“Wrapped in Their Arms”

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Abstract
Family presence is a vital component of quality end-of-life (EOL) care. We conducted face-to-face, in-depth interviews with next-of-kin of deceased veterans to explore perceptions of how hospital nursing staff supported and facilitated family presence during the actively dying phase, at the time of death, and immediately following the patient’s death. We used content analysis to examine respondents’ accounts of the role of nursing staff in fostering and sustaining family presence in the hospital setting. We provide exemplary quotes to contextualize nursing staff behaviors that encouraged, supported, and guided families, enabling them to be present and to function adaptively before, during, and after the loved one’s death. In particular, we focus on nursing behaviors that were responsive to family members’ needs for information, privacy, intimacy, physical comfort, and emotional reassurance. Nurses’ effectiveness in optimizing family support required clinical competency in recognizing the actively dying phase of life and engaging in behaviors that facilitated the delivery EOL care, with thoughtful attention to family needs.

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