Chapter 4: Factors that impact grief

Rural and remote communities


“When you’re working in a small community with limited resources you just improvise or make do. COVID-19 has changed how we think about things and just how ill-prepared we might be if our community were hit all at once.” - Nurse in remote community 

Working in a remote or rural setting, there are additional factors that can add to grief, especially during the pandemic. Stressors related to human and medical resources; multiple layers of responsibility beyond your primary role; and the pressures of personal relationships with patients and families can amplify what you are feeling. Lack of supports for debriefing and counselling can make it increasingly difficult to attend to your grief.   


Challenges that impact grief


Limited resources

PPE, medications, and other medical supplies Lack of ventilation support Limited or no access to specialists such as respirologists and palliative care teams  Limited pool of trained staff for backup Lack of counselling and grief support

Few chances to debrief

Looking for ways to debrief can present a challenge.  There may not be another professional distant enough from you to see the problem objectively. 

Personal relationships
  • Pre-existing personal connections are common. You may have a longstanding relationship with a patient or family. You may be related or good friends, go to the same church, or play hockey together.
  • After a death, you may see the family in the day-to-day course of life. Depending on the outcome and the family’s expectations, this may be comforting or stressful.
Limited mutual support

Sharing may not be possible due to confidentiality.   Turning to colleagues may not be an option if the group of colleagues is small and they are also grieving.  


 What may help? 

  • Explore potential sources of mutual support in your community. Who is available to support you - another healthcare provider, a community or faith/spiritual leader?
  • Consider contacting healthcare providers in other communities who may be interested in connecting for mutual support via Skype, Facetime or Zoom.
  • Consider limiting your exposure to news.
  • Identify a grief counsellor who offers services via videoconferencing.
  • Access online resources for information and support. 
  • Consider joining or forming a Community of Practice, an online group of people who share your concerns or work in similar settings.