Staff Experiences with End-of-Life Care in the Pediatric Intensive Care Unit

Lee, K. Jane; Dupree, Claretta Y.

doi:10.1089/jpm.2007.0283

Cited by 83 publications

(80 citation statements)

References 27 publications

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“…Lo anterior se suma a la necesidad que tienen de ser honestas consigo misma y con sus pacientes, al compartir abiertamente sus pensamientos y sentimientos con el equipo de salud, pero sobre todo con el niño, lo que se condice con lo señalado por otros investigadores quienes sostienen que las enfermeras deben ser capaces de aceptar sus propios sentimientos, vulnerabilidades y limitaciones, y expresarlos dentro del equipo (19). Es por ello que una de las estrategias descritas es estar abierto a la expresión del propio duelo y la "autoexpresión" de su tristeza, lo que las hace más humanas (28). Son estos sentimientos los que en algunas situaciones les generan conflicto al estar regulados por un "código de comportamiento profesional" que limita la expresión de las emociones (19,23).…”

Section: Discussionunclassified

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Revealing the Meaning of the Mourning Process of Pediatric Nurses Facing the Death of Cancer Patients

et al. 2013

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Objetivo: develar el significado del duelo en enfermeras(os) que enfrentaron la muerte de niños con cáncer. La muerte de un niño(a) por cáncer genera un gran impacto en el equipo de enfermería, lo que produce impotencia, frustración y pena, que pueden llegar a causar Burnout. Método: se utilizó la investigación cualitativa fenomenológica basada en Husserl; se recogió la experiencia de diez enfermeras(o) oncológicas(os) pediátricas que enfrentaron la muerte de pacientes con cáncer bajo su cuidado. Los datos se obtuvieron de junio a noviembre del 2011 con entrevistas en profundidad grabadas y transcritas literalmente. El análisis fenomenológico se realizó según el método de Streubert. Resultado: los testimonios entregados develaron tres unidades de significado: las enfermeras vivencian la muerte de un paciente a través del transitar entre su propia forma de enfrentar la muerte y el cuidado profesional que otorgan. Con ello aparece un aprendizaje de vida dado por la comprensión de lo que es trabajar en oncología y los vínculos que establece en este ámbito. Esto permite desarrollar un cuidado con un sello particular. Conclusión: el estudio concluye que las enfermeras experimentan el duelo como un proceso dinámico al que atribuyen sentido a través de la entrega de un cuidado amoroso.

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Section: Discussionunclassified

“…Esta relación genera un soporte emocional recíproco que provee de consuelo y apoyo, favoreciendo el enfrentamiento de la pérdi-da del paciente (25,28).…”

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Revealing the Meaning of the Mourning Process of Pediatric Nurses Facing the Death of Cancer Patients

et al. 2013

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“…Moral stress has later been identified among several health care professional groups, not only as physicians (Austin et al, 2008;Førde & Aasland, 2008;Hamric & Blackhall, 2007;Lee & Dupree, 2008;Lomis et al, 2009), respiratory therapists (Schwenzer & Wang, 2006), pharmacists (Sporrong et al, 2005), and psychologists (Austin et al, 2005), but also as social workers (McBeath & Webb, 2002). Between the professions, there appear to be differences in what causes moral distress and in how it is manifested (Austin et al, 2008;Førde & Aasland, 2008;Hamric & Blackhall, 2007;Lee & Dupree, 2008;Lomis et al, 2009;Schwenzer & Wang, 2006;Sporrong et al, 2005).…”

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confidence: 99%

“…Between the professions, there appear to be differences in what causes moral distress and in how it is manifested (Austin et al, 2008;Førde & Aasland, 2008;Hamric & Blackhall, 2007;Lee & Dupree, 2008;Lomis et al, 2009;Schwenzer & Wang, 2006;Sporrong et al, 2005). However, in an overview of the research field, Epstein and Delgado (2010) argue that moral stress is a 'multi-disciplinary problem'.…”

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confidence: 99%

Coping With Moral Stress in the Swedish Public Services

Thunman

2016

NJWLS

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“…[1][2][3][4] This is particularly relevant in the pediatric intensive care unit (PICU), where two-thirds of hospitalized children die, and two-thirds of those are the result of withdrawal of support. 2,3 Pediatric residents, who may be experiencing a child's death for the first time in the PICU, are likely to be unprepared for this burden.…”

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confidence: 99%

The Wrap-Up: A Unique Forum To Support Pediatric Residents When Faced with the Death of a Child

Bateman

Dixon

Trozzi

2012

Journal of Palliative Medicine

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Objective: The project intended to describe the format of the Wrap-up, a unique multidisciplinary guided debriefing following a child's death. Specific feedback from pediatric residents was sought to assess the model. Methods: The Wrap-ups were timely (within 48 hours of a death), consistent (conducted after each pediatric intensive care unit (PICU) death), multidisciplinary (all care providers were invited), and specifically conducted by someone trained in postdeath facilitation. The role of the conductor was focused on being inclusive, navigating the discussion, diffusing areas of conflict or angst, and managing the tone of the meeting. , there were 36 PICU deaths. The average age was nine years old. All deaths had an accompanying conductor-led Wrap-up occurring, on average, two days after the death. Sixty percent (27/45) of pediatric residents completed the survey. Their qualitative responses showed that the key components (timely, multidisciplinary, and specifically conducted) of the Wrap-ups were valuable. Quantitatively, they agreed or strongly agreed that the consistent Wrap-ups improved end-of-life care, teamwork, stress surrounding the death, and the ability to care for others. Conclusion: The Wrap-up, a unique forum for debriefing after a pediatric death, was well-received by residents and assisted them with processing, understanding, and resolving their experience regarding the pediatric death. The Wrap-up was a valuable addition to residents' experience and education in pediatric critical care medicine and can be replicated in other institutions.

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Staff Experiences with End-of-Life Care in the Pediatric Intensive Care Unit

Abstract: The experience of caring for a child who dies in the PICU is multifaceted. Grief, rather than moral distress, was the dominant psychological response of caregivers. Future research could focus on enhancing communication and emotional support.

Cited by 83 publications

References 27 publications

Revealing the Meaning of the Mourning Process of Pediatric Nurses Facing the Death of Cancer Patients

Revealing the Meaning of the Mourning Process of Pediatric Nurses Facing the Death of Cancer Patients

Coping With Moral Stress in the Swedish Public Services

The Wrap-Up: A Unique Forum To Support Pediatric Residents When Faced with the Death of a Child

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