title: Nurses' experiences providing bereavement follow-up: an exploratory study using feminist poststructuralism.
abstract: OBJECTIVE
  To describe the experiences of nurses who provided bereavement follow-up with families after the death of a child or a pregnancy loss and explore facilitators, barriers and challenges.
  
  
  BACKGROUND
  Bereavement follow-up after the death of a child has been identified as an indicator of quality end of life care by families and health care professionals. Research suggests communication with bereaved families can be challenging and intimidating for nurses, particularly those who have had limited experience. In-depth information about the personal, professional and institutional experiences of nurses providing this care is lacking.
  
  
  METHODS
  Eight registered nurses with experience in providing bereavement follow-up to families were interviewed. Purposive sampling provided information rich cases.
  
  
  METHODS
  Feminist poststructuralism was the guiding theory and methodology used to uncover underlying discourses. This methodology uses the concepts of discourse analysis, subjectivity and agency to enable a critical understanding of the relationships.
  
  
  RESULTS
  The nurses described complex interactions between themselves, the families, hospital practices and policy, and social norms around the discourses of death and professionalism. The importance of relationship, self-care and closure, professional boundaries, invisible nature of the practice and institutional support were prominent themes. Insights into the challenges and rewards of providing bereavement follow-up are discussed in the context of power relations, and recommendations for change are offered.
  
  
  CONCLUSIONS
  Nurses in the study were strongly committed to providing ongoing care to families who had experienced the death of a child or a pregnancy loss. Relationships were important to bereavement follow-up care, and the connections with families were often emotional for the nurses.
  
  
  CONCLUSIONS
  Nurses and other health professionals would benefit from increased support and education related to bereavement and communication with grieving families. Clarity related to institutional policies to support bereavement care is paramount in helping nurses and others in this work.
authors.affiliation: Pediatric Palliative Care Service, IWK Health Centre, Halifax, Nova Scotia and Adjunct Professor, Dalhousie University, Halifax, Nova Scotia, Canada. grace.macconnell@iwk.nshealth.ca
authors.forename: Grace
authors.initials: G
authors.lastname: MacConnell
authors.forename: Megan
authors.initials: M
authors.lastname: Aston
authors.forename: Pat
authors.initials: P
authors.lastname: Randel
authors.forename: Nick
authors.initials: N
authors.lastname: Zwaagstra
mesh_terms: D001293:Attitude to Death; D001601:Bereavement; D005260:Female; D019513:Feminism; D005500:Follow-Up Studies; D006801:Humans; D009740:Nursing Staff / Q000523:psychology*