Nurses and nursing students' experiences on pediatric end-of-life care and death: A qualitative systematic review

• Published in: Nurse education today Vol. 112; p. 105332
• Main Authors: Shorey, Shefaly, Chua, Crystal
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.05.2022; Elsevier Science Ltd
• Subjects: Adolescent; Appraisal; Child; Death; Death & dying; Decision making; Educational programs; Emotional support; End of life; End of life decisions; Experiences; Experiential learning; Health education; Health Personnel; Hospice care; Humans; Infant; Infants; Medical personnel; Nurse patient relationships; Nurses; Nursing; Nursing education; Nursing Students; Occupational stress; Palliative care; Pediatric; Pediatric death; Pediatric end-of-life; Pediatrics; Psychological distress; Qualitative Research; Qualitative systematic review; Quality of care; Student Attitudes; Students; Students, Nursing; Systematic review; Teenagers; Terminal Care; Traumatic life events; Nursing; Pediatric death; Nurses; Experiences; Nursing students; Systematic review; Death; Pediatric end-of-life; End of life; Pediatric; Qualitative systematic review
• ISSN: 0260-6917; 1532-2793
• DOI: 10.1016/j.nedt.2022.105332

End-of-Life care and experiencing death of infants, children, and teenagers remain one of the most difficult and traumatic events for nurses and nursing students, potentially leading to personal and professional distress. Although efforts have been made to alleviate stressors in these settings, improvements remain slow. Understanding nurses and nursing students' experiences of pediatric End-of-Life care and death in multiple care settings may direct interventions to better support quality of care and healthcare professionals in these areas. This review aimed to qualitatively synthesize existing literature to examine the nurses and nursing students' experiences of providing End-of-Life care to children and the death of pediatric patients. The qualitative systematic review was conducted using Sandelowski and Barroso's guidelines. The included studies were appraised using the Critical Appraisal Skill Program. This qualitative systematic review was registered with the International Prospective Register of Systematic Reviews. Six electronic databases (Cumulative Index of Nursing and Allied Health Literature, PubMed, Embase, PsychINFO, Scopus, and Mednar) were searched from the database inception date through May 2021. Thirty articles were included to form three key themes: (1) Emotional impact of pediatric End-of-Life care and death, (2) Perspective of delivering optimal care: What works and what does not, and (3) The complex role of nurses in pediatric End-of-Life care. Overall, the findings suggested that in an emotionally taxing environment, clinical and emotional support were paramount. Furthermore, there is a need to examine nurses' role in End-of-Life decision making and provide more discussion on professional boundaries. This review offered nurses' and nursing students' perceptions of pediatric End-of Life care and death in the nursing profession. Findings can provide useful insights towards the planning of educational programs and institutional changes that supports nurses and nursing students in these settings. •Emotional support for nurses and nursing students in pediatric end-of-life care is very limited•More structural support, clinical trainings, and curricula for end-of-life education are required•Future research could evaluate nurses’ role in end-of-life decision making especially from less developed countries