We're not okay: Report lifts lid on nurses' agony after death of patients

Some nurses deliberately avoid forming attachments and others said they avoid relatives after death.

For many nurses, there is no time to process the moment. The body is moved, the bed is cleaned, another patient is brought in and work continues.

But behind this ‘normal’ practice are thousands of nurses struggling with grief, often without support.

A new Kenyan study conducted at AIC Kijabe Hospital pulls back the curtain on an invisible burden carried by the people who spend the most time at a patient’s bedside.

It shows how repeated exposure to death shapes nurses’ emotions, behaviour, faith, and mental health.

Researchers spoke directly to 50 nurses working in intensive care, maternity, emergency, and paediatric units. These are spaces where death is common.

The findings challenge a common assumption that nurses become “used to death” over time.

Some deaths hurt more because nurses form close bonds with patients. This is common in long admissions and paediatric care.

“I was taking care of this child who looked just like my daughter - she was the same age as my daughter. But that child died. I really worked hard to save her, but she still died, and that really traumatised me,” says one nurse, quoted in the study that was published last week in the Plos Journal.

Nurses said certain deaths follow them home. They think about them at night and remember them years later.

The emotional toll is heavier when death feels sudden or unfair, such as demise of young patients and emergency cases.

“The sad part of working in the critical care unit is witnessing numerous deaths. It is especially painful when young people, simply going about their daily routines, are suddenly taken away.”

Nurses also described deep frustration. They are trained to help and death can feel like failure.

“For me, it is the lack of control. You do everything you can, yet you are still unable to control the patient’s outcome. When it ends in death, you are left feeling completely out of control,” one nurse said.

Hospitals expect nurses to move on quickly after a patient dies.

“Nurses are suffering. You see us walk and you think we are okay. We are not. Deep down, we just wish we could have someone to talk to,” said one nurse quoted in the study, titled “Patient death and nurses’ coping strategies: Perception of nurses at a tertiary referral hospital in Kenya.”

Many of them said prayer and faith help them accept death.

“You comfort yourself that maybe it was God’s will. If you take too much upon yourself, you get drained.”

Others cry in private spaces, some listen to music, while some said they seek conversation with trusted colleagues.

Emotional distancing is another strategy. Some nurses deliberately avoid forming attachments and others said they avoid relatives after death.

“For me, I tend to avoid relatives as much as I can after the scenario.”

The study shows that informal coping cannot replace structured support.

Nurses said hospitals ignore their emotional state because the focus after death remains on paperwork and patient's relatives. The nurse is expected to continue working.

In extreme cases, nurses said they could not return to work immediately after traumatic deaths.

Some even faced anger from grieving families amid accusations of negligence and aggression.

The authors advise healthcare leaders to prioritise the establishment of comprehensive psychological support programmes for nurses. These programmes should include regular accessible sessions with psychologists, support groups for collective encouragement, and counselling services tailored to address the emotional toll of patient deaths.

“They should also work to normalise help-seeking behaviors among nurses. Creating a culture where seeking support for emotional well-being is encouraged and destigmatized can empower nurses to prioritize their mental health and seek assistance when needed,” the authors said.

They are Peris Wategi, Gabriel Okombo and Mary Adam of AIC Kijabe Hospital, and Joel Ambikile of Muhimbili University of Health and Allied Sciences, Tanzania.