scholarly journals Speaking a Different Language: A Qualitative Analysis Comparing Language of Palliative Care and Pediatric Intensive Care Unit Physicians

2017 ◽  
Vol 35 (3) ◽  
pp. 384-389 ◽  
Author(s):  
Anne G. Ciriello ◽  
Zoelle B. Dizon ◽  
Tessie W. October
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Medical Information ◽  
Pediatric Intensive Care ◽  
Icu Physicians ◽  
Pediatric Icu

Background: Family conferences in the pediatric intensive care unit (ICU) often include palliative care (PC) providers. We do not know how ICU communication differs when the PC team is present. Aim: To compare language used by PC team and ICU physicians during family conferences. Design: A retrospective cohort review of ICU family conferences with and without the PC team. Setting: Forty-four bed pediatric ICU in a tertiary medical center. Participants: Nine ICU physicians and 4 PC providers who participated in 18 audio-recorded family conferences. Results: Of the 9 transcripts without the PC team, we identified 526 ICU physician statements, generating 10 thematic categories. The most common themes were giving medical information and discussing medical options. Themes unique to ICU physicians included statements of hopelessness, insensitivity, and “health-care provider challenges.” Among the 9 transcripts with the PC team, there were 280 statements, generating 10 thematic categories. Most commonly, the PC team offered statements of support, giving medical information, and quality of life. Both teams promoted family engagement by soliciting questions; however, the PC team was more likely to use open-ended questions, offer support, and discuss quality of life. Conclusion: Pediatric ICU physicians spend more time giving medical information, whereas the PC team more commonly offers emotional support. The addition of the PC team to ICU family conferences may provide a balanced approach to communication.

Health-related quality of life after prolonged pediatric intensive care unit stay*

2009 ◽  
Vol 10 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Niamh P. Conlon ◽  
Cormac Breatnach ◽  
Brendan P. O’Hare ◽  
David W. Mannion ◽  
Barry J. Lyons
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Stay ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Palliative and End-of-Life Care in the Intensive Care Unit

2019 ◽  
pp. 997-1000
Author(s):  
Maisha T. Robinson
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Palliative Medicine ◽  
Life Care ◽  
Patient Centered ◽  
Consultative Service ◽  
Icu Physicians

Palliative medicine is the specialty that focuses on improving the quality of life for patients and families when the patients have serious or advanced medical conditions. The approach to care is patient centered and goal oriented. It can be performed at any stage of illness with or without a palliative medicine consultative service. All clinicians, including intensive care unit (ICU) physicians, who care for patients with serious or advanced illnesses should be able to provide adequate palliative care.

Purulent Otitis Media—A “Silent” Source of Sepsis in the Pediatric Intensive Care Unit

1985 ◽  
Vol 93 (3) ◽  
pp. 330-334 ◽  
Author(s):  
Michael Persico ◽  
Geoffrey A. Barker ◽  
David P. Mitchell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Middle Ear ◽  
Nasotracheal Intubation ◽  
Pediatric Intensive Care ◽  
Nasogastric Tubes ◽  
High Incidence ◽  
Risk Patients ◽  
Pediatric Icu

Septicemia is common in patients in the pediatric intensive care unit (ICU) who have nasotracheal tubes. Although it is frequently caused by middle ear effusion (MEE), pneumatic otoscopy is not routinely performed in these patients. To demonstrate the value of this procedure, 46 pediatric ICU patients with nasotracheal tubes were followed daily with pneumatic otoscopy for 11 to 98 days and compared with 25 controls without nasotracheal tubes, 12 of whom had nasogastric tubes. Myringotomy was performed whenever blood culture became positive. MEE was significantly more frequent in patients with nasotracheal tubes (87%) than in patients with controls (23%) and occurred first on the side of intubation. Blood bacteria were identical to middle ear pathogens in 80% of patients. Nasogastric tubes were not significant in causing MEE. The high incidence of MEE resulting from nasotracheal intubation indicates the importance of including pneumatic otoscopy in the daily examination of these high-risk patients.

Living with Dying in the Pediatric Intensive Care Unit: A Nursing Perspective

2016 ◽  
Vol 25 (4) ◽  
pp. 350-356 ◽  
Author(s):  
Debbie Stayer ◽  
Joan Such Lockhart
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Emotional Impact ◽  
Pediatric Intensive Care Units ◽  
Personal Support ◽  
Life Threatening

Background Despite reported challenges encountered by nurses who provide palliative care to children, few researchers have examined this phenomenon from the perspective of nurses who care for children with life-threatening illnesses in pediatric intensive care units. Objectives To describe and interpret the essence of the experiences of nurses in pediatric intensive care units who provide palliative care to children with life-threatening illnesses and the children’s families. Methods A hermeneutic phenomenological study was conducted with 12 pediatric intensive care unit nurses in the northeastern United States. Face-to-face interviews and field notes were used to illuminate the experiences. Results Five major themes were detected: journey to death; a lifelong burden; and challenges delivering care, maintaining self, and crossing boundaries. These themes were illuminated by 12 subthemes: the emotional impact of the dying child, the emotional impact of the child’s death, concurrent grieving, creating a peaceful ending, parental burden of care, maintaining hope for the family, pain, unclear communication by physicians, need to hear the voice of the child, remaining respectful of parental wishes, collegial camaraderie and support, and personal support. Conclusion Providing palliative care to children with life-threatening illnesses was complex for the nurses. Findings revealed sometimes challenging intricacies involved in caring for dying children and the children’s families. However, the nurses voiced professional satisfaction in providing palliative care and in support from colleagues. Although the nurses reported collegial camaraderie, future research is needed to identify additional supportive resources that may help staff process and cope with death and dying.

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