Memory Boxes: Helping Nurses Grieve

The death of a loved one can be difficult at any age, but it is often said that parents should not have to bury their children.

When a child dies, it is never looked at as a normal occurrence of life and may be traumatic for both caregivers and family alike.

Grief is a difficult journey for those left behind.

Pediatric and neonatal nurses have the potential to be exposed to multiple losses throughout their career. With each loss grief has the potential to compound itself as nurses have little time to cope with their own pain and sadness.

Nurses have found that creating a memory box can be a supportive and a positive avenue to deal with their own immediate grief over the death of a child. A memory box is a container that holds physical reminders of a child’s life.

Creating a memory box will promote communication with the family, validates the life of that child, and facilitates closure during a difficult time.

As professionals, nurses must be available to provide comfort and support for the family.

Nurses want to do a “good job” for the family and making the memory box helps to show that compassion and caring does not stop when the heartbeat does.

Symbolic Contents

The ritual of creating the memory box empowers the nurse to begin closure.

When the family leaves the hospital without their child, the memory box serves as a physical object to symbolize the life lost.

Nurses are aware that the memory box will be available to provide comfort and solace to families when confronted with life’s milestones, like birthdays, proms, graduations and weddings.

The contents vary with each box as nurses individualize the memories of each child. Commonly the memory box will hold:

  • photographs of the child;
  • a lock of hair;
  • clay or painted handprints / footprints;
  • an EKG strip symbolizing the memory of the heartbeat;
  • a blanket;
  • hospital ID bracelet; and
  • supportive materials on dealing with grief.

Click to view larger graphic.


Memory Box Survey

It is well studied that memory boxes provide comfort for grieving families.1-3

However, during our literature review, there was no mention of nurses’ grief in relation to the memory box.

The purpose of our survey was to explore the nurses’ perception of the act of preparing and giving of a memory box in regards to their feelings of grief.

We conducted a survey consisting of 32 pediatric and neonatal nurses practicing at two tertiary care facilities. Of the participants, 30 were female and 2 were male.

Our survey asked for demographic data related to years of experience as a registered nurse. Groupings included less than 5 years, 5-10 years, and greater than 10 years. This demographic question was asked to determine if years of practice correlated with a difference in perspective.

It was reported by 83 percent of all the sampled nurses that the preparing and giving of a memory box provided the nurse with a compassionate and caring gesture that bridged the communication gap with the family.

Collectively, 86 percent agreed that the memory box allowed the nurse to acknowledge her own feelings of sadness and grief. Further analysis revealed that 81 percent of the 32 nurses agreed that the memory box facilitated a sense of closure for the nurse.

When comparing the 3 groups, nurses with greater than 10 years of experience overwhelmingly felt that the memory box was helpful in all categories.

My name is Grace
I was born into the world
My life was short but full of love and joy
The passionate care I received provided me comfort
My family is crying; the Doctor is talking with them
They do not want to leave me
The Nurse is coming toward my family
There is a beautiful box in the nurse’s hand
Is it a gift?
The Nurse explains it is a Memory Box, which contains my footprints, lock of hair, and blanket
My family is clutching the box and holding it close to them
I am at peace as they are taking memories of me home with them
I will be with them – Always!

For further analysis of the survey data, see the Figure above.


Nursing Implications

When a child dies, so dies the dreams of a family.3

When a child dies in the care of a nurse, the nurse feels sadness and a sense of helplessness.

The memory box provides the nurse a creative outlet to continue to express their caring and compassion. Only then are they able to begin their own journey through grief’s emotions, as nurses never forget.

One of the implications for nurses is that creating memory boxes is an innovative tool that can be retrieved from their essential toolbox after the death of a child.

Nurses are known for going above and beyond to provide empathy and support for families.


Although the memory box is made for the grieving family, our survey demonstrated the act of creating a memory box is an avenue for the nurse to begin closure and deal with their sadness and grief.


Memory boxes would be a supportive addition to pediatric or neonatal bereavement programs, benefiting both families and nurses.


South American Connection

During a study abroad program in November 2011, we traveled to Santa Catarina and Rio De Janeiro, Brazil as Master Degree students from the University of Hartford in West Hartford, Connecticut.


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Our objective was to partner in a research project with Brazilian advance practice nurses.


In Santa Catarina we recognized there was no structured bereavement program in place on their pediatric or neonatal units. And so we used our memory box survey was to determine the cultural interest.

The Brazilian nurses surveyed were in agreement that the memory box would facilitate communication, provide closure, and help deal with the sadness of the situation, which aligned with the nurses surveyed back home in the U.S.

In response to the results, we are currently building a partnership with nurses in Florianopolis, Santa Catarina, Brazil, to introduce the concept of memory boxes into their pediatric intensive care bereavement program.

As one of the Brazilian nurses surveyed stated: “It is a way to say ‘good-bye.'”

References for this article can be accessed by clicking here.

Karri Davis, Kim Trotta and Erin Roland are affiliated with the University of Hartford in Connecticut. Patricia Kuerten Rocha is from Universidade Federal de Santa Catarina, Brazil.

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