‘No second chance’ – Junior neonatal nurses experiences of caring for an infant at the end-of-life and their family

Abstract

Death of an infant is acutely stressful for parents and professionals. Little is known about junior nurses' experiences providing end-of-life care in Neonatal Units (NNU).This study aimed to better understand junior nurses' experiences providing end-oflife care in NNU. Neonatal nurses (n=12) with less than 3 years experience participated in a focus group. Nominal Group Technique (NGT) was used to build consensus around the challenges faced, alongside suggested developments in improving future care provision. Primary analysis involved successive rounds of ranking and decision making whilst secondary analysis involved thematic analysis.All issues, whether environmental, professional or social appeared driven by an awareness on the part of nurses, that there was no 'second chance' which created a huge pressure to 'get if right' for the infants and families. Regarding future care 2 areas of improvement identified were 'Education and Training' and Support. This paper unpacks these findings making recommendations for practice. words

Perinatal/neonatal palliative care: Effecting improved knowledge and multi-professional practice of midwifery and children's nursing students through an inter-professional education initiative

“…While this is in keeping with the increasing drive of service users in the teaching of healthcare delivery (Reeves et al 2016b, GMC 2011, Health andCare Professions Council [HCPC] 2012, NMC 2018b), further attention needs to be given to the fact that some children's nursing students felt uncomfortable when invited to ask questions due to the sensitivity of the topic. In their study of junior neonatal nurses caring for a baby at the endof-life and their family, Nurse and Price (2016) suggest that these group of nurses might be 'shielded' by senior nurses from the taxing job of caring for a dying baby and their family. As such, having these difficult conversations with parents might bring about anxiety.…”

Emotional Responses of Neonatal Intensive Care Nurses to Neonatal Death

“…The most important factors for neonatal intensive care nurses to experience these emotions are that the individuals nurses give care to are vulnerable and that nurses establish special bonds with their patients and their families (Adwan, 2014). According to the literature, nurses who give care to dying infants may experience burnout, stress, and moral distress (Cook et al., 2012; Nurse & Price, 2017).…”

A Network Approach to Neonatal Palliative Care Education

“…6,4,[10][11][12] The broad range of sessions covered in the all-day workshop ensured that key topics such as ethical issues of withdrawal of intensive care, symptom management, and communication skills were included; topics still being identified in the literature and guidance as important areas where training is needed. [23][24][25] The guidance which helped drive the development and implementation of the workshops of this evaluation has recently been updated. 4,12 The need for formal, integrated education programmes on palliative care for perinatal and neonatal staff remains an important goal.…”

“…22 These changes along with the literature and policy drivers and pathways of the last 10 years aimed at improving the quality of palliative care within neonatal units, including the support for the family, strengthen the need for development and evaluation of further education programmes to increase staff awareness, enhance their knowledge of neonatal palliative care, and develop collaborative working, both in the UK and international. [22][23][24][25][26][27] In the North West of England approximately 330 neonates will die of a condition that may require palliative care 28 (Cochrane et al, 2007). The Northwest Children and Young People's Palliative Care Network [NCYPPCN] Strategy and Workplan for 2011-2014 made recommendations for the provision of palliative care for children and provides information on the current levels of provision in the Northwest.…”