The experiences of pediatric nurses caring for children in a persistent vegetative state.
OBJECTIVE
The number of children surviving in a persistent vegetative state is increasing with advances in medical technology. Caring for a neurologically devastated child presents unique challenges not previously described. Our objective was to gain an understanding of the pediatric nurse's experience of caring for children in a persistent vegetative state.


METHODS
Qualitative phenomenologic study using in-depth interviews.


METHODS
Monitored step-down care unit of an academic children's hospital.


METHODS
Eight registered nurses employed at a step-down care unit.


METHODS
None.


RESULTS
Nurses in this study described caring for children in a persistent vegetative state as a dynamic process with negative and positive aspects. Six themes emerged from this study: focusing on the parents, delivering sensorially offensive physical care, enduring conflicting emotions, suffering moral distress, finding relief and comfort, and gaining perspective.


CONCLUSIONS
Our qualitative study suggests that caring for a child in a persistent vegetative state is difficult. Pediatric nurses described the experience as emotionally stressful and ethically challenging. To cope with the demands of caring for the child in a persistent vegetative state, the nurses in this study modified the traditional concept of the pediatric nurse-patient relationship.
Montagnino
Barbara A
BA
Progressive Care Unit, Texas Children's Hospital, Houston, TX, USA. bamontag@texaschildrenshospital.org
Ethier
Angela M
AM
D001291:Attitude of Health Personnel; D002648:Child; D004644:Emotions; D006801:Humans; D007407:Interviews as Topic; D009014:Morals; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000523:psychology*; D018458:Persistent Vegetative State / Q000451:nursing*; D036301:Qualitative Research