Grief among healthcare professionals is a often silent yet deeply impactful reality, shaped by continuous exposure to death, suffering, and loss. Although grief is typically associated with patients’ families, healthcare workers— particularly nurses—form meaningful relationships with those they care for, making them vulnerable to complex and frequently unrecognized forms of grief.
This experience is often described as “disenfranchised grief,” a type of grief that lacks social or institutional acknowledgment (Coelho, Monteiro, & Ramos, 2025). The absence of validation, combined with limited opportunities to express emotions, can intensify psychological distress. In many healthcare settings, organizational cultures prioritize efficiency and objectivity, discouraging emotional expression and reinforcing the expectation that professionals should remain detached, even in the face of repeated loss.
Frequent exposure to death, especially in areas such as intensive care, oncology, and palliative care, increases the risk of compassion fatigue and burnout. Carvalho (2011) highlights that empathic engagement—while essential to quality care—can lead to emotional exhaustion without effective self-regulation strategies. Burnout, as noted by the Portuguese National Health Service (2026), is characterized by emotional exhaustion, depersonalization, and reduced professional fulfilment, and is particularly common in helping professions.
Coping strategies therefore play a crucial role. Nurses often rely on peer support, spirituality, emotional distancing, and finding meaning in caregiving (Azevedo, Capelas, & Coelho, 2018). However, not all strategies are beneficial in the long term. Excessive emotional distancing, for instance, may weaken the therapeutic relationship and contribute to the dehumanization of care.
The helping relationship remains central to nursing practice, involving empathy, active listening, and genuine presence (Coelho et al., 2020). Yet, this emotional closeness also increases vulnerability to psychological suffering. Achieving a balance between professional involvement and emotional protection is therefore essential and requires both individual skills and institutional support.
In high-pressure environments such as emergency departments, professionals often use humour, social support, and rationalization to cope with stress (Garcia et al., 2016). Similarly, Pires and Antunes (2024) show that nurses’ distress is closely linked to the complexity of cases and frequent exposure to death but can be alleviated through team support and shared experiences.
Worden’s (2009) grief theory offers a useful framework, suggesting that professionals must also process loss by accepting it, working through the pain,
adapting, and reinvesting emotionally. However, without institutional recognition, these processes are often incomplete, leading to accumulated unresolved grief.
Promoting healthy work environments—with opportunities for reflection, clinical supervision, and psychological support—is essential to sustaining professionals’ emotional well-being and ensuring quality care. Ultimately, recognizing and addressing grief among healthcare professionals is vital for both their health and the delivery of compassionate, humanized care.
References:
- Azevedo, V., Capelas, M. L., & Coelho, S. (2018). Estratégias de coping utilizadas pelos enfermeiros para lidar com o processo de morrer. Associação Portuguesa de Cuidados Paliativos. http://hdl.handle.net/10400.14/27894;
- Carvalho, P. R. C. (2011). Estudo da fadiga por compaixão nos cuidados paliativos em Portugal: Tradução e adaptação cultural da escala Professional Quality of Life 5. [Tese de mestrado, Universidade Católica Portuguesa]. Repositório da UCP . https://repositorio.ucp.pt/entities/publication/80d18ba6-911d-42b1-9226- 25f07336 44d0 ;
- Coelho, J., Sampaio, F., Teixeira, S., Parola, V., Sequeira, C., Fortuño, M. L., & Merino, J. R. (2020). A relação de ajuda como intervenção de enfermagem: Uma scoping review. Revista Portuguesa de Enfermagem de Saúde Mental, (28), 47–54. https://doi.org/10.19131/rpesm.0273
- Coelho, M., Monteiro, J., Ramos., J. (2025), Luto não reconhecido em profissionais da saúde: o impacto invisível das perdas e o sofrimento de quem cuida. Revista Sociedade Científica, vol. 8, n. 1, p. 2100-2120.;
- Garcia, A., Haddad, M., Dellaroza, M., Rocha F., Pissinati P. (2016). Strategies used by nursing technicians to face the occupational suffering in an emergency unit. Revista Rene, 17(2), 285–92;
- Pires, L., & Antunes, M. (2024). Sofrimento e estratégias de coping em enfermeiros de uma unidade de cuidados intensivos cardíacos. Revista de Enfermagem Referência, VI Série(N. o 3). https://doi.org/10.12707/rvi23.140.33714;
- Serviço Nacional de Saúde. (2026). Burnout.
- Worden, J. W. (2009). Grief counseling and grief therapy: A handbook for
the mental health practitioner (4th ed.). Springer Publishing Company.