Breaking silence: Challenges of non-disclosure directives in paediatric clinical practice

Nurses caring for children hospitalised with a serious illness are optimally placed to advocate for truthful health information. This study explored the phenomenon of truth-telling as experienced and perceived by nurses caring for seriously ill children when parents are contemplating a non-disclosure directive. Data were collected through semi-structured interviews and analysed using Interpretative Phenomenological Analysis (IPA). The thematic analysis identified four themes, including, Child’s absence from the health communication conversation, Child and family’s access to health information, Assessment of the child and family’s understanding for the purpose of communicating health information and Nurse communication after physician communication. Despite access to online medical information and the provision of diagnostic results directly to patients, nurses continue to employ self-regulation strategies, upholding traditional practices of disclosure, before employing a supportive role for parents and children. Nurses’ partnership with the child and family can support the implementation of policies and practices allowing participation and shared clinical decision-making through open and honest communication, ultimately contributing to positive care outcomes.