Nurses' perceptions on working with families in the paediatric intensive care unit (PICU).

Abstract

Background and aims: Working in partnership with families is a core component of paediatric nursing; however many studies have shown that family-centred care (FCC) can be challenging to achieve in PICU settings. No previous studies have been conducted in a mixed adult-paediatric setting. Aim(s): This study aimed to explore the perceptions of nurses working with families of critically ill children in a mixed adult/paediatric ICU. Method(s): The study used a descriptive qualitative design, where interviews were conducted with five registered nurses who care for critically ill children. The study has ethical approval from both the hospital and Monash University. All participants provided written informed consent. Thematic data analysis was undertaken, with credibility enhanced by a reflexive audit trail, member checks and peer review. Result(s): Three interconnected and one overarching theme were uncovered. Role delineation and confusionTM identified the roles nurses ascribed to themselves and the families, and the conflict which occurred when roles were unclear. Information sharingTM demonstrated the positive and negative ways information was used by nurses and doctors to care for families. The PICU environmentTM explored the influence of the physical environment on the delivery of FCC. Finally, the overarching theme of Competing ValuesTM considered the impact of the nurses' own values and those of the PICU on FCC delivery. Conclusion(s): This study suggests the provision of FCC is influenced by multiple factors, both personal and institutional, and requires education of all health professionals, policy development and a change in unit culture to implement. The study is unfunded. The authors have no conflicts to disclose.