How much compassion have I left? An exploration of occupational stress among children’s palliative care nurses

Abstract

Nursing is a stressful occupation. While children's palliative care nurses encounter many of the stressors in common with other nurses, this unique context of care generates specific aspects of stress that warrant further examination. This qualitative study explores the experiences of stress in nurses providing children's palliative care in one region of the UK. In total, four focus groups took place with children's hospice nurses, community children's nurses and children's nurse specialists based in the regional children's hospital. The focus groups were taped, transcribed and analysed through the application of Newell and Burnard's thematic content analysis methodology. Four core themes emerged: work demands; relationships, maintaining control, and support and roles. Of particular note were stressors associated with the sub-themes of relationships, emotional demands and ethical conflicts. Conclusions illustrating how individuals and organizations may reduce the impact of stress in nurses contributing to the palliative care of children and their families are made.

Choice and compassion at the end of life: A critical analysis of recent English policy discourse

“…Thus, many recognise that key to developing compassionate care is to value care staff and reduce burnout (e.g. Firth-Cozens andCornwell 2009, McCloskey &Taggart, 2010). This is challenging because care work entails dirty manual labour cleaning up leaky bodies, which are experienced as polluting (Douglas, 2002;Lawton, 2000).…”

Supportive interventions and their impact on pediatric health care professionals’ emotional well-being: A systematic literature review

“…The process that takes place when a child dies makes a significant impact and often contributes to work-related stress regardless of the professional's medical specialty [3,10,11] . Health care professionals experience moral and ethical stress when asked to perform actions that contradict their personal and professional values about what is right [4] or when nursing staff's and the parents' opinions differ on what is best for the child [3] .…”

“…Health care professionals experience moral and ethical stress when asked to perform actions that contradict their personal and professional values about what is right [4] or when nursing staff's and the parents' opinions differ on what is best for the child [3] . Moral distress occurs when staff cannot put their moral choices into action.…”

“…This leads to feelings of personal pain, anger, resentment, guilt, sadness, frustration, futility, and powerlessness, which undermine the health professional's integrity, self-esteem, and personal maturity [2-5, 12, 19] . Many have sleep disturbances, feel irritable and emotionally drained and on the edge of burnout, and find it difficult to "forget" their work in their free time; many must take sick leave for work-related stress [3] .…”

“…Emotionally, it is very stressful to take part in a child's illness and death [2,3] . Health care professionals often become emotionally drained and on the edge of burnout.…”