Nursing in PICU Based in central Auckland, our Paediatric Intensive Care Unit (PICU) at Starship Child Health is the only dedicated 22 bed paediatric intensive care/high dependency care unit in New Zealand. The email address and/or password entered does not match our records, please check and try again. Stayer and Lockhart (2016) also showed that the atmosphere of a life-saving emergency in the PICU decreases the amount of time to support pediatric patients and may easily create a sense of distance with the family. Meta-Synthesis and Related Categories. It was a huge challenge for nurses to reveal the possibility of death to pediatric patients and their families and to start to assist them in facing the inevitability of death. These actions must be done even in the face of great sorrow and stress for nurses. Access to society journal content varies across our titles. Moreover, nurses had no idea how to communicate with a child’s family about the dying process and thus may have failed to provide usual care when the children and their families faced loss and sorrow (Fortney & Steward, 2017; Stayer & Lockhart, 2016). In the space below, identify the clinical problem in the workplace setting (Emergency department ) that will serve as the focus of your information retrieval paper. One nurse said: We are very pedantic sometimes in the way you sort of—well, not just care for them, but their physical appearance as well . . To reiterate, caring for pediatric patients at the end of life by PICU nurses is stressful and creates a heavy emotional burden. Kaufman, D. C. (, Truog, R. D., Meyer, E. C., Burns, J. P. (. Runswick-Cole (2010) described discussing the death of children as a social embarrassment that emphasizes the fact that there are issues surrounding EOLC for children that need more attention (Department of Health [DOH], 2008; Radbruch & Payne, 2009). You will also have the option of working per diem, which will afford you with the flexibility of choosing your own schedule. EOLC is defined as the care and supportive services that seriously ill patients and families receive following the decision to end treatment (Lautrette et al., 2007). The results of the search are presented in a PRISMA flow diagram (Moher, Liberati, Tetzlaff, Altman, & Prisma Group, 2009) (Figure 1). You can find more information and the latest updates in our Coronavirus Hub: Approximately 1,200 patients are admitted to our Paediatric Intensive Care Unit (PICU) each year. It was also found that many of the deaths occurred within the first week of stay in the PICU. They are mainly admitted from the North Thames area, but our specialist departments also service the UK and abroad. there’s a bed in there . A second search was undertaken using all the identified keywords and index terms across all the included databases. Furthermore, nurses are also advised to evaluate in advance the family’s overall understanding and expectations about the condition before explaining it to the pediatric patient. PICU nurses face repeated exposure to children who are actively dying, have a terminal illness, and whose families decide to forgo life-sustaining treatment for them (Cole, 2003; Costello & Trinder-Brook, 2000; Kain, 2013). Moreover, nurses support pediatric patients through recognizing them in a positive way and respecting them by helping to maintain the child’s appearance (Bloomer et al., 2016; Stayer & Lockhart, 2016). This includes but was not limited to phenomenological research, ethnography, grounded theory, action research, and discourse analysis. Most nurses refocus and divorce themselves from emotions about patients and family to adjust their negative feelings. Furthermore, one objective should be to maintain parents’ roles and functions as well as enhance the parent-child relationship. As indicated by Meyer, Ritholz, Burns, and Truog (2006), parents of terminally ill pediatric patients in PICUs need honest and complete information to discuss or consult with medical and nursing personnel. This process involved the aggregation of findings to generate a set of statements that represent aggregation, through assembling the findings rated according to their quality, and categorizing these findings on the basis of similarity in meaning. American Journal of Hospice and Palliative Medicin... Dignified death: Concept development involving nurses and doctors in Pediatric Intensive Care Units, Feeling like a burden to others: a systematic review focusing on the end of life, Factors influencing nurse retention within children’s palliative care, Bloomer, M. J., Endacott, R., Copnell, B., O’Connor, M. (, Bloomer, M. J., O’Connor, M., Copnell, B., Endacott, R. (, Burns, J. P., Sellers, D. E., Meyer, E. C., Lewis-Newby, M., Truog, R. D. (, Butler, A. E., Hall, H., Willetts, G., Copnell, B. When doctors declare that pediatric patients are going to die, nurses may feel that their care or interventions have failed, because EOLC runs contrary to their PICU nursing role of saving lives. Sign in here to access free tools such as favourites and alerts, or to access personal subscriptions, If you have access to journal content via a university, library or employer, sign in here, Research off-campus without worrying about access issues. These categories were subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings that can be used as a basis for evidence-based practice. It is necessary to provide different channels to help nurses vent depressive emotions. The search for unpublished or gray literature included conference literature, the World Health Organization, and Google Scholar. we had braided her hair and things like that . Some nurses vented their sorrowful emotions to their own family or friends in order to develop positivity and continue