I Never Got to Say Goodbye

Imagine turning up for work one day and being told that your client has died. Maybe it was a patient you'd been treating for months....or a participant you saw every week - someone whose routines, preferences, and wit you knew better than most. You might have seen them only days before, and then they were gone. Just like that.

The thing is, we almost never intend for a meeting with someone to be our last. It catches us off guard - no warning, no time to prepare. But it has happened nonetheless, and yet, the expectation is often that you'll get on with the rest of your shift.

What many care professionals experience in these moments has a name: disenfranchised grief. It's the grief you feel when the world around you doesn't fully recognise your right to grieve. You aren't family or a friend - at least, not in the traditional sense. You are a 'professional'. And so, there's this unspoken expectation to embody the stoic and carry on, unaffected.

But here's what I think is worth saying out loud: just because someone was your client or your participant doesn't mean you didn't care about them as a human being. You may have known their routines, their preferences, their sense of humour. You may have genuinely liked them as a person. The fact that you were paid to support them doesn't make that connection any less real - and it certainly doesn't make the loss any less felt.

Grief affects us all. And when it's left unresolved, it accumulates. Research on ICU staff shows what happens when people experience loss after loss without any space to process it - the grief layers, one on top of another, until it begins to affect not just how we show up at work, but how we live our lives outside of it. Whatever we don't process doesn't go away - it shows up as exhaustion, irritability, disconnection, and even ambition that's rooted in escape. Grief denied is simply grief delayed.

So what can help? One thing the research points to (and something our ancestors understood long before the research caught up) is Ritual. Not necessarily anything religious or elaborate. Just a small, intentional act that marks the moment and gives your grief somewhere to go.

In some hospital settings, teams practise what's called a "sacred pause" - after a patient dies, staff stop for about a minute to acknowledge the life that was lost and recognise each other's efforts. It's simple, and it works. But ritual doesn't have to be organised at a workplace level. Organisations might choose to do something collectively - a card for the family that the support team signs, a small acknowledgement at the next team meeting. And individually, it can be anything that feels meaningful to you. Stepping outside and picking a flower. Saying a quiet prayer before you go to sleep. Lighting a candle. Writing a few words in a journal.

And the benefits go beyond simply feeling better in the moment. Research shows that meaningful ritual builds psychological resilience, strengthens team cohesion, and increases what researchers call compassion satisfaction - the feeling you get from doing this work well and caring genuinely for another person. Perhaps most importantly, it creates a formal moment to express grief rather than suppress it, which as it turns out, makes all the difference.

What matters isn't the form it takes - it's the intention behind it. You don't have to be religious to practise ritual. You just have to be willing to pause, and to let whatever you're feeling be real for a moment. Ritual is how we can do that, by honouring what was and appreciating what is.

Ref: Kapoor, S., Morgan, C. K., Siddique, M. A., & Guntupalli, K. K. (2018). "Sacred Pause" in the ICU: Evaluation of a Ritual and Intervention to Lower Distress and Burnout. American Journal of Hospice & Palliative Medicine, 35(10), 1337–1341.