How to Navigate Grief and Loss as an NP

While being a nurse practitioner is overwhelmingly positive, there are still hard days at work. Being a part of nursing and healthcare, it’s likely that at some point you’ll encounter the loss of a patient or be involved in other upsetting or distressing events. How do you handle decompressing after a bad day?

As an NP, you’re in a provider role. This means that you may be giving bad news to patients. I have had to talk about worsening health and even terminal diagnoses with patients and families. How do you prepare to be the one giving the bad news?

In this post, we’ll go over how to lead difficult conversations around loss and grief and also how to deal with grief within yourself.

Handling Difficult Conversations as an NP

In your clinical rotations, you may not have had the opportunity to be a part of difficult conversations with patients and families. In my 10 years as an NP, there are certain conversations that stick with me. I’ve had to deliver news about cancer, Alzheimer’s, and even a new HIV diagnosis, and I learn from each one about how I can improve.

1. Prepare

When I know I’m going to have to deliver bad, upsetting, or complicated news, the first thing I do is prepare. I want to have a full understanding of the news I’m talking about. I don’t want to walk into a tense conversation and not be able to explain something or be able to tell the patient next steps and where to go from here.

I also try to walk through the conversation in my head before talking out loud. It’s my way of collecting and organizing my thoughts, and making sure I can explain in an easy to understand way.

2. Meet In-Person

It’s also important to note that big conversations deserve to happen in-person. You shouldn’t discuss significant diagnoses or other kinds of negative news over the phone, and definitely never in a voicemail message.

It may seem awkward to have to call the patient and ask them to make another appointment to discuss results. Won’t that be a red flag for them? Won’t the patients come in very anxious? While those statements may be true, patients deserve the respect and confidentiality of talking in-person.

3. Minimize Distractions

When you’re ready for the conversation, set the stage by minimizing distractions and having a quiet environment to have the discussion. You’ll want to start by asking the patient what they know about what they are there to discuss. That will help “open the door” to the topic as well as help you determine where you need to focus your education.

4. Pay Attention & Make a Plan

When talking about the bad news, pay attention to your body language. Show confidence and respect, and convey that in your verbal communication as well. It’s also okay to pause and give the patient time to think about the information and allow time for the patient to ask questions.

At the end, make sure you give a summary of what you talked about and have a solid plan for follow-up.

Dealing With Your Own Grief

Whether you’re giving bad news or just having an overwhelming day, it’s important to take care of yourself and your mental health. It can be hard to “leave work at work” and you may be finding yourself bringing home the grief and the losses you see and experience at work. So, how do you balance that with your personal life?

1. Reach Out

Don’t be afraid to reach out to your colleagues for support and guidance as a way to work through any emotions you may be holding onto. Chances are, they will understand what it’s like working with the stress (and privilege!) of caring for others, and they can be a really safe space for you to explore those feelings. And don’t be nervous to reach out for help elsewhere, like with a support group or a therapist. 

2. Acknowledge Your Feelings

Think of exploring and acknowledging your feelings as a form of debriefing. What went well? What could have gone better? Do you think you explained everything in a way the patient understood? Did you create a safe space for both you and the patient? It’s okay to feel like everything didn’t go completely right.

Instead of staying in that place of sadness or frustration, acknowledge it, think of how it can be better next time or what you’ll do differently, and then move on. Try not to stay in those negative feelings.

3. Practice Self Care

Lastly, you need to practice self care. What does that mean for you? At minimum, make sure you’re getting enough sleep and eating well to heal your body and soul. Physical activity is another great way to help decompress and care for yourself.

When I worked nightshift on a trauma floor, I would go for a 20–30 minute walk after work in the mornings to help clear my mind and get rid of any extra energy I was holding onto. Other good options are practicing meditation, listening to music, or finding a hobby that brings you joy. 

Final Thoughts

No matter what setting you practice in as an NP, there will be days that are harder than others. Do your best to prepare yourself with knowledge and information and create a calm and safe space for you and the patient.

Once it’s over, whether a tough conversation or a difficult loss or just a bad day, make sure to take care of yourself. Reach out and talk to others and practice good self care. You’re worth it! 💜

Check out our other posts exploring communication topics!

• 4 Common Communication Challenges for New NP
• 6 Tips for Communicating with Patients as an NP
• [Podcast] Mental Health as a New NP