Death and dying of newborns and children: relationships between nursing and family according to Travelbee

Abstract

Objective: Identify the nursing staff's perception of their relationship with families of newborns and children who are in the process of death and dying. Methods: Qualitative research, carried out in the Neonatal and Pediatric Intensive Care Unit of a public maternity hospital in Rio Grande do Norte, with 17 nursing professionals, through a semi-structured interview. After being transcribed, the data were subjected to Bardin's content analysis and interpreted in the light of the theory of Interpersonal Relations proposed by Travelbee. Results: Four categories emerged from the analysis: "Caring and welcoming people, feelings and stories"; "Reactions in the midst of pain: moving between acceptance and suffering"; "Communication of bad news: challenges and strategies"; "The weight of caring and suffering". Final considerations: Family assistance can be established using Travelbee's principles, as they offer timely theoretical support for nursing actions in the context of the process of death and dying.

Experiences of healthcare personnel with death in the neonatal intensive care unit: a systematic review of qualitative studies

“…The main cause was differences in values and beliefs about patients’ prognosis and treatment plans 23 25 29 30. Other causes included lack of trust and transparency,10 language barriers10 and parents’ inability to understand medical information,19 especially when parents were in a state of shock or grieving 11 15 18 26 31…”

“…HCP suffered from feelings of guilt, helplessness and compassion fatigue. HCP felt guilty when they perceived care decisions potentially caused more suffering to the child15 20 22 23 25 or when they felt unable to answer parents’ questions about the child’s uncertain prognosis 29 31. Some HCP also felt guilty for their own emotional responses 29.…”

“…Many ascribed patients’ deaths to failure of their professional duty 18 22 25 33 35–38. They also felt helpless when dealing with grieving parents, especially those they were unfamiliar with,15 17 26 31 and when they had to communicate bad news 15 16 22 24 28 33 35 39. HCP experienced compassion fatigue in long-term care settings17 19 25 27 36 and after experiencing deaths of many patients 19 32.…”

“…By providing compassionate care and clear communication about the dying infant’s condition, treatment plans and potential complications with the family, the healthcare team facilitated shared decision-making and mental preparation for future scenarios 12 15 26 31 32…”

Learning report: SWOT analysis of an adolescent death experience in the context of clinical teaching

“…De facto, a enfermagem enquanto ciência do cuidado humano faz o elo entre o sujeito, a família e os restantes profissionais da equipa multidisciplinar. Neste sentido, durante a hospitalização em enfermarias pediátricas, é comum um forte vínculo entre a equipa de enfermagem e os familiares das crianças que se fortalece em caso de internamentos prolongados ou repetidos no tempo (Medeiros et al, 2022). Esta ligação foi notória e favoreceu a boa gestão da situação.…”