Nurses’ Experiences of End-of-life Photography in NICU Bereavement Support

PURPOSE: To qualitatively explore neonatal intensive care nurses’ experiences with end-of-life photography as part of their bereavement support work with families. DESIGN AND METHODS: An Interpretive Phenomenological Analysis with data collected through a focus group (n=6) and one semi-structured interview (n=1) with neonatal nurses from a Level 3/4 NICU in a Canadian pediatric hospital. RESULTS: Participants’ comfort with EOL photography developed over time through exposure to bereavement scenarios and positive experiences with families. Participants’ experienced a feeling of pressure to balance the photography with clinical responsibilities and find the right time to introduce photography while being sensitive to family experiences. Participants experienced EOL photography as something tangible to give families and were satisfied knowing the images might play an important role in the family’s healing after the NICU. CONCLUSIONS: All participants had come to value EOL photography as a positive and meaningful part of their work with bereaved families. Identified challenges related to balancing the practice with the unpredictable flow and demands of critical care and to developing an appreciation for and comfort with the photography as part of their healing and the families’ healing. PRACTICAL IMPLICATIONS: Findings contribute insight into care-provider experience that can inform best practices, training, and staff support for palliative and bereavement work in neonatal and pediatric settings. The findings suggest a need to support nurses emotionally and clinically in carrying out this photography as part of their care for families.