As an oncology nurse, I’m trained to treat illnesses, not to carry the invisible weight that grief leaves behind.
As a new graduate nurse coming into the healthcare field amid a deadly pandemic, inpatient oncology was not where I thought I’d end up. As a matter of fact, I swore I would never work with adults, only children and infants, as most of my grad school experience revolved around.
Never in a million years did I imagine myself as an adult inpatient oncology nurse, nor did I predict the stress and grief that would come with it.
When caring means carrying grief
Oncology nursing can be an emotional career to pursue. While millions of Americans can thrive with a cancer diagnosis today, many are still suffering the painful and emotional toll cancer takes on the body and mind.
In this specialty, we often bear that same burden as we see dozens of patients daily going through the most difficult journey, with only some making it out on the other side. In that moment of caring for a terminally ill patient, fight or flight takes hold. We prioritize the daunting task at hand without a second thought for how we handle it in the moment or process it later.
As nurses, it’s in our nature to put others first. Someone else’s grief and suffering come before our own, even if our own is developed from watching that same person grieve and suffer. We then move on to see our next patient with their own challenges that we’re now guiding them through.
Oncology nurses spend so much time buried in someone else’s grief. When do we have time to address our own?
Research confirms what we feel every day
A 2023 study out of Iran resonated with me. It looked at the experiences of 18 oncology nurses and identified four categories contributing to grief that we face:
- Exposure to a patient’s painful death
- Depressing work atmosphere
- Awareness of the financial burden on patients
- Patients’ helplessness in the healthcare system
Exposure to death makes the greatest impact. And in oncology, exposure to death is inevitable.
Another point that stuck with me from this 2025 study is how our relationship with death in healthcare has shifted over time. The researchers pointed out that, historically, most people died at home, surrounded by family.
Now, thanks to medical advancements, death often happens in hospitals, in clinical spaces where nurses, not relatives, are the ones present at the very end. This means we’re facing death on the frontlines, rather than only seeing the aftermath.
Saying goodbye again and again
After five years at the bedside, there were many days when it felt like I was sending more patients to the morgue than home with their families. Some of these patients looked just like me or my family, young and otherwise healthy, if it weren’t for a terminal illness weighing on their shoulders.
Many of these patients were in and out of the hospital over several months, allowing us to get to know them and their loved ones as if they were our own family. As a result, nurses caring for these patients on a long-term basis are often witnesses to their death as well.
As their illness progresses, hospitalizations become more frequent, treatment options narrow, and suffering increases. For nurses, that means being present not just for one loss, but for many, often without the time or space to grieve before the next patient begins to decline.
Finding closeness in illness
I met many of my patients when they were dying. At the time, none of us knew. We didn’t realize that the erratic lab results, diffuse pain, and exorbitant fatigue were signs that the end of their cancer journey was nearing.
On admission, there were expected side effects of treatment or a short-term setback. We often didn’t see the magnitude of these symptoms and their meaning in terms of life expectancy until the reality was front and center.
In many instances, I had cared for these patients since their diagnosis, or maybe their relapse. I knew the names of the most important people in their lives, what they did for a career before cancer robbed them of it, and what mattered most to them as their whole life unraveled.
My relationship with some of my patients was sometimes more intimate than with my own friends and family. I couldn’t tell you the name of my mom’s favorite pet growing up, but I could absolutely tell you all about the 30-year-old feud between Mrs. Jones in bed 02 and her oldest sister.
Empathy helps us care, and resilience helps us survive
Empathy and resilience are two key factors in how we respond to frequent death exposures and how we grieve in the long term, according to the 2025 study I mentioned before. While high levels of empathy may work against our ability to grieve and experience short-term bereavement when we lose a patient, it also allows us to recognize the emotional needs of others during a time of change and defeat. It allows us to provide more compassionate, whole-person care for the patients who need it most
Similarly, resilience can act as a protective factor against the effects of long-term bereavement as it allows us to adapt to challenges and make sense of the concern at hand. While our empathetic response helps us to manage patient and family grief, it’s resilience that allows us to manage our own grief.
Navigating and finding support systems
Over the years, I collected enough grief to last a lifetime (or at least the length of my nursing career). It was difficult not to feel burned out some days, wanting so desperately to do anything to help your patients and knowing that you can’t. At least not in the way you planned to.
With minimal resources available to help cope, it was easy to feel drained at the end of each shift and forget all the good you did for everyone else. There are support systems out there, like employee assistance programs (EAPs), but most of us either don’t use them or don’t fully understand what they offer. In fact, one study pointed out that in 2018, only about 5.5% of healthcare workers used their workplace’s EAP, and by 2022, that number barely crept up to just under 10%.
Caring for ourselves must come first
My nursing career started in 2020 with the stress and anxiety following shortly after; however, it’s taken me until now to embrace therapy and prioritize my mental health.
Nursing is a stressful career. As healthcare workers, we’ve come to accept that stress, burnout, and grief are “just part of the job.” That mentality should no longer be tolerated.
Five years of caring for others during their worst days without considering my own needs took its toll. It’s something that I will forever remember but no longer tolerate. I will not grieve the loss of a great career, simply because I couldn’t learn how to effectively grieve my patients. Caring for others can be the greatest privilege, but only if we take care of ourselves first.
