One method of coping: resident debriefing after the death of a patient.
OBJECTIVE
To describe residents' exposure and reactions to pediatric deaths, their debriefing experiences, and factors associated with debriefing.


METHODS
Cross-sectional survey completed at the end of residency. The survey reflected experiences from the prior 18 months concerning number, type, and setting of deaths; resident reactions; whether resident debriefed and with whom after a patient's death.


RESULTS
Seventy-four residents (84%) completed the survey over 4 academic years accounting for 363 deaths; 59% were inpatient deaths of patients with chronic diseases, 22% were inpatient, 18% were emergency department (ED) deaths of previously healthy patients, and 1% were deaths of patients with chronic diseases who died in the ED or in their home. Mean number of deaths experienced per resident was 4.6 (range, 0-19). Thirty-one percent of residents expressed guilt, and 74% stated they had debriefed at least one time, but debriefings took place after only 30% of deaths. Resident debriefing was associated with an inpatient death of a previously healthy child, OR 5.3 (95% CI: 1.31, 22.3), P=.01, whereas there was not an association with number of previous deaths, acute outpatient or chronic inpatient deaths, or resident guilt.


CONCLUSIONS
Pediatric residents were involved in a small number but varying types of death experiences. Debriefing took place after a minority of deaths. Future research needs to investigate the potential benefits of debriefing.
Department of Pediatrics, Johns Hopkins Children's Center, Baltimore, Maryland 21287, USA. jserwint@jhmi.edu
Janet R
JR
Serwint
D000223:Adaptation, Psychological; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D011368:Professional-Family Relations; D011795:Surveys and Questionnaires