Understanding Grief: A Component of Neonatal Palliative Care

Tricia L. Romesberg, MSN, CNNP


Journal of Hospice and Palliative Nursing. 2004;6(3) 

In This Article

Abstract and Introduction

The death of an infant is devastating, and the grief that surrounds the loss is a journey. Healthcare professionals often struggle to accept that death is inevitable and families often struggle to maintain hope against all odds. Understanding grief and offering bereavement support are key components to providing beneficent neonatal palliative care.

Technological advances have provided extended longevity for many patients, which frequently results in a prolonged dying process.[1] The ramifications of this situation are poignantly stated in the following quotation:

My hope is that it won't be the epitaph of our generation that people will say: Here was a community which developed the most amazing, dazzling fields of science and yet proved themselves so indifferent or incompetent, that they didn't address the serious social and ethical consequences of what they were up to. [2(p674)]

Although death in old age is much more common in the United States than death in childhood, approximately half of all childhood deaths occur during infancy. The death of a child is often regarded as the most painful, stressful, and enduring bereavement experience.[3,4] As parents are confronted with the grief following the loss of a baby, they also face the difficult tasks of giving meaning to a very short life, assigning an identity to who this person was and would have been, and redefining their own identities as parents.[5] Bereavement support is considered an integral part of palliative care and serves to support families before, during, and after the death of an infant.[6] Consequently, healthcare professionals must be prepared to assist families throughout the grieving process and accept the transition from the role of hero to the role of witness.[7] It has been said that "Our care [as nurses] is life-changing, even when life is lost."[8(p35)]


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