Nurses Facing Suffering of Paediatric Patients at the <scp>ICU</scp> : A Qualitative Study

BACKGROUND: Paediatric and neonatal intensive care nurses are frequently confronted with the suffering of prematurely born babies or critically ill children, which has a profound emotional impact on them. Yet, little is known about how they interpret such suffering and how they perceive their professional role in these situations. AIM: To explore how nurses in the neonatal intensive care unit (NICU) and paediatric intensive care unit (PICU) perceive their professional role when confronted with patient suffering. STUDY DESIGN: A qualitative study using semi-structured interviews with NICU and PICU nurses in an academic hospital in the Netherlands. The transcribed interviews were thematically analysed. FINDINGS: Nine NICU nurses and 10 PICU nurses were interviewed. They were deeply aware of their role and responsibility when confronted with the suffering of their patients. Especially when they considered the continuation of treatment to be pointless and harmful, nurses struggled with their role to advocate for their patient. This advocacy can place them in conflict with physicians or parents. During medical case deliberations, many nurses found it hard to bring their professional view forward. CONCLUSIONS: The suffering of patients has a severe impact on paediatric and neonatal ICU nurses and they deserve support and management to deal with it. Future studies should explore how nurses at the neonatal and paediatric ICU may bring forward their expertise during medical case deliberations. RELEVANCE TO CLINICAL PRACTICE: This study highlights the barriers and enablers experienced by PICU and NICU nurses when caring for suffering patients. Understanding these dynamics can inform strategies to better support nurses in their critical advocacy role.