Reflections on grief during COVID-19 from a personal and professional perspective…

 Sandra Campbell 22 Jun 2020

As we go through this pandemic, I describe an anticipated “tsunami of grief” that will be different to anything we have seen before. I also think we will continue to see  an increase in  psychological stress for staff as they reflect on what they may have experienced during the last few months and also live with the uncertainty of the future in this new world in which we all now live…

Grief is described as a “process” with various theories of grief…however, personally, I would describe it as a complex web of thoughts, feelings and emotions that are often so intense and distressing… there are no words to truly describe or define it. COVID-19 has compounded this complexity mainly because of the enforced separation from those we love and care for and who care for us. This is particularly difficult in end of life care, whether the person is dying from COVID-19 or something else  … the reduced contact and indeed none for some. Not being able to sit with someone you love when they are dying must be horrendous. Imposing these restrictions is also so hard for staff, going against all our natural caring instincts at the very heart of nursing. Social distancing, sometimes referred to as “physical” distancing because during this traumatic time we need more social contact, not less, is having a radical impact on service delivery and communication. Many staff in all roles are struggling with having to share “bad news” or what Fallowfield et al (2005) would refer to as “sad, bad and difficult information” on the telephone. Increased use of technology, whilst helpful to facilitate virtual consultations, brings its own challenges. Nurses have shared with me how they miss not being able to touch patients. Some feel that wearing a mask during sensitive conversations is a barrier. I say to staff repeatedly, in an attempt to help, that this is all totally outwith our control and to say to patients/carers we would not choose to work like this. 

And I can’t imagine how painful it must be with the restrictions imposed on reduced numbers at funerals…robbed of the opportunity to have reflective conversations, reminiscing on the person’s life… no hugging or crying and laughing together. Looking back, we were actually lucky to have had about five hundred people attend our son’s funeral thirteen years ago… and I thank each and every one for taking the time to share their grief with us as a family. Recently, whilst talking to a friend who had just lost her son, I was so struck by her comment “how do you choose who can come?”  Being deprived of the normal ritual of a funeral is unthinkable. I have spoken with people bereaved in the months before the pandemic and they tell me it is making their grief worse. 

With regards COVID-19, everyone working in health and social care will be affected, especially those directly involved in caring for people with COVID-19. There is such a broad spectrum of illness trajectory and highly complex dying that requires skilled expertise to identify need and manage effectively.  I have personally experienced how COVID-19 has affected those in hospital, community and especially in care homes. It has affected me as a nurse but also on a very human level as a mum, granny, wife, sister, aunt and friend.  I feel so much sadness for the families who perhaps hadn’t seen their loved ones for many weeks before they died. Some may have been fortunate enough to have a short time with them just before they died but many will have not. The missed opportunities for precious time and last conversations… I feel for the staff in care homes who have cared for multiple residents dying at the same time…utterly unimaginable and we have to learn from this to support our very valuable workforce: no blame culture! What I have found hugely helpful is the wonderful support locally and across the country through networking with colleagues across the UK and organisations like the Scottish Partnership for Palliative Care (SPPC) and Hospice UK. I have heard beautiful stories of how staff have managed to provide compassionate care with immense kindness in amidst this nightmare by trying to maintain connections with various initiatives across the UK. 

We need to support staff as we move into the next phase of living with this virus, including learning how to provide the best care possible for those whose experience of having COVID-19 has been life changing. 

So, on reflection, grief is highly complex: phrases like “time is a healer” and “move on” and a phrase I heard recently “draw a line under” should never be used. Let’s talk more openly about how we are feeling- coping or not… share resources to support each other. The best resource of all is the human resource of personal contact…let’s not pretend we are “okay” or “fine”… we may have wounds from this war but they will heal… my deepest fear is the scars they may leave behind if we do not tend to them with love and tender care. 
 
Sandra Campbell

Sandra Campbell

Pain and Palliative Care Committee Member

MacMillan Nurse Consultant Cancer and Palliative Care

Strategic and professional lead for cancer and palliative care nursing across acute and primary care . Passionate about person centred care and communication and also lead on bereavement. 

Page last updated - 22/06/2020