Decision-Making Process for the Implementation of the Child Therapeutic Support Limitation Plan: Nurses' Experiences

Inquiry. 2022 Jan-Dec:59:469580221100777. doi: 10.1177/00469580221100777.

Abstract

Aim: To present nurses' experience in the decision-making process for implementing a therapeutic support limitation plan in the PICU. Method: Qualitative exploratory research was conducted through semi-structured interviews with 25 intensive care nurses from January to June 2019. The textual corpus was then submitted for content analysis. Results: Two categories emerged: the nurse and decision-making process of the TSLP and ambivalence of the participating nurse's feelings in implementing the TSLP. These categories are interrelated in that the decision-making process mobilizes the ambivalence of the participating nurses' feelings. Final considerations and implications for practice: The starting point of communication between the health teams consists of acquiring information about the concerned child's end-of-life care plan with no prospect of cure and with some form of therapeutic limit admitted to the PICU. Therefore, this study helps to map possible research gaps on the topic and mobilize researchers to build educational materials, protocols, and tools for comprehensive care that can be used by nurses when faced with ethical dilemma, such as decision-making through TSLP.

Keywords: care in pediatric therapy units; decision-making process; end-of-life care; nurse; palliative care; therapeutic support limitation.

MeSH terms

  • Child
  • Communication
  • Decision Making
  • Humans
  • Nurses*
  • Qualitative Research
  • Terminal Care*