Nurses are trained to heal, comfort, and remain composed in the face of adversity, but there’s one form of emotional strain that often goes unnamed and unsupported: anticipatory grief.

Unlike traditional grief that follows a loss, anticipatory grief is the emotional process of mourning a future loss—a patient whose prognosis is terminal, a resident whose decline is inevitable, or even the slow, visible unraveling of a beloved colleague’s health.

This type of grief is especially prevalent among nurses working in hospice, oncology, long-term care, or intensive care settings. Over time, carrying the emotional burden of “what’s to come” can lead to chronic stress, emotional exhaustion, and burnout—yet it’s rarely acknowledged or addressed in training or workplace wellness programs.

A 2023 study published in Healthcare developed the Anticipatory Grief Counseling Competency Scale (AGCCS) to assess nurses’ abilities to support caregivers of terminal cancer patients. The study found that many nurses lacked the necessary competencies to effectively manage anticipatory grief, highlighting a gap in both education and practice.

Signs of Anticipatory Grief May Include:

• Heightened emotional sensitivity or irritability
• Difficulty detaching after a shift
• Repeated intrusive thoughts about a specific patient’s decline
• Guilt for “bracing” before a death occurs
• Physical symptoms such as fatigue or headaches

Why It Matters Now

In the wake of COVID-19 and continued staffing shortages, many nurses are encountering more deaths, more frequently—sometimes with less emotional processing time between. When anticipatory grief goes unaddressed, it compounds other mental health challenges, such as compassion fatigue or secondary trauma.

What Can Be Done?

• Naming it is the first step – Talk openly with colleagues and supervisors about the grief you’re experiencing before a loss occurs.
• Include it in wellness programming – WNA encourages healthcare systems to incorporate anticipatory grief awareness into mental health resources and debriefing sessions.
• Access counseling – Many employee assistance programs (EAPs) offer grief-specific therapy. Free and low-cost services can also be found via resources like Give an Hour or Psychology Today’s therapist finder.
• Peer support matters – Sometimes, another nurse who’s “been there” can make the biggest difference. Consider starting or joining peer-led support circles in your workplace.

At WNA, we believe a healthy nurse is not just physically well, but emotionally supported—and that includes grief, in all its forms. Recognizing and validating anticipatory grief is one more way we can help Wisconsin nurses feel visible, valued, and vital.