Nurses' experiences, coping and support in the death of a child in the emergency department: A qualitative descriptive study

"Even though it is difficult, …, is truly worth everything": A qualitative study on pediatric nurses' end of life care experiences

PURPOSE

This study explores the end-of-life care experiences of pediatric nurses in Turkey.

METHOD

This study was conducted using the phenomenology design, one of the qualitative research designs. A total of 20 nurses participated in the study, which utilized purposive and snowball sampling methods, including two pilot interviews.

RESULTS

The analysis revealed four categories: (1) the ideal pediatric nurse, (2) caring for a child at the end of life, (3) effects of pediatric end-of-life care, and (4) requirements for ideal pediatric end-of-life care. Within the scope of these categories, the characteristics of an ideal pediatric nurse, the stages and difficulties of end-of-life care, the effects on nurses, and the necessary actions to be taken to improve the quality of care and to strengthen the mental health of pediatric nurses were discussed.

CONCLUSION

This study highlights the growth that pediatric nurses experience despite the challenges they face in end-of-life care and sheds light on potential actions to improve the quality of end-of-life care and empower pediatric nurses.

IMPLICATIONS FOR PRACTICE

Professional training, psychosocial support, and ethical guidance should be provided to pediatric nurses during the end-of-life care process.

Bereavement coping strategies among healthcare professionals: A qualitative systematic review and meta-synthesis

OBJECTIVES

Coping with a patient's death is one of the most challenging events faced by healthcare professionals in clinical practice. A broad understanding of the coping strategies used by healthcare professionals is fundamental to the development of effective interventions and the provision of good bereavement care. This review aims to systematically synthesize the coping experience of healthcare professionals in the course of their work when they are confronted with patient deaths.

METHODS

PubMed, Embase, ScienceDirect, CINAHL, PsycINFO, Web of Science, Cochrane Library, Scopus, and Wiley online library were searched in April 2023 with no restriction on publication date. A 3-stage thematic synthesis method was applied for data integration and analysis.

RESULTS

Thirty studies involving 545 participants met the inclusion criteria and scored a high level on quality assessment ranging from 9.0 to 10.0. Six themes were identified: emotional coping, cognitive coping, behavioral coping, relational coping, spiritual coping, and occupational coping.

SIGNIFICANCE OF THE RESULTS

Overall, the coping strategies used by healthcare professionals in response to bereavement were found to be unique and multidimensional. Understanding how healthcare practitioners use emotional, cognitive, behavioral, relational, spiritual, and professional strategies to cope with bereavement will prove extremely beneficial in helping them to manage their grief, and can furthermore promote their professional growth and ensure the provision of excellent bereavement care for patients.

An Exploratory Study of ICU Pediatric Nurses' Feelings and Coping Strategies after Experiencing Children Death

BACKGROUND

This study aims to explore the feelings and experiences of nursing staff when faced with the death of a pediatric patient in the ICU.

METHODOLOGY

A qualitative study based on hermeneutic phenomenology was conducted through semi-structured interviews. Ten nurses (30% of staff) from the Pediatric Intensive Care Unit of a referral hospital were interviewed in April 2022. Text transcripts were analysed using latent content analysis.

RESULTS

Content analysis indicated that the interviewees had feelings of sadness and grief; they had a misconception of empathy. They had no structured coping strategies, and those they practiced were learned through personal experience, not by specific training; they reported coping strategies such as peer support, physical exercise, or strengthening ties with close family members, especially their children. The lack of skills to cope with the death and the absence of support from personnel management departments were acknowledged. This can lead to the presence of compassion fatigue.

CONCLUSIONS

The feelings that PICU nurses have when a child they care for die are negative feelings and sadness, and they possess coping strategies focused on emotions learned from their own experience and without institutional training support. This situation should not be underestimated as they are a source of compassion fatigue and burnout.

Family-centered care and pediatric death in the emergency department: A qualitative study using framework analysis

BACKGROUND

Family-centered care is an important concept underpinning care of children. Although much researched in some settings, little research has explored specialist settings, or areas where both children and adults are cared for, such as the emergency department.

METHODS

This study sought to explore how nurses employ family-centered care in delivering care to children and families when a child dies in the emergency department. Using a descriptive, qualitative approach, semi-structured interviews were conducted with 24 emergency nurses from six Australian states. Interviews were audio-recorded and transcribed verbatim. Framework analysis was applied to examine alignment with family-centered care principles.

FINDINGS

Nurses described providing support and education, and encouraged families to engage in care decisions, including about ceasing resuscitation efforts. Commonly, senior staff members were allocated during emergencies to support parents.

DISCUSSION

Emergency nurses should be offered education on family-centered care, and research undertaken to explore families' experiences of their child dying in the emergency department.

PRACTICE IMPLICATION

Family-centered care should be a focus for the care of children and their families in the emergency department, regardless of the pressure from rapidly occurring events.