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Abstract
Aims Neonatal death is not uncommon in tertiary neonatal intensive care. Though nurses are focussed on supporting parents through their loss, it is unclear how they are coping with this stress. We therefore aimed to explore the experiences of our nurses during end of life care (EOLC) to identify areas to support.
Method We designed and conducted a 17-item paper-based survey between March and June 2015 exploring the views of nursing staff on their recent EOLC events.
Results 46 (94%) out of 49 nurses completed this survey. 78% of nurses gained knowledge from reading the unit’s bereavement guidelines, while 34% had attended formal training.
Just over half reported being the named nurse for a dying baby, on at least one occasion in the past year. The average confidence rating in their role was 3.2 (scale of 1(low) to 5(high), SD 1.21) with a clear association between seniority and confidence (Figure 1).
Association between seniority and confidence rating
Confident nurses mentioned good consultant support, awareness of procedures and acknowledgement that there is ‘always more to learn’ as their secret for success, while less confident nurses mentioned lack of experience or training, and uncertainty about procedures being the main hurdles. The average confidence rating in providing culturally sensitive bereavement support was lower at 2.56 (SD 1.22).
About 69% received support from a wide range of people and resources and rated this positively (mean 3.78, SD 1.23). (Table 1).
Sources of support for nurses
Common themes described include strong sense of sadness, frustration over unclear procedures, emotional affect lasting for a week, the value of debrief sessions and a sense of professional satisfaction.
Conclusions Our study highlights varied experiences and support needs of neonatal nurses in providing EOLC to babies and their families. Staff appeared to gain confidence with experience, good support and improved training opportunities. This could be achieved through on-the-job training by working closely with experienced staff or a family support worker, regular debrief sessions and improved access to unit guidelines. We propose to introduce these measures in our unit to support nursing staff to improve their confidence, wellbeing and job satisfaction.