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The Emotional Weight of Supporting Dying Patients

The COVID-19 pandemic has been a massive stressor to health care workers (HCWs) – it has come with long hours, fear of exposure, and frustration towards people who don’t believe (or don’t care about) how serious the virus is, or take measures to prevent its spread. Being a HCW during this time likely means you’re experiencing greater and more prolonged emotional exhaustion than ever before in your career. In Mental Health America’s survey of HCWs, 76% of respondents said they were experiencing exhaustion and burnout.

There are likely a number of things contributing to those feelings, some of which you’ve experienced before to a lesser degree, or for a shorter period of time. But others are fairly specific to pandemic times, like being the only in-person support a patient has while they die. Many patients in Intensive Care Units (ICUs) with COVID-19 aren’t prepared for death - logistically or emotionally - and while loved ones can video call in, it’s HCWs who are physically by their side at the end of their life.

Allow yourself to grieve.

Whether you’re saying goodbye to a patient you knew well or someone you just met who needed a hand to hold, you’re experiencing a loss. You’re likely facing a lot more death than usual and it may feel safest to detach yourself from what you’re witnessing, but grief is a very normal human emotion – pushing it down won’t provide prolonged relief. Let yourself feel your sadness; crying activates your parasympathetic nervous system and rids your body of toxins and hormones that contribute to increased stress,[i] so letting it out actually does help you feel better. Acknowledge the deaths you’re seeing in whatever way feels best to you (you can talk to others who worked with the patient, take a private moment to think about them, write a note to their family, or seek support from a supervisor or grief counselor).

Get support from your team members.

If anyone can relate to what you’re going through right now, it’s other people who do the same job as you. None of you have to carry the weight of this alone – you’re in it together and can support each other in your shared distress and understanding. If you want this support to be more structured, check out PeerRxMed for weekly, monthly, and quarterly check-in prompts and guidance.

Try to really disconnect when you’re off the clock.

In a field like patient care, it’s difficult to mentally leave work at the workplace. This is especially true right now because the pandemic has touched nearly every aspect of life, so watching the news or scrolling through social media just keeps work stress at the top of your mind. You may want to consider taking a break from the online world for a few days (or longer) to avoid constantly seeing photos of people not taking the pandemic seriously, information about what you’re dealing with daily on the frontlines, or infuriating misinformation and conspiracy theories. Keep yourself distracted by making plans for your time off – leaving your free time unstructured may send you on a thought spiral. Rest is important but keeping your brain active (by reading a book, talking to a friend, or learning a new hobby) is what will give your mind a rest from the emotional intensity you feel at work.  

Take care of your body.

The mind and body are very closely connected, and treating your body well is always important for mental wellness. This is especially true when you’re experiencing trauma or toxic stress – the energy from this kind of response is physically stored in your body. Physical activity like working out, going for a walk, or even some light stretching helps release this energy.

Be gentle with yourself.

This is beyond your typical scope of work. While you may have been with people as they died before, being the sole person physically with them is a tremendous weight. What may have been a particularly tough day at work every once in a while, is now something you experience regularly. The constant stress can cause emotional overload – it’s okay if you’re having a really hard time with this. Try not to compare how you’re coping to others, or to your own expectations for yourself. Treat yourself with the same kindness and compassion you’d extend to a friend during this time and give yourself credit for holding on – just getting out of bed in the morning is an accomplishment.

Know the signs of compassion fatigue and burnout.

It can feel selfish to take time for yourself during a time like this, but you can’t perform your best if you’re stretched too thin. Symptoms of compassion fatigue and burnout can include difficulty sleeping, numbness, anger, inability to focus, sadness, and helplessness. It’s important to recognize if and when your job is becoming too much to handle – pushing through isn’t sustainable long-term.

Know where to find help.

If you’re doing your best to take care of yourself and still really struggling, take an online mental health screen – you may be experiencing symptoms of a mental health condition like depression or post-traumatic stress disorder (PTSD). For immediate support, call the National Suicide Prevention Lifeline at 1-800-273-TALK or Magellan’s crisis line for healthcare workers at 1-800-327-7451. You can also text MHA to 741-741 to text with a trained crisis counselor. For longer term support, check out The Emotional PPE Project to connect with a licensed mental health professional.

[i] Marcin, A. (2017, April 14). 9 ways crying may benefit your health. Healthline.