The collective imagination associates the medical profession with people who save lives. This is certainly true. But it is also true that death is part of a healthcare professional’s daily life — an issue for which one is not always prepared and that can eventually take its toll.

In fact, there are several studies on this topic. In 2024, BMC Palliative Care published the study “Impact of Dealing With Patients’ Suffering and Death on Healthcare Professionals’ Well-Being and Burnout.”

Analyzing the experiences of 109 healthcare professionals, 58% in oncology and 42% in palliative care, the study found that 30% witnessed intolerable suffering at least nine times a month, 45% reported moderate-to-high levels of burnout, 39% suffered from anxiety, and 11% from depression.

This raises a fundamental question: Interventions are needed to help professionals cope with patients’ deaths, especially for those who experience them firsthand.

Accompanying Patients at the End of Life

On this issue, El Médico Interactivo, part of the Medscape Professional Network, spoke with María Herrera Abián, communications officer for the Spanish Society of Palliative Care (SECPAL). “Accompanying a person to the end of their life is one of the greatest privileges a healthcare professional can experience, but also one of the most emotionally demanding experiences.”

Regarding how these professionals cope, Abián said the key lies in finding spaces to process the emotions generated by these losses. Grief does not have to become something negative. When it is acknowledged, shared and cared for, it can also become a source of professional maturity, empathy, and personal growth.

The expert also points out that working closely with death often teaches us to value life and time more highly. Many professionals learn to put everyday worries into perspective and develop a deep sensitivity toward human suffering.

Effects of Unresolved Grief

A study published this June in JACC: Advances, focusing on grief among cardiologists, found that the emotional impact of a patient’s death was associated with greater psychological distress. In a cohort of 747 physicians, 201 (26%) exhibited high emotional impact. In this group, symptoms of anxiety (52%), depression (42%), posttraumatic stress disorder (60%) and severe burnout (51%) were found. This group also reported more frequent conflicts with colleagues and increased use of psychotropic or addictive substances.

“The emotional impact of patient death is significantly associated with symptoms of psychological distress among healthcare providers, highlighting an underrecognized dimension of physician well-being that requires targeted institutional support and training,” the study concluded. Furthermore, it warns that the overall impact on mental health may be broader, given the lack of awareness among physicians regarding burnout.

Beyond this general conclusion, the study also found interesting data, such as the fact that being female was associated with a greater emotional impact from patient deaths.

Factors Affecting Grief Over a Patient’s Death

Regarding the factors that can influence the intensity of this grief over a patient’s death, Abián explained that the main factor is the bond. The longer we accompany a person and their family, the more meaningful the farewell becomes.

However, identification with certain stories also plays a role, including cases involving young patients, people with young children or situations that echo our own experiences. In these cases, it is inevitable to see ourselves in them — for example, when a mother says goodbye to children who are the same age as her own.

Marisa Blasco, coordinator of the Bioethics Working Group of the Spanish Society of Intensive Care, Critical Care and Coronary Care — a group of professionals who also regularly face death — agrees with this idea.

As she told El Médico Interactivo, “This impact usually has two components: first, empathy with family members and loved ones, and second, a more personal reaction tied to a sense of ‘failure’ in the face of the situation.”

Furthermore, “the emotional impact is directly influenced not only by training — which is challenging because of the variety of situations, especially the professional’s own background — but also by the professional’s experience, training in these situations including how to deliver bad news, and the type of case.”

Improving Emotional Coping Tools

Thus, the scientific literature reminds us that experience alone does not immunize against the impact of grief and outlines potential tools that may be useful for health care professionals. Among others, these include holding memorials, performing small rituals or setting aside time to remember the patient if the professional needs it.

Furthermore, some studies have also evaluated these potential tools in specific settings, such as ICUs.

As noted in an article published in 2025 in the American Heart Journal, the impact of grief does not diminish as physicians advance through their training. However, it has been observed that emotional support sessions help normalize grief among physicians, foster camaraderie, and prevent difficult experiences from falling solely on a single professional.

“Dealing with extreme situations that lead to expected — or sometimes unexpected — deaths makes it a priority that part of professionals’ training include the acquisition of knowledge, skills, and attitudes that enable them to handle such situations,” emphasized Blasco. There are many options that institutions should implement to prevent situations like those experienced in recent years. There are training and support tools for healthcare professionals that, rather than being merely an individual and voluntary choice on the part of the professionals, should be an institutionalized routine implemented by the administration. Occupational health and safety services play a fundamental role in providing this psychological support to healthcare professionals.

The reality is that, for years, the ability to cope with a patient’s death has been linked to experience and individual resilience. However, the most recent proposals also point in another direction: not letting the burden of managing these losses fall exclusively on the professional. Emotional debriefing sessions, team meetings, or spaces for reflection help share the emotional impact of difficult cases and normalize reactions that might otherwise be experienced in isolation.

Sense of Professional Failure

As the experts note, beyond the grief over the loss, on a professional level one must also consider the weight of the decisions made and the feeling that something might — or might not — have been done differently.

“The concept of ‘no blame’ is deeply entrenched in the ICU, where absolute priority is given to establishing an impeccable ‘culture of safety.’ In that culture, one of the main premises is to avoid the concept of blame at all costs.”

According to Blasco, meetings among healthcare professionals including doctors, nurses, physical therapists, and any other involved professionals should be a regular practice that allows for the sharing of specific cases that generate conflict, in order to engage in joint deliberation.

SECPAL echoes this idea, noting that team meetings, psychological supervision when available, and maintaining self-care habits outside of work — such as resting, nurturing personal relationships, exercising or setting aside time for activities that help us regain balance — are helpful. We cannot adequately support others in their suffering if we neglect our own.

Grief, therefore, need not be viewed as a weakness on the part of the professional or as something that must be overcome alone. Support tools, training, and spaces for reflection can help ensure that these experiences become part of medical practice without their impact falling exclusively on those who experience them.

The experts disclosed no relevant financial relationships. 

This story was translated from El Médico Interactivo on Univadis, part of the Medscape Professional Network.