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Supporting coworkers after a personal loss

Chichester, Melanie, BSN, RNC-OB, CPLC; Janney, Regina, MSN, RNC

doi: 10.1097/01.NURSE.0000529804.60418.6f
Feature: NEW HORIZONS
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What should you say to coworkers when they return to work after losing a loved one? Follow this practical advice to provide support and show you care.

At Christiana Care Health System in Newark, Del., Melanie Chichester is a clinical labor and delivery unit nurse, and Regina Janney (posthumously) was a clinical ED and psychiatric crisis nurse.

The authors have disclosed no financial relationships related to this article.

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WHEN A COLLEAGUE returns to work after experiencing the death of someone close, peers are often uncomfortable speaking about the loss. But their response to a bereaved coworker can significantly impact his or her healing process.1 Even though death is a normal part of life, people need time to adjust to the loss and experience grief.

The terms grieving and mourning aren't synonymous. Grieving is a multifaceted internal reaction to loss. Mourning is a person's external expression of the loss, such as talking about the individual, crying, commemorating special dates or birthdays, and sharing memories.2

When death affects someone on a personal level, the impact on his or her physical and psychological well-being can be substantial.3 People need time to rebuild their lives without the person they lost. As an expression of mourning, talking about loved ones helps to form this new reality and may ease the bereaved person's grief.3 Here are some strategies to employ when supporting a grieving coworker.

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Back to work

For various reasons, many people return to work while still in the early stages of grief. It may be necessary due to their financial situation; or, they may fear losing their job if they don't return quickly.4 In addition, some people find that returning to work helps by making life feel more normal and predictable.5 Those who felt that their job was meaningful or had purpose before the loss usually return to the same job. For those whose work has less meaning to them, a significant loss or change in life often leads to a reevaluation of their career and a desire for something new.5

Bereaved individuals may struggle to understand that grief isn't a sign of weakness or lack of faith, but a process to work through. It's at these times that simple words from colleagues can offer meaningful comfort and strength.

Although returning to work may have positive effects following a loss, never assume that a coworker has left grief entirely at the door.6,7 The human mind demands time to process a tragic event, and grief can't be turned on and off at will.8

People typically spend as many (or more) hours at work as at home. This is one reason coworkers play such an important role in their grieving colleague's return to the workplace.9 It's understandable that at such times work colleagues often become extensions of family.10 Being at work can feel routine, safe, and normal, which can increase self-esteem. However, a colleague who returns to work while grieving may become easily distracted or miss details, which can lead to safety concerns in the healthcare profession.7 To this end, coworkers can be supportive by double-checking work or offering reminders. Simply knowing someone “has your back” can be a great relief to a grieving coworker. Here are some caring behaviors to adopt:11

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  • Ask bereaved colleagues if they need to take a break.
  • Ask them if you can help with anything.
  • Be willing to listen if and/or when they're ready to talk.
  • Organize a collection benefitting your colleague's family, if appropriate.
  • Acknowledge bereaved colleagues by showing them you appreciate and value them.
  • If bereaved colleagues are smiling or laughing, enjoy/support good moments together as well.

Although coworkers are rarely deliberately insensitive, they can feel awkward or unsure about what to say to a colleague following a loss.7 They may worry about saying “the wrong thing” and avoid the topic altogether.12,13 See Phrases to use and avoid for some simple guidelines that may help coworkers feel more comfortable addressing a colleague's loss.

Some believe they're being intrusive by talking with a coworker about a loss, but a valued colleague may be the best person with whom to discuss these feelings. There are no set rules for mourning, and there is no time limit for when a person should be “back to normal.” It's important to offer support, even when it feels uncomfortable.14,15

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Taking the lead

In times of loss, nurses and nurse managers are often leaders and role models for patients, families, and other clinicians. People don't expect nursing professionals to be experts in grief counseling, but they may look to you for help to say the right thing with the right intent.1

A nurse manager's presence is important during the mourning process. Attending a visitation or memorial service sends a clear message of support. Sending flowers or a card with a personal message also shows concern and support. Listening is another way to support grieving employees and gives them the gift of presence.1 Nurses who feel supported by their management team not only have higher job satisfaction, but also take fewer sick days.16

If you're a nurse manager, be sensitive to the fact that individuals grieve differently. Some may find great comfort in their work, while others may view work as an extra (sometimes unbearable) burden.6,17 One challenge for nurse managers is recognizing when a return to work may have been premature, or when an employee needs professional help or perhaps a referral for counseling.

In some instances, distinguishing between normal grieving and dysfunctional grief is difficult, because even normal grief lowers energy and productivity and can alter the ability to think clearly and rationally.18 Be observant for signs that may indicate that the bereaved individual is struggling with normal daily activities, such as poor grooming or a noticeable weight loss or gain. If the employee seems unusually angry, guilty, bitter, or obsessed with discussing the loss, be alert for maladaptive coping behaviors, such as increased use of alcohol, medications, or drugs.

All nurses are responsible for monitoring and maintaining a safe work environment. If you're a clinical nurse, discuss any concerns about your coworker's ability to function professionally with your nurse manager. If you're a manager, speak frankly with the employee about how you can help. Does he or she want to talk about the loss at work? Would it help to share certain information with coworkers, and if so, what details should be shared or withheld?

Establishing a plan for a phased-in return to work can improve performance and increase confidence.4 Discuss reduced work hours or how to handle the need to leave work if the employee feels overwhelmed or ambushed by emotions. Individuals who complete the bereavement process and integrate their personal and work lives are likely to emerge with greater commitment to their employer.18

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Helpful strategies

Grieving people often have trouble asking for help for fear of being burdensome or depressing. Bear in mind that asking people who are mourning what might be helpful may not be something they can answer. Being present and available can contribute greatly to a grieving person's healing, regardless of the depth of one's relationship with him or her.

Approach your coworker to ask about the loss in a location that offers some privacy; this gives the mourner an opportunity to talk. Let the grieving coworker control the pace of the conversation and the content. If he or she doesn't wish to talk about the loss, ask if you can do anything else to support him or her. Checking on your coworker periodically to see how he or she is doing and feeling can be important. Offer some assistance if you see a coworker struggling to keep up with work.

If you have a personal relationship with the coworker, consider calling the person during nonworking hours, especially if the person is now living alone. Inviting him or her over to dinner or out to a movie when the time is appropriate can be helpful. Even if you don't have a close relationship with your coworker, offering support is still appropriate. Being present for your coworker is 90% of the battle.10,14

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Cultivate social capital in the workplace

Bereavement doesn't have a predictable pattern. Be understanding of the inner turmoil and stress your coworker is experiencing as he or she moves through the grief process. The support work colleagues can provide, also called social capital, goes a long way toward building a workplace culture that's conducive to a healthy recovery.19 A workplace with social capital supports mental health.20 Such workplaces are rewarded long term with job satisfaction, fewer absences, and greater loyalty.16

Depending on the relationship and timing, some grief never really ends: Life will never be the same again and some people never get over their loss. But with the support of family, friends, and colleagues, they may learn a new way to live and move forward. For additional information on coping with grief, see Online resources.

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Online resources

www.compassionatefriends.org

www.helpguide.org

www.americanhospice.org

www.hospicefoundation.org

www.journeyofhearts.org

www.goodgrief.org

www.griefnet.org

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