Dying child: direct observation of nursing interactions
Creators: name: Ross, Susan
Publisher: name: University of Utah
Year: 2012

description: An exploratory study was designed to investigate the verbal interactions of nurses with fatally ill children and their mothers as compared with non-fatally ill children and their mothers on an inpatient pediatric unit.  The verbal behavior of registered nurses, licensed practical nurses and nurse's aides was tape recorded as the came in contact with four children with fatal illnesses and four children with non-fatal illnesses.  Verbal behavior of mothers and children were also recorded.  All units of verbal behavior were coded and classified using the Dier Nurse Orientation System.  Percentage profiles of verbal units per category of the Nurse orientation System were calculated.  The major findings were: a) All nursing personnel were patient-oriented in their verbal behavior toward both groups.  b) All nursing personnel were oriented to the patients as physical persons in greater proportion than they were oriented to the patients as thinking-evaluative or feeling persons, regardless of patient group.  c) All personnel were oriented to the fatally ill children and their mothers as feeling persons in lower proportion than they were to the non-fatally ill children and their mothers. d)  All nursing personnel were oriented to the fatally ill children and their mothers as thinking-evaluative persons in greater proportion than they were to the non-fatally ill children and their mothers.  e)  All nursing personnel were oriented to themselves in greater proportion when interacting with the fatally ill children and their mothers than with the non-fatally ill children and their mothers.  f) Licensed practical nurses had a greater proportion of patient-oriented response in the feeling dimension for both groups than did the registered nurses and aids.  g) Mothers of fatally ill children were more patient-oriented more thinking-evaluative-oriented, and more nurse-oriented than the mothers of non-fatally ill children.  They were less feeling-oriented and less other-oriented than the mothers of non-fatally ill children.  h) Fatally ill children were less patient-oriented, less feeling-oriented, and less nurse-oriented than the non-fatally ill children. They were more thinking-evaluative-oriented and more other-oriented than the non-fatally ill children.  the findings of the study suggest that although nursing personnel were predominantly oriented toward their patients in their verbal behavior, differences were present in their patterns of interaction with fatally ill and non-fatally ill children and their mothers.  In particular, the findings revealed lower proportions of patient-oriented interactions, especially in the feeling dimension, with fatally ill children and their mothers.  Fatally ill children and their mothers had patterns of interaction which differed from the non-fatally ill children and their mothers.  the study suggests that further investigation of the verbal interactions of nurses, mothers, and children is warranted as a basis for developing a therapeutic nursing role with fatally ill children and their families.