away from lung cancer after a 17-month fight. I felt I was not ready to face my grief as the eldest daughter, yet facing the grief for others came easier. Maybe it was just the nurse in me! 

Stages of Grief

Elisabeth Kubler-Ross, a Swiss-American psychiatrist, identified five stages of grief as:  

• Denial 
• Anger 
• Bargaining 
• Depression 
• Acceptance

This sets the framework for how we deal with, and live with, the death of a loved one. Not everyone takes the same steps in the same prescribed order. Grief is a personal yet varied experience that people go through, even if some people skip some of the stages Ross explains. They could also experience complicated grief, which does not allow for acceptance immediately but might continue for an extended period.  

Absent grief is said to occur when someone displays little or no signs of everyday grief occurrences, such as crying, listlessness, depression, or vocalizing their thoughts about the person who has died. These could be symptoms of the first stage of denial.   

Genuine Struggle with Loss of a Loved One

A major struggle that we, as nurses, may undergo is our roles as caregivers and our grief. Nurses are taught to render compassionate care and emotional support to family members, hold their hands, and help them cope. However, when faced with a personal loss, such as a parent or sibling, this might cause a delicate challenge in which the nurse separates their grief from professional obligations. As nurses, we render comfort, guidance, and support. This may become a massive expectation for the nursing professional dealing with their grief process.   

I can recall visiting my mother in the hospice center. Two family relatives held her hand and told me she was sleeping. They did not understand what was happening, so I tried my best to explain things, knowing full well that my mother was nearing her end on this earth. I answered questions, all while trying to keep my answers short and understandable for them. I left shortly, but not before telling my mother it was time to go, that my dad was waiting for her so they could finally be together. I had to wait until family members left as they would not understand giving my mother that permission.  

Unintentionally Masking Grief

My grief never surfaced in front of family and friends. I was still in nurse mode, giving explanations and comforting everyone else. My grief came in the moments when I was alone, driving in my car, peaceful and in solitude. To this day, when my phone rang at 1:35 a.m., I knew before even answering that she had passed. Still, there were no tears.   

In my mind, I do not think I went through the stages of grief. I jumped right to acceptance. There might have been some guilt that I did not stay with her longer. Her nurse, who had been in hospice nursing for a long time, reassured me that she was waiting for me to go, as I gave her the permission she wanted.   

The Bottom Line

We are so busy taking care of everyone else that we often put our own grief on the shelf. We will deal with it later, we reason. We accommodate others and help them begin their healing while neglecting our own course of grief and sorrow.  

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