I’m not sure if you noticed my recent videos on the suspension of my license that I went through some 6 years ago. I lost my license for 4 months in 2017, and while it was reinstated and I’ve practiced nursing ever since, I’ve never fully recovered from that loss. Losing my license triggered a years-long emotional reaction that I’m still processing to this day.
In the mental health field, we talk quite a bit about loss, because loss is a hard reality that we all go through. The longer we live, the more losses we encounter. Getting through these losses is a dance we must learn how to master. Franklin D. Roosevelt’s quote may be one of my favorites – “a smooth sea never made a skilled sailor.” But in this current era of (insert anything you wish here, because I’m not quite sure how to describe the era we’re in), a blemish on my professional career was very hard to swallow.
In 1969, Swiss-American psychiatrist Elisabeth Kübler-Ross introduced us to the five stages of grief. While losing a license can’t quite be compared to losing a loved one, the psychological and emotional process of grief after loss seems to have a lot of the same undertones. Whether it’s losing someone to death, losing a relationship, losing a limb, being fired, or losing a license, different kinds of loss can trigger similar emotional reactions.
Elisabeth Kübler-Ross proposed that grief can often be broken down into these five distinct stages:
Denial: “This can’t be happening!”
Anger: “Why did this happen? Who is to blame?”
Bargaining: “Make this not happen and I will…”
Depression: “I can’t bear this; I’m too sad to do anything.”
Acceptance: “I acknowledge that this has happened, and I cannot change it.”
DENIAL: “This can’t be happening!”
In my case, at first, I tried emotionally denying that my license as a provider could be suspended. I was in shock and disbelief that anyone would want to prevent me from helping others, a job that I took very seriously. I’d heard of others whose licenses were suspended, but always thought of it as “they screwed up, they were bad people, they didn’t care enough about their job, they were lazy, they were uneducated, they were somebody else.” I didn’t feel as though any of these labels applied to me. If anything, I worked harder than anyone else! I was not lazy or uneducated, and I cared very much about my patients. As a result, the suspension of my license simply wasn’t something that could happen to me!
ANGER: “Why did this happen? Who is to blame?”
Once it sunk in that I was going to lose my license and lose my ability to help my patients, as well as lose the ability to support myself financially and pay my bills, I experienced anger. I felt a lot of anger at the healthcare system that sets a lot of providers up for failure. With the growing number of regulations, requirements, and changing laws, it’s extremely difficult to keep up and do everything that is required of one provider. Solo practitioners are also easier to attack, and because so many practitioners are focused solely on clinical care and helping their patients, they don’t have enough time to read the Ohio Revised Code. I felt anger that the system is not set up to identify these struggling providers and help them change for the better without an immediate suspension of their license. The Board of Nursing treated me as if I was a criminal because I committed administrative errors. I felt rejected, used, ashamed, angry, sad, depressed, and every other shade of terrible.
BARGAINING: “Make this not happen and I will…”
This stage can be a bit confusing to understand, but typically it involves internal and sometimes external bargaining. Following my suspension, I can remember going over the details of every patient interaction, every conversation I’d had, and all of my notes. I remember trying to read the Ohio Revised Code, becoming tired or discouraged because the language used for writing anything legal is confusing by design and difficult to understand. I remember feeling like I was all alone in dealing with all of this, and praying to God to help me get through this period of my life. I remember feeling like I was burning inside – feeling inadequate and trying to come up with what other things I could do in life if my ability to be a provider was permanently taken away from me.
DEPRESSION: “I can’t bear this; I’m too sad to do anything.”
I ate, but it didn’t feel like I was eating. I slept, but I didn’t feel like I was sleeping. I saw patients but it felt like an excruciating effort, because I was told by the authorities that I was “no good.” I don’t even think that the license suspension itself caused me the most grief, but rather the way the system was treating me, like I was a criminal. I kept reminding myself to just keep going forward, one foot in front of the other. No matter what happened, and no matter what others thought of me, I had to get through this. I lost weight, I lost trust in my profession, and while I didn’t want this to show in my care for patients, I’ve never been good at concealing my emotions, so I’m sorry to say that it did.
ACCEPTANCE: “I acknowledge that this has happened, and I cannot change it.”
Acceptance is described as a more positive stage, which occurs when a person comes to terms with their difficult circumstances, including both what happened and why it happened. While I completely acknowledge what happened and that I cannot change it, I’m not sure that I ever completely reached the acceptance stage of my journey. To me, acceptance symbolizes that I’m okay with what happened, and I don’t know that I am at this point. There are hundreds of resources set up to help patients get better, but somehow, we providers are expected to be more than human, and never make any mistakes. And when we do, it feels as though everyone rejects us and continues to punish us for the mistakes that we made. Right now, I’m not sure whether I’ll ever fully reach the acceptance stage, but believe me, I’m doing my very best. Perhaps the first stage to acceptance is being willing to talk about what happened, and I suppose it’s better late than never. This is my attempt to heal from this trauma and move forward.
How does one move forward after experiencing loss?
Whatever your loss may be, while no one’s experience and pain can be compared to yours, the overarching goal is to persevere through your grief. Understanding the stages of grief and your current place in the process can certainly help, but I think there are a few more things you can do.
Be patient – Getting through loss is challenging, and exercising patience with yourself is a must. In my case, the whole system told me that I was wrong, no good, and worthless. I had to be patient with myself, my emotions, and my human errors.
Be open – Sharing your grief, sadness, and feelings with others can be helpful and healing. While I did my fair share of confiding in those around me, I also withdrew and isolated myself at times because I felt ashamed of my mistakes. Do what you need to do at your own pace. If you need to withdraw for a period of time, that’s okay too. Just remember that you don’t need to go through everything alone, and that it’s okay to reach out to others when you feel ready for that.
Be loving – There’s an important concept known as “radical acceptance.” It’s something I practice with my patients. I believe that accepting people for who they are without judging them is the key to healing. It was hard for me to accept myself in my defeat. But despite the system telling me that I was no good, I decided to practice radical acceptance of myself. I practiced an “I love you” mantra every day, because I knew that the predicament that I was in required me to love myself even more than usual.
Be contemplative – Loss is something that we will all experience. If possible, it’s helpful to try and find something we can learn from the situation, or how we can best grow from it as human beings. Processing your experience, assimilating it, and making it a part of your story will help you to become a better person.
Be humorous – This can be difficult when you feel like you’re going through hell. If you aren’t quite ready to find humor in your situation just yet, try to find it when you are ready. Humor can help you to accept things and move on. In my case, I tried to laugh through the experience, but sometimes it would end in either sarcasm or tears. Sometimes allowing those feelings, whatever they are, can be necessary for moving on, so go ahead and let them flow. I love to laugh. I laugh, therefore I am.
Be spiritual – Experiencing loss can often leave us reflecting on the meaning of life. What is the meaning of my life? Why am I going through this? Will this pain ever end? Loss brings you closer to God. We spend a considerable amount of time in Western cultures trying to deny that God exists. But loss makes you more likely to search for a connection to your roots, and there is no better time to pray than when you feel all alone. God may not change your circumstances, but your belief and trust in something greater than yourself can be healing.
No matter what the circumstances or the kind of loss you’re experiencing, we are all in this together. May the Force be with you as you deal with these struggles, and whatever difficulties life happens to bring your way.