Beyond the Guidelines: Nursing Leadership in Pediatric End-of-Life Care

aring for dying children in the intensive care unit is one of the most complex challenges in pediatric health care.Members of the health care team must simultaneously navigate advanced life-sustaining technologies, uncertain prognoses, emotionally charged decisionmaking, family-centered communication, symptom management, ethical dilemmas, and their own experiences of grief and moral distress.1,2 Families are asked to make momentous decisions in rapidly changing circumstances, 3,4 while nurses and other team members work to find a balance among hope, comfort, and goal-concordant care.For the majority of children, the most common place of death is in the hospital, [5][6][7] highlighting the need for evidence-based guidance to provide high-quality end-oflife (EOL) care and maximize quality of life for children and their families.To address this need, the Society of Critical Care Medicine (SCCM) convened an interprofessional panel of experts to develop the 2026 Guidelines on the Care and Management of Pediatric and Neonatal Intensive Care Patients at the End of Life.8,9