Stamping Out Stress in the Pediatric Intensive Care Unit

Abstract

Nurses in pediatric intensive care units (PICUs) frequently provide care to children at the end of life. Evidence-based interventions, such as peer-based support programs, are needed to help nurses cope with end-of-life events and overwhelming case experiences. The purpose of this project was to develop and evaluate a peer support intervention to help PICU staff cope with end-of-life and other stressful events. PICU nurses at a large children's hospital completed a needs assessment. Data were analyzed using descriptive statistics to inform the development and implementation of a grief support intervention for PICU staff. Postimplementation surveys are planned to evaluate the program. Administrative review by the institutional review board indicated that the project did not meet criteria for human subjects research. The needs assessment demonstrated that patient deaths affected job satisfaction at least moderately for 16%. In addition, 32% of respondents were dissatisfied with support currently provided during escalation of care or patient death. Seventy-four percent of respondents indicated a need for a nurse-driven grief support system in the PICU. The most frequent recommendations were a grief box with comfort items such as chocolate or coffee (87%), a peer support nurse (66%), and peer debriefing (33%). Based upon the findings, grief boxes were implemented, and bimonthly peer debriefing or “stamp out stress” sessions were implemented. Evaluation data are pending. Preliminary results indicate a need for additional support during patient death or escalation of care. The PICU staff can benefit from a peer-driven support intervention.