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What to say to a bereaved colleague

How to offer support, bearing in mind variations in the ways faiths and cultures deal with loss

How to offer support, bearing in mind variations in the ways faiths and cultures deal with loss

  • Some nurses may have faced deaths among patients, colleagues and family members as a result of the pandemic
  • While there are universal needs at a time of loss, it’s important to consider differences in bereavement practices between individuals
  • How to support team members by showing understanding and compassion, but also bear in mind that ways of expressing grief vary

Many nurses will have experienced bereavement during the coronavirus pandemic, with those from black and minority ethnic communities disproportionately affected.

As well as the loss of family members, some staff have seen many

How to offer support, bearing in mind variations in the ways faiths and cultures deal with loss

  • Some nurses may have faced deaths among patients, colleagues and family members as a result of the pandemic
  • While there are universal needs at a time of loss, it’s important to consider differences in bereavement practices between individuals
  • How to support team members by showing understanding and compassion, but also bear in mind that ways of expressing grief vary
Picture: iStock

Many nurses will have experienced bereavement during the coronavirus pandemic, with those from black and minority ethnic communities disproportionately affected.

As well as the loss of family members, some staff have seen many patients die and others have lost colleagues. Furthermore, rules related to lockdown and social distancing have affected the way we mark someone’s death and how we grieve for that person or celebrate their life.

Grief is a unique experience for every individual

Knowing what to say to a colleague when they have lost someone can be difficult. How should managers and other staff respond to and support individuals, bearing in mind there are variations in the way different faiths and cultures deal with loss?

RCN professional lead for community and end of life care Carolyn Doyle says: ‘Grief is a unique experience for every person who is bereaved, and it is vital that employers and managers understand that. Treating someone with compassion and respect when they are grieving is something we would expect as a matter of course.

‘It’s important to appreciate that there may be specific rituals based on someone’s ethnicity or faith, and these must be considered. Many nursing staff will have experienced more death and dying than they ever have before, and managers must also allow them time to reflect and grieve.’

Advice on finding the right words and actions

A publication by Our NHS People suggests the size-limited funerals that have taken place during the pandemic mean there are likely to be many more memorial services in the year ahead.

The document, endorsed by the RCN and others, offers advice on finding the right words and actions when responding to staff who have lost someone. It highlights different faith and cultural practices and the importance of respecting those differences when offering support.

NHS Employers managing director Rebecca Smith says the pandemic has shown that taking religious and cultural beliefs into consideration is vital. ‘Staff will have preferences and needs that are specific to them when they face bereavement – something that, tragically, has become far more likely.

‘When contact with family and friends is limited, it’s even more important that line managers are aware of religious and cultural preferences and can support staff as much as possible.’

Advice on supporting bereaved colleagues

  • When a colleague informs you of a bereavement, express condolences and discuss bereavement or compassionate leave
  • Consider how much time the person may need to make arrangements or fulfil religious or cultural needs
  • Identify ways they would like you to keep in touch
  • Ask how much they would like you to tell other staff about their bereavement
  • When a colleague is ready to come back, consider a phased return and be open to flexible working
  • After a colleague returns, be sensitive to requests for further time off
  • Talk to the person about their well-being and check that any phased return or flexible hours suit them
  • Offer support where appropriate, but don’t be offended if further help is rejected
  • Signpost to additional support, such as occupational health or general practice, if appropriate
  • Remember that every emotion is normal – there is no right or wrong way to experience grief
  • Grief can endure and may be lifelong – remind yourself to check in with the bereaved person at intervals

Source: Our NHS People

Are there universal needs at a time of loss?

While respecting individual preferences, there are perhaps universal needs at a time of loss. What might a bereaved person be looking for most from managers and colleagues? Understanding and compassion, suggests hospital chaplain Rev Mark Stobert. ‘And I guess empathy.’

In his experience, most people who have lost someone reach a point where they are ready to return to work. ‘Work is the world they know to be still intact, and getting back to that is often important.’

But bereavement brings change, says Mr Stobert, who is lead chaplain at Cambridge University Hospitals NHS Foundation Trust and chair of the UK Board of Healthcare Chaplaincy. ‘When you come back to work you’re a slightly different person from the one who was bereaved in the first place.’

He uses the analogy of a snow globe. ‘When people have experienced some kind of trauma, and bereavement is one, the snowflakes get shaken up. They will come down, but slowly. And when they do, the scene that’s revealed is slightly different from the one before.’

An opening question: ‘How are you doing?’

So everyone – managers, colleagues and teams, as well as the bereaved person – has to adjust to that, he says. To anyone feeling unsure about what to say to a colleague recently bereaved, his advice is: ‘Just be brave. The opening question, I suppose, is “How are you doing?” Begin that process of ensuring they’ve got an open door.’

Project manager Amy Green, of bereavement charity Cruse Bereavement Care, says that often uncertainty over the right words causes some people to say nothing at all.

‘But it’s better to say something, even if it’s just a case of offering condolences and saying that if they need anything you’re there for them.’

‘Time heals’: what not to say

Avoid using cliches such as ‘I know how you feel’, ‘Time heals’ or ‘You’ll get over it.’ Simply saying, ‘I’ve been thinking of you’ is preferable, she suggests.

Mr Stobert stresses that managers should not feel that the burden of providing support rests solely on them. ‘A manager doesn’t need to do it all,’ he says. ‘As chaplains, we often get requests from managers saying, “One of my staff has come back. I wondered if you had a minute to come and say hi.” I would say to use us chaplains as a resource.’

