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Infant suffering and nurse advocacy in neonatal intensive care
1High-Risk Perinatal Nursing, School of Nursing, University of Texas, Austin.
This discussion of nurse advocacy and infant suffering in neonatal intensive care was based on content analysis of interviews of 20 neonatal nurses in three NICUs over a period of 6 years. Throughout that span of time, nurses experienced significant emotional distress when they believed that therapies resulted in infant suffering without proportional benefit. In all of the nurses interviewed, infant suffering triggered a variety of acts of advocacy, ranging from changes in nursing care to decrease infant distress to formal requests that the medical plan of care be reviewed. Characteristics of infants, nurses, and the NICU organization were described as possibly influential to nurse advocacy. Finally, some thoughts about an ethic of the good were presented. Gajardo-Velasquez noted, "Nothing really great and important can be obtained without a certain amount of sacrifice; therefore, suffering is present in every human action that tends to transform and create new conditions for life." Our technology in the NICU has saved many lives and prevented much suffering and avoidable disability. It has also, for some, been a source of profound suffering. It is hoped that nurses in neonatal intensive care will use the ideas presented here as a starting point for their individual and collective examination of what constitutes an ethic of the good. Perhaps such an ethic can minimize the cost in suffering of the powerful technology of neonatal intensive care.
This discussion of nurse advocacy and infant suffering in neonatal intensive care was based on content analysis of interviews of 20 neonatal nurses in three NICUs over a period of 6 years. Throughout that span of time, nurses experienced significant emotional distress when they believed that therapies resulted in infant suffering without proportional benefit. In all of the nurses interviewed, infant suffering triggered a variety of acts of advocacy, ranging from changes in nursing care to decrease infant distress to formal requests that the medical plan of care be reviewed. Characteristics of infants, nurses, and the NICU organization were described as possibly influential to nurse advocacy. Finally, some thoughts about an ethic of the good were presented. Gajardo-Velasquez noted, "Nothing really great and important can be obtained without a certain amount of sacrifice; therefore, suffering is present in every human action that tends to transform and create new conditions for life." Our technology in the NICU has saved many lives and prevented much suffering and avoidable disability. It has also, for some, been a source of profound suffering. It is hoped that nurses in neonatal intensive care will use the ideas presented here as a starting point for their individual and collective examination of what constitutes an ethic of the good. Perhaps such an ethic can minimize the cost in suffering of the powerful technology of neonatal intensive care.