Working Through Loss: A Critical Discourse Analysis of Physicians' Grief

Area of Science:

• Medical Humanities
• Qualitative Research
• Sociology of Health

Background:

• Grief is a universal human experience but often unspoken in professional settings, particularly within healthcare.
• Physicians frequently downplay their grief, viewing it as insignificant compared to patient suffering and influenced by professional norms.
• Societal discourses can contribute to the minimization of grief experienced by healthcare professionals.

Purpose of the Study:

• To examine how physicians narrate their grief experiences within clinical practice.
• To identify the discourses surrounding grief that are represented, enacted, and resisted by physicians.
• To understand the impact of professional norms and hierarchy on grief expression among physicians.

Main Methods:

• Qualitative study involving physicians (n=12) and residents (n=5) in Atlantic Canada.
• Two rounds of interviews conducted 6 months apart.
• Critical discourse analysis applied to interview transcripts to analyze language used to describe grief.

Main Results:

• Two dominant discursive framings of grief emerged: 'grief as interference' and 'grief as an invitation for meaning-making'.
• Physicians experienced tension and frustration when balancing grief with professional duties, while some found meaning and value shifts.
• Residents faced more challenges with grief expression boundaries, whereas experienced physicians felt more comfortable, framing grief as wisdom.

Conclusions:

• Physicians' framing of grief evolves with their career progression, influenced by status and hierarchy.
• Empowerment to engage in grief-positive discourse is linked to professional maturation and institutional factors.
• Developing 'grief literate' clinical environments through formal education and institutional support is crucial for physician well-being.