A: A listening presence is always best for grief. The death of a coworker is considered a "critical incident" in employee assistance program (EAP) language. Even when a coworker is a patient and dies, it has significant effects.

The sudden code while working constitutes an acute traumatic situation. The employee who witnessed it did quite well to maintain patient care and finish her shift. When the next shift came in, both their reactions and let down explains her feeling the heartbreak "all over again."

I would normalize the reaction and recommend the opportunity for intervention for all who wish to participate. Does the employer have an EAP the manager can call to assist the group, as well as individuals who might need to talk one-on-one or privately?

If no EAP is in place, then perhaps a hospital chaplain or resources outside the facility would work.  

--Kathryn Bishopric, MSW, RN, LCSW, BCD, CEAP

A: Experiencing sudden death in the workplace is traumatic. Each day you come to work, you are reminded of the event. Maintaining focus may be one of the more difficult effects to deal with. Feeling stunned and sad, you wonder how to get through the day.

To cope, take one step at a time; complete one task at time. Take a break if you feel you are distracted. If you need to step away, let someone know and take a few minutes to refocus.

In the days after the death, plan a gathering, separate from work time, to help coworkers discuss the death and their reactions. This group could be guided by the hospital's pastoral care department, EAP, counseling services or management.

A group of employees also could help plan a memorial or service to honor the coworker, which can help direct emotion in a way that gives meaning to the person's life. Some of the ways to memorialize could include an article in the hospital newsletter, a special service, a scholarship fund, dedication plaque, or tree or garden planting. 

--Debra Ciuba, RN

A: The characteristics, intensity and duration of grieving will be different for each of you. The suddenness of the death likely aroused feelings of helplessness and fear that sudden death could happen to others you care about and even to yourself.

Once the shock of the death begins to wear off, you will likely miss and long for the deceased and may regret you didn't have a chance to say good-bye, settle any old business or acknowledge caring for the deceased. Give yourselves permission to give and receive support from each other. Crying is normal and healing for some who grieve. Be kind to each other and yourselves as you cope with this sad event.

It would be great if you could help colleagues write a short vignette about the deceased and send it to the family. They would so appreciate it and the gesture will help you and your colleagues.

--Nancy S. Hogan, PhD, RN, FAAN

Our Panel

• Kathryn Bishopric is regional lifeworks program director at Baptist Health South Florida in Miami.
• Debra Ciuba is coordinator for psychiatric emergency services at Robert Wood Johnson University Hospital at Rahway (NJ).
• Dr. Nancy S. Hogan is distinguished professor and associate dean for research at the Niehoff School of Nursing, Loyola University, Chicago.