Resilience as a mediator between empathy and professional grief among nurses in high-mortality services

Background

Nurses working in high-mortality clinical services, such as intensive care, oncology, and palliative care units, frequently witness patient deaths. This repeated exposure places them at a high risk of bereavement reactions; however, limited research has explored how individual emotional traits, particularly empathy and resilience, shape this experience.

Aims

This study aimed to investigate the mediating role of resilience in the relationship between empathy and bereavement reactions—both short-term emotional reactions and long-term cumulative effects—among nurses working in high-mortality services.

Methods

A cross-sectional design was used. Data were collected online from 238 purposively sampled nurses working in a tertiary public hospital in northwestern Turkey. Standardized tools were used to measure empathy, resilience, and professional bereavement.

Results

Nurses reported moderate levels of bereavement reactions following patient deaths. Empathy was positively associated with both short-term bereavement reactions (β = 0.253, p = 0.001) and long-term cumulative effects (β = 0.359, p < 0.001). Resilience partially mediated these associations, reducing the impact of empathy on both short-term bereavement reactions (β = 0.071, 95 % CI [0.017, 0.133]) and long-term cumulative effects (β = 0.137, 95 % CI [0.084, 0.193]).

Conclusion

Nurses in high-mortality services are particularly vulnerable to experiencing bereavement. While higher empathy intensifies bereavement reactions, resilience plays a protective role. Interventions aimed at strengthening resilience may help mitigate the negative effects of bereavement and promote emotional well-being, job sustainability, and improved patient care outcomes in these emotionally demanding settings.