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Posted: April 4th, 2022

Pediatric Nurses in Providing Emotional and Bereavement Support

Supporting Families in Pediatric End-of-Life Care: Exploring the Role of Pediatric Nurses in Providing Emotional and Bereavement Support

Pediatric end-of-life care is a complex and sensitive topic that requires a multidisciplinary approach. One of the key professionals involved in this process is the pediatric nurse, who has a unique role in providing emotional and bereavement support to families of children with life-limiting conditions. This blog post will explore the challenges and opportunities that pediatric nurses face in this context, as well as some strategies and resources to enhance their practice.

Challenges of Pediatric End-of-Life Care

Pediatric end-of-life care poses several challenges for nurses, such as:

– Uncertainty about prognosis and timing of death, especially for children with chronic or fluctuating conditions (Linebarger et al., 2022).
– Ethical dilemmas and conflicts between the preferences and values of the child, family, and health care team (NICE, 2019).
– Emotional distress and compassion fatigue due to witnessing the suffering and death of children and their families (Linebarger et al., 2022).
– Lack of formal training and education on pediatric end-of-life care and palliative care principles (Linebarger et al., 2022).
– Limited availability and accessibility of specialized pediatric palliative care services and hospice programs (Linebarger et al., 2022).

Opportunities for Pediatric End-of-Life Care

Despite these challenges, pediatric end-of-life care also offers opportunities for nurses to make a positive difference in the lives of children and their families, such as:

– Establishing trusting and compassionate relationships with the child and family throughout the illness trajectory (NICE, 2019).
– Providing holistic care that addresses the physical, emotional, social, spiritual, and cultural needs of the child and family (NICE, 2019).
– Facilitating advance care planning and shared decision making that respects the child’s wishes and best interests (NICE, 2019).
– Supporting the child’s comfort and quality of life by managing distressing symptoms, such as pain, agitation, seizures, or respiratory distress (NICE, 2019).
– Ensuring adequate hydration and nutrition for the child, while avoiding unnecessary or burdensome interventions (NICE, 2019).
– Recognizing the signs and symptoms that indicate that the child is likely to die within hours or days, and preparing the family for what to expect (NICE, 2019).
– Helping the family choose the preferred location of death for the child, whether it is at home, in the hospital, or in a hospice facility (NICE, 2019).
– Providing emotional support and interventions to the family during the dying process and after the death of the child (Linebarger et al., 2022).
– Collaborating with other professionals involved in caring for the child and family, such as social workers, chaplains, psychologists, or bereavement counselors (Linebarger et al., 2022).

Strategies and Resources for Pediatric End-of-Life Care

To enhance their practice in pediatric end-of-life care, nurses can use some of the following strategies and resources:

– Seek continuing education and training on pediatric end-of-life care and palliative care principles, such as online courses, webinars, workshops, or conferences (Linebarger et al., 2022).
– Consult with specialized pediatric palliative care teams or hospice programs when available, or refer families to these services when appropriate (Linebarger et al., 2022).
– Use evidence-based guidelines and tools to guide their assessment and intervention in pediatric end-of-life care, such as the NICE guideline on end of life care for infants, children and young people with life-limiting conditions (NICE, 2019) or the Together for Short Lives guide on caring for a child at end of life (Together for Short Lives, n.d.).
– Seek peer support and supervision from colleagues who have experience or expertise in pediatric end-of-life care, or join professional networks or communities of practice that focus on this topic (Linebarger et al., 2022).
– Practice self-care and coping strategies to prevent or reduce emotional distress and compassion fatigue, such as mindfulness, relaxation techniques, journaling, exercise, hobbies, or counseling (Linebarger et al., 2022).

Conclusion

Pediatric end-of-life care is a challenging but rewarding area of practice for pediatric nurses. By providing emotional and bereavement support to families of children with life-limiting conditions, nurses can help them cope with their loss and find meaning in their experience. Nurses can also improve their own skills and well-being by accessing education, resources, and support on this topic.

References

Linebarger JS., Johnson V., Boss RD. Guidance for Pediatric End-of-Life Care. Pediatrics. 2022;149(5):e2022057011. doi:10.1542/peds.2022-057011.

NICE. End of life care for infants, children and young people with life-limiting conditions: planning and management write my essay. NICE guideline [NG61]. 2019. https://www.nice.org.uk/guidance/ng61.

Together for Short Lives. Caring for a child at end of life – a guide for professionals on the practical and emotional aspects of caring for a child who is dying. n.d. https://www.togetherforshortlives.org.uk/resource/guide-end-life-care/.

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