Silent Grief: When Healthcare Providers Suffer the Loss of a Patient

I was on a much-needed girls’ getaway when I got the text. This kind of text does not come often when you are an outpatient pediatric occupational therapist. This is the kind of text that makes the world go silent and stops you dead in your tracks. My patient whom I had been seeing multiple times per week for over a year and a half had passed away during the night.

I had seen her two weeks before. She had had one of her best therapy sessions yet and was progressing so well that I was going to have to update her therapy goals. When our session was over, I walked her and her mom to the waiting room like I always do and told them I would see them next week. I did not realize that was the last time I would see my sweet girl.

When I got the text that she had passed, it was early in the morning. I couldn’t go back to sleep, but I just stayed frozen in bed. My brain could not process the thoughts swirling in my head. It did not seem right. There was no way. Was this real?

I returned to the clinic two days later after vacation. It was business as usual. There was no time to grieve. Her vacant spots on my schedule were sent to the front desk to be filled with new patients, and I had a full schedule of kids to treat. I put on my friendliest smile and went through all the motions. Then, I sat down at my desk and wrote the discharge note with the discharge reason reading “deceased.” Deceased? A child who was thriving in therapy the last time I saw her is now discharged as deceased.

Deceased sounds so clinical. While I was the clinician on this child’s case, my relationship with her and her family went beyond the clinical. As a pediatric therapist, yes, I am addressing clinical needs in every session and focusing on goal attainment. However, occupational therapy sessions are so much more than the clinical. We build relationships with the children and their families. To the child, I am just a grown-up she comes to play games with twice per week. That kind of relationship begins to feel like a friendship. Sometimes, on the hard days, her mother would just talk to me and cry. That is not just a clinical relationship.

However, when a patient passes, us therapists are expected to just move on to the next patient without a hiccup. Bereavement as explained in our facility policies is for family members. There’s no policy for how to handle the loss of a patient. You just have to pull yourself up by your bootstraps, put on your big girl panties, or whatever other inane phrase we use to tell people to toughen up.

There really is no good outlet for this sort of grief because HIPAA limits our ability to talk about the individual, and we have no real time to slow down and process. What people do not seem to realize is how confusing and painful this sort of loss can be for the healthcare provider. The grieving process looks different, but that does not lessen the hurt it brings.

Unfortunately, I did not write this post because I have a brilliant solution for how to mitigate this sort of grief. I do think employers of healthcare providers can take steps to support their staff when this sort of tragedy occurs. Perhaps they could offer counselling and/or check-ins with the affected employees at minimum. I do not know what employers typically offer in other facilities. Like I said, I do not have an answer to the problem; I wrote this article to process my own grief and to offer support to others who have been through similar experiences.

Hug your babies, show kindness, and never forget the power of a smile. You never know who around you are wrestling with grief in silence.