Introduction
The death of a family member usually leaves the surviving relatives with heavy emotional loads. Considering the high frequency of grief and loss, nurses in specialized settings, like emergency departments (EDs), are therefore required to be adequately prepared to fulfill their supportive responsibilities effectively. It is also vital to incorporate into nursing care the provision of empathetic support to families grieving the loss of a family member. Unfortunately, nurses have been found to prioritize patient care over the concerns and needs of families, as evidenced by numerous research studies (Hsiao et al., 2017; Özlü & Yildirim, 2018). Evidence also suggests that nurses, in particular, may not be fully aware of the grieving process that families go through (Ito et al., 2021).

Barriers faced by nurses 
The nurses may face significant barriers even if they believe that providing emotional support to grieving families is frequently of great value. The attributes of the nurses, the causes of mortality, the available resources, and the ED culture are some examples of such barriers (Aquino et al., 2022). The psychological distress and logistical challenges that they may face when working in acute hospital settings without sufficient workplace support were highlighted in an integrative review (Meller et al., 2019). For example, adverse personal and professional repercussions might occur because of such circumstances (Meller et al., 2019). This condition nevertheless solicits several considerations, such as how best to assist grieving family members after an emergency-related fatality.

The way forward 
Each family has different physiological, psychological, and emotional reactions to seriously ill family members in the emergency room and needs time to grieve. Thus, nurses must understand and adapt to families’ unique needs. This status includes how culture and healthcare affect family reactions. Although it may be challenging to offer comprehensive family support, even small acts of kindness, compassion, and empathy can make a big difference. Families may significantly lessen their grief by acknowledging what happened and seeing if more efforts can be taken to provide more comfort during this crucial period. Furthermore, open, honest, and prompt communication between the patient, family, and healthcare professionals was deemed the best way to navigate the grief process. Families could be encouraged to ask questions while expressing their thoughts (Giles et al., 2019). Nurses may also find utilizing the six steps of SPIKES (setting, perception, invitation or information, knowledge, empathy, and summarize or strategize) protocol helpful when engaging with bereaved families (Baile et al., 2000). Family members also lauded the ED nurses for their information-giving or communication, for humanizing death in emergency services, and for their professional judgment in the caring component (Berbís-Morelló et al., 2019).
In summary, one of the most essential roles of ED nurses is to provide prompt, proactive emotional support and care, especially in a specialized environment like ED. Death can be viewed as a progressive phenomenon that will enable the patient and their family to receive vital care at every stage of the patient’s final journey. Together with the patients, families need professional care as part of the dying process to avoid a further maladaptive grief process. Protecting the above-mentioned is crucial to lessen the pain these families may go through when they are grieving. Through empathetic care, ED nurses can assist families in traversing this challenging time by providing and facilitating the most appropriate and timely resources and support possible.

Ethical Considerations

Compliance with ethical guidelines
The paper is based only on the authors’ reflections and does not include hospital data.

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.

Authors' contributions
All authors read and approved the final manuscript.

Conflict of interest
The authors declared no conflict of interest.




References  

Aquino, J., Crilly, J. & Ranse, K., 2022. The end-of-life care practices of emergency care nurses and the factors that influence these practices: An integrative review. International Emergency Nursing, 63, pp. 101168. [DOI:10.1016/j.ienj.2022.101168] [PMID]

Baile, W. F., et al., 2000. SPIKES-A six-step protocol for delivering bad news: Application to the patient with cancer. The Oncologist, 5(4), pp. 302-11. [DOI:10.1634/theoncologist.5-4-302] [PMID]

Berbís-Morelló, C., et al., 2019. Exploring family members’ experiences during a death process in the emergency department: A grounded theory study. Journal of Clinical Nursing, 28(15-16), pp. 2790-800. [DOI:10.1111/jocn.14514] [PMID]

Giles, T. M., et al., 2019. Nurses’ perceptions and experiences of caring for patients who die in the emergency department setting. International Emergency Nursing, 47, pp. 100789.   [DOI:10.1016/j.ienj.2019.100789] [PMID]

Hsiao, P. R., et al., 2017. Family needs of critically ill patients in the emergency department. International Emergency Nursing, 30, pp. 3-8. [DOI:10.1016/j.ienj.2016.05.002] [PMID]

Ito, Y., Tsubaki, M. & Kobayashi, M., 2022. Families’ experiences of grief and bereavement in the emergency department: A scoping review. Japan Journal of Nursing Science, 19(1), pp. e12451. [DOI:10.1111/jjns.12451] [PMID]

Meller, N., et al., 2019. Grief experiences of nurses after the death of an adult patient in an acute hospital setting: An integrative review of literature. Collegian, 26(2), pp. 302-10. [DOI:10.1016/j.colegn.2018.07.011]

Yildirim, T. & Özlü, Z. K., 2018. Needs of critically ill patients› relatives in emergency departments. Nursing and Midwifery Studies, 7(1), pp. 33-8. [Link]