The Place in Which the Suffering of Living is: How Nurses Enact Compassion in Pediatric Intensive Care
Creators: Neufeldt, Amy L.
Publisher: name: University of Alberta Library
Year: 2023

<p>In pediatric intensive care units, nurses enact compassion as they enter in with patients and families to the place where the suffering of living is and take action to make that suffering even a little bit easier to bear. This study sought to answer the question: how do nurses enact compassion in their clinical practice in pediatric intensive care?</p>

<p>This study used interpretive description to explore the practice knowledge nurses have regarding how compassion is enacted in the unique setting of pediatric intensive care. Seven semi-structured interviews with registered nurses who worked in pediatric intensive care units in Alberta were conducted and then analysed using reflexive thematic analysis.</p>

<p>Two non-linear phases of Opening the Door and being Inside were the main themes that provided an overarching metaphor of opening the door and stepping inside the physical room and the experience with patients and families.</p>

<p>Participants offered narratives describing ways of enacting compassion that opened the door including introductions between the nurse, the patient, and the family as well as the nurse introducing the patient and family to their healthcare environment. Making offers of varying natures such as offering a physical comfort, information, or family involvement helped to alleviate suffering, but also invited patients and families to begin to open up about their experiences and needs. Finally, enacting compassion involved the nurse’s self - attending to one’s own attitude. In view of the humble fragility of human life, entering in to places of devastating loss required courage and an understanding of the gravity of the situation along with a keen awareness of trying to understand how the patient and family were experiencing the situation. In the inside space - the place where the suffering of living is - nurses were with patients and families in a deeply engaged way. Sometimes that involved creating a calm space, comforting through physical touch, speaking emotional support, or gently guiding. Other times, compassion was enacted by staying present when there was nothing more to say. Throughout these acts of compassion, nurses built trust and spoke truth while balancing the complex dynamic of time.</p>

<p>This study offers a novel distinction between compassion that opens the door and compassion that is dependent upon being inside or trusted. Among ways that nurses invited patients and families to open the door, novel contributions include Introduction to the Healthcare Environment and Making an Offer. In the vulnerable place of being inside the patient or family experience with them, the most novel themes were Being the Calm in Their Storm and Guiding. Both focused on the role of nurses to support patients and families in the disorienting experiences they encounter in pediatric intensive care. The narratives given by participants in this study provide powerful exemplars of how nurses in pediatric intensive care can enact compassion in unique ways in a challenging setting. As nurses balance the many demands on their limited time, the way they integrate life-saving tasks with compassion can become a beautiful dance in the midst of the suffering.</p>