Nursing care for the families of the dying child/infant in paediatric and neonatal ICU: Nurses’ emotional talk and sources of discomfort. A mixed methods study

Bloomer, Melissa J., O’Connor, Margaret, Copnell, Beverley and Endacott, Ruth 2015, Nursing care for the families of the dying child/infant in paediatric and neonatal ICU: Nurses’ emotional talk and sources of discomfort. A mixed methods study, Australian critical care, vol. 28, no. 2, Special issue : End of life care and bereavement, pp. 87-92, doi: 10.1016/j.aucc.2015.01.002.

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Title Nursing care for the families of the dying child/infant in paediatric and neonatal ICU: Nurses’ emotional talk and sources of discomfort. A mixed methods study
Author(s) Bloomer, Melissa J.ORCID iD for Bloomer, Melissa J. orcid.org/0000-0003-1170-3951
O’Connor, Margaret
Copnell, Beverley
Endacott, Ruth
Journal name Australian critical care
Volume number 28
Issue number 2
Season Special issue : End of life care and bereavement
Start page 87
End page 92
Total pages 6
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2015-05
ISSN 1036-7314
Keyword(s) Death
dying
emotional talk
end of life care
Summary BACKGROUND: The majority of in-hospital deaths of children occur in paediatric and neonatal intensive care units. For nurses working in these settings, this can be a source of significant anxiety, discomfort and sense of failure.

OBJECTIVES: The objectives of this study were to explore how NICU/PICU nurses care for families before and after death; to explore the nurses' perspectives on their preparedness/ability to provide family care; and to determine the emotional content of language used by nurse participants.

METHODS: Focus group and individual interviews were conducted with 22 registered nurses from neonatal and paediatric intensive care units of two major metropolitan hospitals in Australia. All data were audio recorded and transcribed verbatim. Transcripts were then analysed thematically and using Linguistic Inquiry to examine emotional content.

RESULTS: Four core themes were identified: preparing for death; communication challenges; the nurse-family relationship and resilience of nurses. Findings suggested that continuing to provide aggressive treatment to a dying child/infant whilst simultaneously caring for the family caused discomfort and frustration for nurses. Nurses sometimes delayed death to allow families to prepare, as evidenced in the Linguistic Inquiry analysis, which enabled differentiation between types of emotional talk such as anger talk, anxiety talk and sadness talk. PICU nurses had significantly more anxiety talk (p=0.018) than NICU nurses.

CONCLUSION: This study provided rich insights into the experiences of nurses who are caring for dying children including the nurses' need to balance the often aggressive treatments with preparation of the family for the possibility of their child's death. There is some room for improvement in nurses' provision of anticipatory guidance, which encompasses effective and open communication, focussed on preparing families for the child's death.
Language eng
DOI 10.1016/j.aucc.2015.01.002
Field of Research 1110 Nursing
111099 Nursing not elsewhere classified
Socio Economic Objective 920211 Palliative Care
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30081894

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