| Sumario: | The death of children in healthcare settings, particularly in oncology units, has profound, multifaceted, and emotionally distress impact on nurses. Implementing effective coping strategies is essential not only to improve the nurses' mental well-being but also to enhance the quality of nursing care. Therefore, this study aimed to investigate the coping strategies employed by nurses in response to the challenges arising from patient deaths in pediatric oncology units. This descriptive qualitative research utilized a conventional content analysis approach and was conducted in Iran between October 2023 and July 2024. Purposeful sampling was employed, and the process continued until data saturation was reached, which was achieved after 20 interviews. Initially, unstructured interviews and subsequently in-depth, semi-structured interviews with open-ended questions were conducted to gather information. Data analysis identified one main theme titled "coping". This overarching concept represents the participants' efforts to confront the challenges stemming from the death of their patients. This theme comprises five categories: "positive coping", "emotional expression", "avoidant behaviors", "seeking support", and "spirituality". The findings highlight the diverse and complex coping strategies used by pediatric oncology nurses to deal with patient loss. Gaining a deeper understanding of these coping mechanisms is crucial, as it can support efforts to promote nurses' psychological resilience and improve the quality of patient care. Support from healthcare policymakers and managers in developing tailored psychological, educational, and organizational interventions is essential to strengthen nurses' coping efforts. Such support can enhance the mental well-being of pediatric oncology nurses and ultimately contribute to improved care outcomes for both patients and their families. • The death of children in oncology units has profound and multifaceted effects on nurses. • Confronting the circumstances that arise during the end-of-life care and dying process prompts nurses to adopt coping strategies that can have psychological consequences and affect their professional performance. • Recognizing and supporting nurses' coping efforts can enhance their mental health and improve the quality of care in pediatric oncology.
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