Those working in the health and care system especially need to tell their stories

Pre covid-19 our society was largely a “death-denying” one. We hid death from sight; in nursing homes, hospitals, and hospices. Now it fills our lives, every day. Each evening we have a daily tally of the number of people who have died. Images of coffins, shrouded bodies, and grieving relatives fill our TV screens. We see photos of the dead in newspapers—reminding us of the real human cost of this disease. People announce on social media the death of their loved ones and we increasingly receive personal communications about the death of friends, relatives, and colleagues. It is not just the loss of people we are grieving, but also of the life we were living before the virus came along.

Grief is a complex process: its duration, intensity, and the impact of the loss, a unique experience. Even those from the same family will respond differently to, for example, the death of a parent. What is universal though is the need for grief to be made visible and shared. The Swiss-American psychiatrist Elisabeth Kubler Ross told us that grief must be witnessed, through mourning rituals and storytelling for the individual to be healed. [1] Grief shared is indeed grief abated. If we don’t bear witness to each other’s grief, then the burden of loss falls onto the individual who suffers alone, shedding silent tears.

Covid-19 has affected us all—patients, public, professionals, politicians. Each one of us have stories we must tell and emotions we need to express. Those working in the health and care system especially need to tell their stories. Not just of their heroic endeavours, of the lives saved, but of the darker side of their work. The porter wheeling yet another recently deceased person to the hospital morgue. The care worker, quietly holding the hand of a much loved care home resident as their life ebbs away. The junior doctor contacting relatives by phone to tell them the bad news about their loved one who has hours left to live. The GP sitting in their bedroom, trying to comfort those who have been bereaved through the medium of virtual consultation, or the senior manager despairing at having to resolve two irreconcilable demands from below and above.

We are currently in a lull. Going forward we must not rush in our quest to restore normal services following the first peak of infection. Bearing witness to grief means allowing time to talk and for others to listen. Health and care staff need this time and space to digest, reflect, discuss, and mourn our collective losses.

Our three top tips for allowing yourself and your team the space and time they need to grieve during covid-19 are:

• Build in a regular time for your team to come together and share their experiences, where people can speak or simply listen if they don’t want to. 
• Consider the broader losses of what you miss and what you long for—your roles, your ways of working, your security, and the predictability of life.
• Remember that the many emotions of grief (including shock, anger, bargaining, sadness, and acceptance) come in unpredictable and sudden waves and can take many months to pass; be kind to yourself and your colleagues over the months to come.
  

Clare Gerada, Medical Director of NHS Practitioner Health and Chair of Doctors in Distress Charity

Caroline Walker, Psychiatrist and Therapist at NHS Practitioner Health and Founder of The Joyful Doctor

Visit www.practitionerhealth.nhs.uk to access free and confidential support from NHS Practitioner Health.

For free and confidential bereavement and loss support call: 0300 303 4434 (England)

Or text FRONTLINE to 85258 (UK-wide)

Reference:

1] Kübler–Ross, E., (1969) On death and dying. The Macmillan Company, New York.