Experiences of NICU Nurses Facing Perinatal Death: A Phenomenological Study

Background: Perinatal death in Neonatal Intensive Care Units (NICUs) represents one of the most emotionally challenging experiences for nurses. While parental bereavement has been widely studied, nurses' experiences in neonatal end-of-life care remain insufficiently explored. Objective: To explore the experiences of NICU nurses facing perinatal death, focusing on emotional, professional, and institutional dimensions of care. Methods: A qualitative study with a hermeneutic phenomenological approach was conducted through ten semi-structured interviews with NICU nurses in a tertiary-level hospital in Spain. Data were analyzed using reflexive thematic analysis supported by NVivo 15. Results: Seven main themes were identified: emotional responses, therapeutic bond, coping strategies, perceived institutional support, training needs, infrastructure and humanization, and professional repercussions. Nurses reported intense emotional responses, including sadness, guilt, moral distress, and perceived failure, particularly in cases of prolonged hospitalization or unexpected death. Peer support emerged as a key protective factor, whereas the lack of formal psychological support and adequate infrastructural conditions were identified as significant gaps. Conclusions: Strengthening institutional support for NICU nurses through structured debriefing, accessible psychological services, targeted training in neonatal palliative care, and improved care environments may enhance their well-being and resilience, contributing to sustainable and compassionate clinical practice.