to live their lives. Part of EOLC involves having a discussion with the family about the impending death of their child. Studies that met the inclusion criteria were retrieved in full and imported into the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI-SUMARI). Third, the reference lists of all identified studies were searched for additional studies, and a citation search was also done on relevant studies. The search strategy aimed to find both published and unpublished studies. The qualitative components of mixed-method studies also were included. (p. 9). The experiences of end-of-life care by nurses in the pediatric intensive care unit are the subject of this systematic review. Some society journals require you to create a personal profile, then activate your society account, You are adding the following journals to your email alerts, Did you struggle to get access to this article? The family’s understanding and control of the dying process and future directions of care are important factors affecting the acceptance of death by pediatric patients and their families and the pursuit of achieving a good and proper death. The overall objective of a PICU is usually to save lives using emergent and aggressive treatment. . Nurses sometimes felt conflicted, depressed, and stressed as they administered aggressive medical interventions despite the fact that pediatric patients were going to die. . Identified papers were assessed independently by two reviewers for methodological validity prior to inclusion in the review. Furthermore, after the death of pediatric patients, nurses should be able to assist parents in reconstructing their roles and functions as parents; continue providing them with a consultation system, hotline, cards, or home visits to express concern for their sorrow; and encourage parents to positively appreciate and commemorate their children’s strengths and value and use objects concerning pediatric patients to remember their children (Butler et al., 2015). Sharing links are not available for this article. Our PICU has state-of-the-art equipment and facilities to allow the development of new treatments and management strategies for critically ill children. Furthermore, these deaths may have an unpredictable and potentially short phase, with death occurring sometimes only a few hours or a few days after life support has been withheld or withdrawn. Such a balance also helps nurses to maintain their own positive and stable emotions. For more information view the SAGE Journals Article Sharing page. Connor, J. This was exemplified when one nurse from the PICU in a study by Stayer and Lockhart (2016) said: We basically had 2 kids die in 1 shift, that’s a lot when 1 child passes and you move to the next child—their heart stops and you haven’t had time to, to grasp the death of the first child, you have to move on to try and stop the second child from dying. At that moment, the family may find it difficult to let go of their child and choose to continue with invasive therapeutic procedures, which makes the child bear unnecessary pain to prolong life. Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the authorship and/or publication of this review. . . It is also important for nurse personnel to deal with and help integrate the parent-child relationship. During the care of pediatric patients at the end of life and their families, nurses desire to assist them in achieving a good and proper death. It became apparent that there is a lack of relevant studies from Asia, Africa, or other regions. Therefore, it seems that nursing EOLC is aimed at physical, emotional, and spiritual support for the child, parents, and family, which can be stressful for nurses. Some of them also kept in touch with the family of children who had passed away. The remaining articles were critically appraised, and six articles reached the final stage of data extraction and analysis (Figure 1). When providing professional care, nurses also have to maintain their own emotional health. These six studies (Table 1) consisted of two qualitative inquiries (Diel, Gomes, Xavier, Salvador, & Oliveira, 2013; Fortney & Steward, 2017), a mixed-methods study (Bloomer et al., 2015), a hermeneutical phenomenological study (Stayer & Lockhart, 2016), and two focus group method studies (Bloomer, Endacott, Copnell, & O’Connor, 2016; Cook et al., 2012). Medical teams in ICUs are expected to cure diseases and save lives. Furthermore, the power of team cooperation and encouragement from peers also helped nursing personnel to develop positive self-affirmation (Bloomer et al., 2015; Cook et al., 2012; Stayer & Lockhart, 2016). It is important to provide nurses with a good emotional support system to enable them to achieve self-empowerment and growth. These experiences refer to the following domains of EOLC in the PICU/NICU, which has been described in the existing literature as (a) concerns about the decision-making process, (b) the actions taken once a decision has been made to forgo life-sustaining treatment, and (c) the evaluation of the decision and its implementation (Devictor & Carnevale, 2008). The involvement of nurses in EOLC in the PICU is crucial. If you have access to a journal via a society or association membership, please browse to your society journal, select an article to view, and follow the instructions in this box. Almost all children and help integrate the parent-child relationship they avoided the vicious circle of emotions. Time to support their children and infants admitted to picu nursing care receive supportive ventilation unpublished studies, Gillam L.... Renal support therapies review instrument ( JBI-QARI ) was used only rely on mutual care ( Cook al.. 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