Excerpted from The Image, Deconstructed:

Photographer Alex Boerner:

There wasn't much complication in this situation, but I think that was because there was a lot of communication beforehand that everyone was comfortable. This assignment, in particular, was pretty straightforward. For both the nurse and for Marian, it was pretty much business as usual. Our presence didn't really change that dynamic.

In delicate situations, I think communication with the subjects is key. Discussing the reasons why you want to photograph someone is a good place to start. It lets people understand why they are important, what your ideas are and if possible, what the outcome might be in regards to publication (a lot of people ask me what I plan to do with the photos). If they are on board, then they become invested in the process and you have made a connection with them through that understanding. From there, the connection can deepen as you move forward. And if that foundation gets established, you will be more likely to work openly and discuss important developments.

And even if all of that foundation is in place, they may always change their mind or become uncomfortable. That's their right. It's their life and their story, but if you've built a relationship then you can appeal your case more effectively. This happened to me during another story. I got shut out at a critical time while photographing a woman who was pregnant and going through treatment for breast cancer simultaneously. She decided to go through with the pregnancy, despite the advice of some doctors. I was with the couple when she went into labor and was planning to photograph the birth when the mother changed her mind about me being in the delivery room with them. I was disappointed, but that's her right, however I remained at the hospital. Less than an hour after the birth, she began to feed her new daughter with her one remaining breast. I was outside the room, but able to convey the significance of the situation to her husband, who talked to her and then she let me in. I had a really good relationship with the husband and throughout the story, he and I talked about certain things that I photographed. I would like to think that those past discussions led to him having a better understanding of why it was important for me to be there after their daughter was delivered, since I couldn't be there during the delivery.

In addition, it's about building a rapport and trust. I try to be open about my personal life because this exchange is not a one-way street. I can't expect them to open up to me if I'm not willing or able to open up to them. Finding ways to connect helps build those trusting relationships that lead to more honest photos. Sometimes it comes easily and sometimes it can be difficult.

Learn more about Alex Boerner, his approach to photojournalism and how he made this picture on The Image, Deconstructed