Abstract
This study explores school nurses’ experiences of supporting children grieving the death of a family member. Using a mixed-methods approach, 62 school nurses shared their perspectives through a web-based survey. The central theme, Creating security for the child, was explored through two domains: Security for the school nurse (confidence in the meeting and team support) and Security for the child (providing a safe environment and being present). Most respondents had prior experience of supporting bereaved children and felt secure in their professional role. Findings emphasise the importance of normality, accessibility, and collaboration to ensure schools remain safe spaces for grieving children.
Connection to nursing theory, practice, and research
The findings align with holistic nursing principles, particularly Dossey’s theory, which highlights the nurse’s role in promoting healing through presence and patterns of knowing (Garmy et al., 2021). For Specialist Community Public Health Nurses (SCPHN) school nurses in the United Kingdom (UK), these insights are highly relevant. Grief can mask safeguarding concerns such as self-harm, substance misuse or withdrawal from education (Farella Guzzo and Gobbi, 2023; Hoffmann et al., 2018;). Creating emotional security is therefore integral to safeguarding practice. McManus and Paul (2019) noted that bereavement is often a taboo in schools, leaving staff hesitant to engage. Their findings show that targeted training can break this barrier and build confidence, reinforcing the need for proactive, trauma-informed approaches alongside holistic nursing principles.
These findings resonate with me personally. My mother died when I was 6 years old, and throughout my childhood, I received no structured support for my grief. This absence of care highlights the critical role school nurses can play in ensuring that children do not feel isolated during such life-changing events. Reflecting on this experience reinforces the importance of creating security and normality for bereaved children, as described in the study, and underscores why proactive, trauma-informed approaches are essential.
Developmental theory offers further insight. According to Erikson (1968, cited by Orenstein and Lewis, 2021), adolescence is a critical stage of identity formation, and bereavement can disrupt this process. Bronfenbrenner’s bioecological model (in Brofenbrenner and Evans 2000) reminds us that grief reverberates across multiple systems – family, school, peers – requiring holistic, multi-agency support. Our recent case study (Wason and Hayward, 2025) demonstrated how therapeutic relationships and person-centred care enable adolescents to manage anxiety and regain a sense of control. Techniques such as mindfulness and breathing exercises can support emotional regulation (Gitler et al., 2025) while respecting adolescents’ autonomy over disclosure helps maintain dignity and reduce isolation (Lytje, 2018).
Practical implications
The study’s findings have clear implications for practice, education and policy. For school nurses, adopting a trauma-informed approach is essential when supporting bereaved children. This includes being visible and accessible, offering flexible support and creating spaces where children feel safe to express their emotions. Simple strategies such as normalising feelings, providing opportunities for quiet reflection and maintaining routines that promote health can make a meaningful difference (Riely, 2003). Training evidence suggests simple strategies, such as using clear language, acknowledging death explicitly, and preparing for a child’s return, are effective in reducing isolation and promoting emotional security (McManus and Paul, 2019).
Education and training must also reflect the reality that grief is a common experience among school-aged children. According to Child Bereavement UK (2022), approximately 46,300 dependent children lose a parent each year, around 127 every day, and 1 in 29 children aged 5–16 has been bereaved of a parent or sibling. Winston’s Wish (2024) further estimates that 1 in 20 children will lose a parent by age 16, and surveys suggest that up to 78% of 11–16-year-olds have experienced the death of a close relative or friend. Evidence from recent UK research highlights that almost all children will experience bereavement by age 16, yet grief education is rarely included in the curriculum (Dawson et al., 2023). The Marie Curie Report (Goss et al., 2024) and the UK Commission on Bereavement (2022) call for statutory grief education and whole-school bereavement protocols. Penny (2018) advocated a spiral approach within Personal, Social, Health and Economic education (PSHE) and Relationships and Sex Education (RSE) to normalise conversations and reduce stigma. McManus and Paul (2019) demonstrated that even short training significantly improves confidence, supporting calls to embed grief education in SCPHN programmes and ongoing professional development.
Policy and collaboration are equally important. Schools should have clear bereavement protocols and strong communication pathways between health and education professionals. Multi-agency safeguarding partnerships must recognise grief as a potential vulnerability and respond with coordinated support. International models, such as Denmark’s bereavement response plans (Wardley, 2022) and global guidance from World Health Organization (2025) highlight the value of structured school-based approaches and social-emotional learning programmes to support child mental health. Children benefit most when schools provide continuity, normality, and opportunities for peer connection (Lytje, 2018). For adolescents, targeted mental health interventions may prevent long-term consequences such as depression or risk-taking behaviours (Melhem et al., 2011; Wason and Hayward, 2025).
Closing reflection
This study reinforces the vital role of school nurses in mitigating the impact of grief on children’s health and education. By embedding bereavement support within holistic, safeguarding-oriented practice, school nurses can help grieving children feel seen, secure, and supported. UK policy reports and national recommendations highlight grief education as a priority for reducing inequalities in support. Evidence shows that targeted training and clear policies break taboos and build confidence, strengthening whole-school approaches. These interventions would ensure that children receive consistent, proactive care rather than relying on chance or individual goodwill. Further research should explore UK-specific contexts, evaluate curriculum-based grief education and examine how multi-agency partnerships can better address the emotional and safeguarding needs of bereaved children, while recognising the potential for resilience and post-traumatic growth when support is timely and person-centred.
