The Cost of Compassion: A Grief Counselor in NYC on Burnout and Loss in Healthcare Professions

Healthcare is one of the fastest-growing industries in the U.S., especially for new graduates. According to the U.S. Bureau of Labor Statistics, employment in healthcare occupations is projected to grow 13% from 2021 to 2031, much faster than the average for all occupations. This growth is driven by many factors: a population that’s living longer, expanded access to healthcare, and increasing interest in holistic wellness. For many entering the workforce during a time of economic uncertainty, healthcare offers stability, specialization, and the chance to build a meaningful, long-term career.

But this comes at a cost. I’ve worked in healthcare settings for over a decade, including two hospital systems, in both direct clinical and leadership roles. And like many others, I’ve experienced the weight of grief in this work. I’ve grieved patients. I’ve grieved a coworker. I’ve supported teammates and staff who were grieving. I’ve navigated personal loss while still expected to show up and provide care for others. And these are just the literal deaths, there’s also grief around layoffs, broken systems, and environmental loss. When I was an intern at Bellevue Hospital, I was there when it flooded during Hurricane Sandy. It was the first time in its 275-year history that it closed. I still remember the eerie visual of the National Guard transporting patients to other facilities and the ad-hoc clinic we created in the lobby.

Of course, not every role in healthcare involves direct patient care. Many work in administration, operations, or support services. But whether you’re on the frontlines or behind the scenes, healthcare is ultimately the business of people’s lives and deaths. Even if you're not in the room when it happens, you’re part of the system that responds to it. Grief is woven into the fabric of the field, even when it's not acknowledged.

When I was training and later working in the psychiatric emergency room at Bellevue, I remember coming home from long, intense shifts and just sitting on my couch, feeling my heart race. I’d think, “Why do I feel so anxious? Everything’s fine now.” It took me years to understand that my nervous system was still in a state of high alert. The environment I worked in daily was chaotic, unpredictable, and often traumatic. It wasn’t something I could just turn off at the end of a shift.

Working in healthcare requires patience (not just patients) and deep wells of empathy. Now, in my private practice as a grief therapist, I support many people who work in healthcare. They come to me overwhelmed, depleted and unsure how much longer they can sustain this level of giving. The cost of compassion is real. Burnout is rampant. Vicarious trauma and compassion fatigue are deeply felt.

Physicians have some of the highest burnout rates across professions. Nurses and social workers face similar pressures, with usually much less appreciation and acknowledgement. Add to that the expectations outside of work (family responsibilities and grief that’s unfolding in their personal lives) and it becomes nearly impossible to hold it all. The COVID-19 pandemic laid these truths bare. It pushed healthcare professionals to their limits while shining a national spotlight on their collective grief and exhaustion.

And yet, the systems we work within rarely make space for grief. Bereavement leave is typically just three days for only those who HR deems have the closest relationships. There’s no standard protocol for how staff should process the death of a patient. When I worked at Mount Sinai, a fellow supervisor and I started holding voluntary group supervision sessions anytime there was a particularly impactful patient death. We recognized the need for a pause, a moment to acknowledge and reflect. But those sessions were the exception, not the rule. More often, it’s back to business as usual.

What happens when you’re grieving something outside of work? Some people struggle to meet expectations, while others use work to compartmentalize their pain. That can be useful in the short term, but it can also become avoidant – another way to push feelings down in order to keep functioning. Grief doesn’t clock out. And the people who work in healthcare who are trained to be composed, competent, and self-sacrificing are often the ones least supported when they’re hurting.

Ari Simon, who has worked in civic and constituent-facing roles, writes:
"Loss—defined broadly—is an inevitable experience and can cause us great pain. When we tend to loss, nurture each other through grief, and transform systems that perpetuate loss, we suffer less and carry forward better. Now more than ever, effective leadership requires competence and confidence in how to be supportive in the face of grief and loss."

It’s time we build workplaces that reflect this wisdom where tending to grief isn’t seen as optional, but essential. Where leadership models vulnerability and healing, not just resilience.

If you work in healthcare and you’re grieving – whether it’s the loss of a person, a dream, a system, or simply your own capacity – I see you. And your grief deserves space.

Natalie Greenberg, LCSW, is a dedicated grief therapist based in New York City, specializing in helping young adults navigate the complexities of loss. After experiencing the profound impact of her mother's death by suicide at 23, Natalie found healing through therapy and support groups, inspiring her to guide others through their unique grief journeys. She earned her Master's in Social Work from New York University and holds a post-master's certificate in Cognitive Behavioral Therapy. With over a decade of professional experience, including roles at Bellevue Hospital's Psychiatric Emergency Room, Mount Sinai Hospital's leadership team and New York University’s Student Health Center, Natalie brings a wealth of knowledge, empathy and humor to her practice. She currently offers virtual therapy sessions, providing accessible support to clients throughout New York.