Pediatric intensive care unit nurses' reflective experience in caring for maltreated children and adolescents in...

To examine pediatric intensive care unit (PICU) nurses' experiences when caring for maltreated pediatric patients, clarify their interactions with the patients' family members, provide a reflective examination of their values, and understand the dilemmas and value conflicts they encounter.

To reduce the working stress of PICU nurses and retain nurses in the profession, in-depth examinations of the value conflicts experienced by PICU nurses when caring for maltreated pediatric patients is needed.

This study adopted a narrative qualitative design. Through purposive sampling, 20 PICU nurses from a medical center in Taiwan were included in this study. Face-to-face interviews using a semi-structured interview outline were conducted, obtained data were transcribed into verbatim transcripts, and thematic analysis of the data was performed following the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.

Three main themes emerged from participant responses: "Complex emotions when caring for maltreated children," which describes the various emotions and uncertainties of PICU nurses when caring for such cases; "Conflicting relationship with family members of maltreated children," including concerns of potential medical violence by family members; and "Self-reflection on caring for maltreated cases," which clarifies nurses' overall perspectives and emotional projections in caring for such cases.

Since PICU nurses experience considerable psychological exhaustion when caring for maltreated pediatric patients due to the emotions they experience, interactions with family, and reflections on their own values, emotional counseling and relevant self-awareness and recovery courses should be implemented toward their stress alleviation and emotional release.

Understanding the emotional distress, perceptions toward family, and internal value conflicts of PICU nurses enables medical institutions and managers implement effective interventions to eliminate healthcare violence, create a safe and supportive work environment, empower nurses' clinical competence, and support PICU nursing staff facing challenges.