Posted: November 14th, 2023

Pediatric ICU: Living with Dying – From a Nursing Perspective

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Pediatric ICU: Living with Dying – From a Nursing Perspective

The pediatric intensive care unit (PICU) is a place where life and death are constantly intertwined. Children who are critically ill or injured are admitted to the PICU, where they receive specialized care from a multidisciplinary team of health professionals. The PICU nurses are at the forefront of this team, providing continuous monitoring, assessment, intervention, and support to the children and their families.

The PICU nurses face many challenges and rewards in their work. One of the most difficult aspects of their job is dealing with the death of a child. According to a study by Meert et al. (2015 – Research Paper Writing Help Service), the mortality rate in PICUs in the United States was 2.4%, which means that one in every 42 children admitted to the PICU died. The same study found that 69% of the PICU nurses reported experiencing moderate to severe levels of moral distress related to end-of-life care. Moral distress occurs when nurses feel that they cannot act according to their ethical values or professional standards due to external constraints or conflicts (Jameton, 1984).

How do the PICU nurses cope with the emotional and ethical challenges of caring for dying children and their families? What are the sources of their resilience and satisfaction? How can they provide compassionate and competent care in such a stressful environment? These are some of the questions that this blog post will explore, based on the current literature and the personal experiences of PICU nurses.

Coping with Grief and Loss

The death of a child is one of the most traumatic events that anyone can experience, especially for the parents and siblings. The PICU nurses are often witnesses to this tragedy, as they accompany the child and the family through the dying process. They may develop strong bonds with the child and the family, especially if they have cared for them for a long time or have seen them repeatedly. They may also identify with the child or the family, imagining how they would feel if they were in their situation.

The PICU nurses may experience various reactions to the death of a child, such as sadness, anger, guilt, anxiety, helplessness, numbness, or shock. These are normal and healthy responses to grief and loss, but they can also affect the nurses’ well-being and performance if they are not addressed properly. The PICU nurses may also experience compassion fatigue, which is defined as “a state of exhaustion and dysfunction, biologically, physiologically, and emotionally, as a result of prolonged exposure to compassion stress” (Joinson, 1992). Compassion fatigue can lead to symptoms such as insomnia, irritability, depression, cynicism, burnout, or reduced empathy.

To cope with grief and loss, the PICU nurses need to acknowledge their feelings and express them in healthy ways. They can seek support from their colleagues, managers, chaplains, counselors, or other professionals who understand their situation. They can also participate in debriefing sessions, memorial services, or rituals that honor the child and the family. They can also engage in self-care activities that promote their physical, mental, emotional, and spiritual health, such as exercise, meditation, hobbies, or spending time with loved ones.

Finding Meaning and Purpose

Another way that the PICU nurses cope with the death of a child is by finding meaning and purpose in their work. They may reflect on how they have made a difference in the child’s life and comforted the family during their time of need. They may also focus on how they have contributed to the advancement of pediatric critical care through research, education, or quality improvement initiatives. They may also derive meaning and purpose from their personal values, beliefs, or faith.

Finding meaning and purpose in one’s work can enhance one’s resilience and satisfaction. According to a study by Feudtner et al. (2015 – Research Paper Writing Help Service), PICU nurses who reported higher levels of meaning in life had lower levels of moral distress and higher levels of job satisfaction. The same study found that meaning in life was positively associated with spirituality and negatively associated with emotional exhaustion.

To find meaning and purpose in their work, the PICU nurses need to reflect on their motivations, goals, and achievements. They can also seek feedback from their peers, managers, patients, or families about how they have impacted them positively. They can also participate in activities that foster their professional growth and development, such as continuing education courses,

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