What can help

Always tell the truth. Honesty is a vital ingredient and establishes trust in you as a member of the professional team. Tell parents everything you know about their child's death. Be honest about what you don't know. Suggest you can seek the information and make arrangements for relevant colleagues to speak to parents.

Expressing emotions

Give parents permission to talk about their feelings. As a professional, showing your emotions if you are truly sad is something parents appreciate. Don't hide your feelings to protect them. You are in a position of authority and your humanity gives their feelings validity. Some parents are unable to accept the sad news and may cope by denying it. Do be patient with parents as denial is a form of emotional protection which will disappear when an individual is ready. Everyone is on a different timetable; remember there is no right way to grieve. Very often parents' initial feelings of shock stop the expression of feelings. Withdrawing and being angry are also natural ways of expressing grief. However parents react, it is a normal reaction to an abnormal event.

Sensitivity to parents' needs

Refer to their child by name - this is just as important after death as before. Recognise that sometimes there will be a need to repeat the same explanation or information several different times. Parents under stress may only absorb a little of what you have explained. Allow enough time for parents to ask questions. Ask them to tell you what they have understood from you. In this way you can take responsibility for communication and be sure that what the parents heard and understood was correct. This is your responsibility as a professional, not the parents' responsibility.

Show parents you care

Touching is our most basic form of comfort and communication. Don't hold back if you want to put your hand on a parent's arm, or your arm around a parent's shoulder, or if you want to say "I'm sorry". Saying sorry doesn't mean you have done anything wrong. Be sensitive to where the need to touch may be yours and not what the parents want or need. The more self-aware we are as individuals, the more likely we are to provide parents with the care appropriate to their needs, recognising culturally what might be important to families. Don't 'hit and run'. If you break bad news, do not rush away. Let parents know when and where they will see you again and be specific regarding the place and time agreed.

For further useful information reference The Paediatric Intensive Care Society "Standards for Bereavement Care 2002" document which is available from www.ukpics.org