Chapter 3: Grief and COVID-19

Unrecognized grief

What the grief expert says
Dr. Ken Doka, international grief expert, discusses the unrecognized grief people working in healthcare often experience. (3:22)Video transcript

“I read a quote recently - ‘some things can’t be fixed, they can only be carried’. Sometimes I wonder how much more I can carry with me.” – Emergency and on-call doctor

Grief for people working in healthcare is largely unacknowledged and unrecognized. This is known as disenfranchised or unrecognized grief.  This can occur when the grief a person is experiencing isn't recognized or validated. It may be a person, a workplace, a society or a culture that doesn't recognize the grief.  Unrecognized grief may also include:

  • Grief that is not death-related, such as financial loss, job loss, loss of the world as we know it
  • If the relationship between the person grieving and the deceased is not recognized or understood 

Health system barriers  

Grief is commonly under-recognized and unsupported in healthcare systems and settings. This is reinforced by:

  • Professional norms of practice - healthcare providers may think it is unprofessional to show grief
  • Health systems that don't make grief a priority- there is no time or space for employees to attend to their work-related grief
  • Lack of resources, including education and supports - lack of onsite counselling, a place to gather one's thoughts, onsite training and continuing education

Personal barriers

  • When we have experiences, thoughts, or feelings that our colleagues do not seem to have, it can create a barrier between us and them. This can add to a sense of isolation.
  • We may feel that our grief is ‘not like’ everyone else’s, leading us to question or doubt ourselves.  


In certain health systems, COVID-19 amplifies the likelihood of unrecognized grief as workloads increase due staff shortages, patient admissions, procedural changes, and often limited resources. It is difficult to process work-related grief when we are in survival mode.

Recognizing grief is the first step in learning how to move through grief.