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Nurses' experiences of providing palliative care for children with life-limiting conditions
Bernie B Reid1, Patricia Brogan2
1Ulster University, Derry/Londonderry, Northern Ireland.
Insights
Nurses providing paediatric palliative care (PPC) experience emotional distress and challenges, yet are motivated to ensure a "good death" for children. Enhanced support and education are crucial for these healthcare professionals.
Area of Science:
- Nursing
- Palliative Care
- Pediatrics
Background:
- Paediatric palliative care (PPC) has grown due to increased life-limiting childhood conditions.
- Nursing is central to PPC, making nurses' experiences vital for quality, child-centered care.
Purpose of the Study:
- To systematically review nurses' experiences in providing palliative care for children with life-limiting conditions.
Main Methods:
- A systematic database search of CINAHL Complete, Ovid Medline, and Scopus was conducted.
- Keywords included variations of 'palliative care', 'children', and 'nurses' experiences'.
- Included peer-reviewed English-language studies published between 2016-2023.
Main Results:
- Eleven papers were analyzed, revealing three themes: emotional distress, finding meaning in care, and challenges.
- Nurses reported mixed feelings and emotional distress when caring for dying children.
- Lack of knowledge, communication issues, and personal dilemmas contributed to negative experiences.
Conclusions:
- Nurses require further education and policy development to address practice and emotional needs in PPC.
- Evidence-based nursing interventions are needed to improve PPC quality for children and families.
- Support systems are essential for nurses providing paediatric palliative care.
Background:
Paediatric palliative care (PPC) has evolved in response to the increased prevalence of children who have been diagnosed with life-limiting conditions. Nursing care is a fundamental aspect of PPC and understanding nurses' experiences is imperative to the provision and development of quality holistic child-centred services.
Aim:
To review nurses' experiences of providing palliative care for children with life-limiting conditions.
Method:
A systematic database search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Ovid Medline and Scopus was undertaken. Key words consisted of 'palliative care' or 'terminal care' or 'dying' or 'end-of-life care' and children* or paediatric* or pediatric* and 'nurs* experience*' or 'nurs* view*' or 'nurs* perspective*' or 'nurs* feeling*'. Inclusion criteria included peer-reviewed studies published between 2016-2023 in the English language.
Findings:
A thematic approach was adopted with the 11 papers selected for the review and each study critically analysed to identify three recurring themes. The themes included: 'a broken wreck', 'makes a life worth living' and 'challenges in doing 100%'. Findings point to mixed feelings among nurses in providing PPC and suggest that nurses experience emotional distress when caring for dying children. With appropriate supports and inspiration from their paediatric patients, nurses are determined to provide a 'good death' for the children in their care. Nevertheless, the perceived lack of knowledge and experience, communication struggles and personal dilemmas can be predisposing factors in triggering negative experiences among nurses when providing palliative care for children with life-limiting conditions.
Recommendations:
Education and policy development is required to meet the practice needs and support the emotional needs of nurses engaged in PPC. Further research is required to generate PPC evidence-based nursing interventions. In doing so, high quality PPC practice will be promoted, thereby ensuring high quality PPC for the children and their families.
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