Abstract
Background: Nurses in Pediatric Intensive Care Units (PICU) are daily exposed to the suffering and death of their patients. Often the emotional burden may become unbereable, dysfunctional responses may arise and reflect negatively on patients' care. Aim: To explore emotions and personal, social and professional consequences experienced by nurses working in PICU. Support currently available and the need for specialistic support were examined, together with possible positive outcomes. Methods: Exploratory approach supported with Van Kaam method for qualitative data analysis. All nurses providing direct care to patients in PICU were included and asked to fill a questionnaire about feelings and consequences regarding the patients' death, and open-ended answers. Results: Results show nurses changes in emotional state (93%), in relationship with patients (73%) and with own partner/children (53%), with colleagues (40%) and in physical health (20%). Nurses report crying, diminished energy, troubled sleep, headache, difficult concentration, physical exhaustion, changes in appetite. Nurses use informal support, but they would use specialistic help if available. Among the positive outcomes, an enhanced purpose in life and a more intense caring for patient towards a dignified death. Conclusions: Caring for dying babies is a heavy burden for nurses, leading to personal and social consequences on health and work. There is a strong need for specific support to maintain a high quality of care, the ability to establish a therapeutic relationship with patients, providing support to patient's family members and minimize negative consequences for nurses.
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