Picture: iStock

Nor do managers need to know everything regarding the practices of different faiths. ‘Don’t assume, but always ask,’ says Mr Stobert. ‘Build a relationship with your staff around what’s important to them and what might help them in making the transition through this period in their life and back to work.’

Consider the wider impact on them and other team members

Ms Green encourages managers to consider the wider effects of bereavement on a staff member, both for that individual and the employing organisation. ‘Taking the bereavement into account, consider whether there will be an impact on performance and what that might mean for other members of the team.’

And be aware of changed circumstances for the bereaved person. For example, they might need to take on extra family care responsibilities because of their loss. It’s also important to remember that grief happens in many different ways, she says.

‘It’s unique to the individual, so not everyone will grieve the same. If someone comes back to work and they seem fine, that’s not to say they’re not grieving, they’re just doing it in their own way. Be respectful of that.’

Bereavement practices in different religions and cultures

Drawn from the Our NHS People document, the following is intended as a starting point to help line managers and colleagues consider how they can offer compassionate support to a bereaved staff member.

It is not an exhaustive guide, but reflects common practices in the religions or cultures most recorded in NHS staff data.

Buddhism

Many Buddhist funerals involve cremation rather than burial, but a natural burial, with an environmentally friendly return to the earth, is compatible with the Buddhist beliefs of samsara, the cycle of life.

Buddhists traditionally hold mourning services on the third, seventh, 49th and 100th day after the death of a loved one. Managers should take these dates into account, because Buddhist colleagues may wish to take compassionate leave on those days, as well as on the date of the funeral.

Christianity

Christianity has many different denominations, but broadly they are Catholic, Protestant and Orthodox. Funeral and bereavement practices vary across these groups.

The death of a Christian is regarded as the end of the person’s life on earth, and a funeral allows friends and family to grieve and give thanks for the individual’s life.

In Orthodoxy, cremation is not permitted and burial takes place as soon as reasonably possible after death. There are also variations in mourning. In the Orthodox church the full mourning period can last for 40 days. Line managers should communicate with bereaved Christian colleagues to learn and understand their practices and the best way to offer support.

Hinduism

In Hinduism, cremation is carried out as soon as possible after death and preferably within 24 hours. This is so that the soul can find a new body to inhabit, as Hindus believe in reincarnation. Ritual bhajans – hymns and songs of praise – continue for 13 days after cremation.

In India, the day after a Hindu funeral the ashes are scattered in the Ganges or the nearest river. Line managers should bear in mind that a Hindu colleague may wish to travel to India, when restrictions allow, to repatriate ashes and to grieve with other family members.

Hindu men traditionally do not shave until after the funeral.

Islam

Islamic funeral arrangements begin immediately after death, and the deceased should be buried as soon as possible. Selected relatives and community members will wash and shroud the body. Cremation is forbidden.

The mourning period can extend for up to 40 days, but may vary depending on the family and regional customs.

There will be variations in how Muslim staff members choose to mourn and managers should be aware of this. Some Muslim women may attend work in black mourning clothes for 40 days after a loved one’s death. They may also not wish to speak to any male, single colleagues during this period.

Judaism

The funeral will usually take place within 24 hours of death. During Shiva, the first period of mourning in the seven days after the funeral, family members will not work.

Jewish people do not traditionally send flowers to funerals. If line managers are considering sending condolences they should be aware that the family may instead suggest a charity to which donations, or tzedakah, can be sent.

Mourners will attend their synagogue on the anniversary of the death in remembrance of the individual and on various religious days, such as Yom Kippur. They may wish to take compassionate leave on those occasions.

Sikhism

In Sikhism, the time and place of the mourning period is determined by the immediate family – starting on the day of death.

Line managers should be mindful that the mourning period can range from five to 14 days, depending on the date of death, until the day after the cremation. During this period the deceased’s immediate family members have prayers, either at home or a gurudwara, a Sikh place of worship, where family attendance is compulsory.

If sending condolences to the family, Sikh funeral flowers are typically orange and white chrysanthemums, which are mourning blooms in India and in many parts of Asia.

Atheist, agnostic or humanist

Staff who do not identify with a particular religion may consider themselves:

Atheist – they do not believe or have little belief in God.

Agnostic – they are unsure of their beliefs or believe we cannot know definitively if there is a God.

Humanist – those who believe that human experience and rational thinking provide the only source of knowledge and a moral code to live by.

Funeral practices will vary for those who identify as one of the above and managers are encouraged to offer compassionate support without questioning the person’s beliefs. If colleagues have declined bereavement leave it is still appropriate to check in with them and give appropriate support.

Other cultural practices

Nine-Nights is a tradition among some Caribbean and West Indian cultures of holding an extended wake.

Friends and family are invited to view the body and pay their respects. Nine-Nights is often seen as a community event with music, games, stories and sharing of traditional foods.

The Day of the Dead is an annual holiday observed throughout Mexico and by people of Mexican heritage. It is marked by festivities and prayers, offering a time to remember and celebrate friends or family who have died.

Other cultural beliefs

Nursing staff from the Philippines, along with other colleagues from minority ethnic backgrounds, have been disproportionately affected by COVID-19.

As with other religions and cultures, there are variances in bereavement practices across the Philippines. Many Filipinos are Catholic, and a typical Filipino funeral will be preceded by a wake lasting three to seven days, allowing family members living far away time to travel.

Immediate family members will not work during this period and will continue to mourn the deceased for a long period after the funeral.



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