Experienced Physicians More Likely to Struggle With Grief: Poll

Asked how often they struggle with grief after a patient dies, 35% of physicians who responded to a recent Medscape poll said they always or often did.

The percentages who answered that way differed by gender (42% of female physicians commonly struggle with grief for patients vs 32% of their male colleagues) and generally increased with years in practice.

While 27% of physicians who had less than 5 years of practice reported that they always or often struggle with grief for lost patients, 43% of those with more than 30 years of practice said they did.

Nurses and advanced practice registered nurses (APRNs) were slightly less likely overall to say they often struggle with grief for patients (31% said they always or often did) and, unlike the trend for physicians, the more experienced nurses were less likely to struggle with grief.

While 37% of nurses with less than 5 years' experience said they struggle with grief for patients, only 29% of those with more than 30 years in practice said they always or often did.

One healthcare provider who commented on the poll theorized about the effect of length of exposure, saying, "Newer healthcare providers (HCPs) may have a more difficult time with more exposure to trauma, death, etc., while more seasoned HCPs may have a more advanced 'tool box' to cope. That being said, more veteran HCPs may either be desensitized or more overwhelmed with the trauma and death witnessed. We all cope (or don't cope) a little differently."

The poll, first posted July 24, received responses from 1366 nurses and APRNs and 654 physicians.

Physicians Much Less Likely to Receive Support for Grief

The poll also asked whether those who have struggled with grief have received help from various sources. Nurses and APRNs were twice as likely as physicians to receive help from coworkers, managers, counsellors, or therapists.

Table. Percentage of Those Who Struggle With Grief and Receive Support

Female physicians who have struggled with grief were more likely than their male counterparts to receive support from coworkers and managers (46% vs 33%) and from professional counselors or therapists (under 5% for both).

Commenters Share Grief Experiences

Respondents to the poll overwhelmingly agreed that healthcare providers need more education and resources on how to handle their grief in a healthy and professional manner. Some shared their experiences in the comments.

A registered nurse (RN) who worked in a neonatal intensive care unit (NICU) wrote, "One NICU [where] I worked had an unfortunate spell of 4 or more premature/non-viable infants die within about a 3-week period. (Congenital herpes, holoprosencephaly, placental abruption, extremely premature twins). We were exhausted from the intensity of the infants, then they died in spite of our best efforts. The manager at the time did call a group support meeting and we could all speak and share our feelings. It was helpful."

A hospice nurse wrote, "As an RN practicing in hospice, all of my patients die. Grief and support are part of our daily practice, but we often are too busy to remember to formally grieve and move forward in healthy ways. We all could use some professional help in this area, and the dismal reality of this poll shows that none of us are leaning on our psychology/psychiatry colleagues for their professional guidance."

The numbers in the poll suggest that many suffer silently. More than half of physicians (56%) and 36% of nurses and APRNs who said they had struggled with grief said they did not receive help from colleagues or from a professional counselor or therapist.

An RN commented, "(Patient) died this morning. Not expecting it. Been seeing her every week for 10 years. Got very close. Feeling very sad tonight but no one knows."

Have You Attended a Patient's Funeral?

One poll question asked whether healthcare providers had attended a patient's funeral. Only a few had done so in their first year. Just 13% of physicians and 17% of nurses and APRNs had done so in the past year; 67% of physicians and 40% of nurses and APRNs responded that they had never attended a patient's funeral.

An RN commented that there's a misconception that healthcare workers should experience grief. She says extended grief indicates that there was something wrong in that provider-patient relationship.

"Sadness, yes; tears, sure, especially sharing moments with the family/friends at time of death (really heart wrenching in pediatrics)," she wrote. "But if a nurse or doctor has protracted grief after a patient dies there is something wrong with that relationship."

However, another RN countered, "With all due respect your comments are a bit harsh and judgmental. I'm not a robot, I have formed relationships with my patients especially after caring for them over three months at times. I have certainly grieved some of their deaths."

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Cite this: Experienced Physicians More Likely to Struggle With Grief: Poll - Medscape - Nov 29, 2019.