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Nurses Facing Suffering of Paediatric Patients at the ICU: A Qualitative Study
Jeannette L Falkenburg1, Elise Aartsen2, Monique van Dijk3
1Department of Pediatric Surgery Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, the Netherlands.
Insights
Neonatal and paediatric intensive care nurses face emotional challenges caring for suffering patients. They struggle to advocate for patients when treatment seems futile, sometimes conflicting with physicians and parents.
Area of Science:
- Nursing
- Intensive Care
- Patient Suffering
Background:
- Pediatric and neonatal intensive care nurses experience significant emotional distress due to patient suffering.
- Limited understanding exists regarding nurses' interpretations of suffering and their professional roles in these critical care settings.
Purpose of the Study:
- To explore the perceptions of neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) nurses regarding their professional roles when faced with patient suffering.
Main Methods:
- Qualitative study utilizing semi-structured interviews with NICU and PICU nurses.
- Thematic analysis of transcribed interviews conducted in a Dutch academic hospital.
Main Results:
- Nurses are highly aware of their responsibilities concerning patient suffering.
- Nurses experience role conflict when advocating for patients against continued, seemingly futile treatment, potentially clashing with medical staff or families.
- Nurses find it challenging to voice their professional opinions during medical case discussions.
Conclusions:
- Patient suffering profoundly impacts pediatric and neonatal ICU nurses, necessitating supportive interventions.
- Further research is needed to understand how ICU nurses can effectively contribute their expertise during medical case deliberations.
- Identifying barriers and facilitators for nurses in advocating for suffering patients can guide strategies to enhance their support and role effectiveness.
Background:
Paediatric and neonatal intensive care nurses are frequently confronted with the suffering of prematurely born babies or critically ill children, which has a profound emotional impact on them. Yet, little is known about how they interpret such suffering and how they perceive their professional role in these situations.
Aim:
To explore how nurses in the neonatal intensive care unit (NICU) and paediatric intensive care unit (PICU) perceive their professional role when confronted with patient suffering.
Study Design:
A qualitative study using semi-structured interviews with NICU and PICU nurses in an academic hospital in the Netherlands. The transcribed interviews were thematically analysed.
Findings:
Nine NICU nurses and 10 PICU nurses were interviewed. They were deeply aware of their role and responsibility when confronted with the suffering of their patients. Especially when they considered the continuation of treatment to be pointless and harmful, nurses struggled with their role to advocate for their patient. This advocacy can place them in conflict with physicians or parents. During medical case deliberations, many nurses found it hard to bring their professional view forward.
Conclusions:
The suffering of patients has a severe impact on paediatric and neonatal ICU nurses and they deserve support and management to deal with it. Future studies should explore how nurses at the neonatal and paediatric ICU may bring forward their expertise during medical case deliberations.
Relevance To Clinical Practice:
This study highlights the barriers and enablers experienced by PICU and NICU nurses when caring for suffering patients. Understanding these dynamics can inform strategies to better support nurses in their critical advocacy role.
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