End-of-life Decision-Making in Neonatology: The Role of Nurses and Parents

¹Nurse research coordinator at the University Hospital Sant John of God, Barcelona, Spain.

²Pediatrics Professor at San Rafael Health Sciences Centre, Antonio de Nebrija University, Madrid, Spain.

³Pediatrics nurse specialist, University Hospital La Paz, Madrid, Spain.

Corresponding Author:Garcia Fernandez, Miguel, Saint John of God Hospital, Passeig Sant Joan de Deu, 2. 08950. Esplugues de Llobregat, Barcelona, Spain,Tel: +34 655754520; E-Mail:[email protected]

Received Date: 18 May 2016   Accepted Date: 21 Oct 2016   Published Date: 25 Oct 2016

Copyright © 2016 Fernandez MG

Citation: Garcia Fernandez M, Vazquez Sellan A and Ramos Cruz A. (2016). End-of-life Decision-Making in Neonatology: The Role of Nurses and Parents. M J Pedi. 1(1): 004.

ABSTRACT

Background: End-of-life decision-making is highly stressful for nurses, faced with ethical dilemmas and great discrepancies between their anticipated and actual role.

Study Aim: To explore the perception of nurses in a neonatal intensive care unit of a tertiary hospital regarding ethical decision-making and the role of the parents involved.

Methods: A prospective, cross-sectional study with a sample of 79 nursing staff using a mixed-method (qualitative and quantitative) approach. Participants completed ad hoc questionnaire.

Results:75.9% of respondents were caring for infants in the treatment withdrawal process. 84.9% of nurses somewhat, or strongly, agreed that all staff should be involved in the process. Regarding the timing of the treatment withdrawal, 83.5% of respondents believed that the decision is excessively delayed. 91% of nursing professionals believed that their opinion should be considered in the end-of-life decision process. 73.4% believed that the childs welfare is not currently prioritized. For 84.8% of subjects, parents should be actively involved in decision-making processes regarding treatment withdrawal.

Conclusion: Results of this study demonstrate that neonatal intensive care nurses demand a more active role in decisionmaking during end-of-life and defend the participation of parents. Efforts should be made to improve the participation and communication within these units.

KEYWORDS

Bioethics; End-of-life decision; Humanization of Assistance; Neonatal Nursing, Parental Consent; Treatment Withdrawal.