Sudden death in paediatrics as a traumatic experience for critical care nurses

BACKGROUND: Research shows that nurses working in critical care units and in particular, paediatric units, are at risk of developing symptoms of secondary traumatic stress (STS). However, little attention has been given to this phenomenon when associated with situations of sudden death in paediatrics. AIM: This study aimed to examine the impact of sudden death in paediatrics on nurses working in paediatrics critical care units and to explore nurses' experiences of this event. METHODS: This study used a mixed-methods design. The Impact of Event Scale - Revised was used for investigating the presence of STS symptoms. In addition, an interview was conducted with six nurses. RESULTS: Fifty-seven percent of nurses responded to the surveys and six nurses were interviewed. The results showed that the sudden death of children and adolescents is an event that elicits symptoms of STS in nurses. The quantitative assessment, revealed that 19·4% presented total scores indicating high impact. The participants interviewed described experiences of subjective distress, such as intrusive thoughts, avoidance and hyperarousal. Other factors were also reported as influencing the experience of the sudden death of a child/adolescent, namely, the child's age, the cause of death and the family's reaction to the loss. According to the participants, the emotional impact was also determined by parenthood, previous training and professional experience. CONCLUSIONS: Sudden death in paediatric critical care units is one of the most difficult situations in nursing practice and elicits STS symptoms, which may severely impact the physical and psychological health of nurses and ultimately affect the quality of the provided care. RELEVANCE FOR CLINICAL PRACTICE: This study emphasizes the need for promoting better conditions for professional practice, namely, with regard to emotional support, as well as training programmes for skills development in the area of management of traumatic situations and of communication with clients.