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- Paediatric Intensive Care Nursing | Great Ormond Street Hospital
- Nursing in PICU
We are a diverse team who work incredibly hard for the children and families in our care.
We aim to minimise stress through reflective practice, the preceptorship programme, psychosocial meetings and regular social events, as well as close co-operation and teamwork. Taking the initiative and innovation are encouraged on the unit and we fully support nurses who take on research and teaching projects to improve their knowledge and clinical practice. We also use a system of individual performance review to facilitate personal and professional development.
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Also, we are unable to accept flowers in this unit. Children's Critical Care - information for patients and their families and carers pdf, 00 KB. We try to find accommodation for parents, although families sometimes have to share accommodation when demand is high, and occasionally there is a waiting list.
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In the Paediatric Intensive Care Unit PICU we look after children with a variety of needs including long-term respiratory, cardiology, surgery, trauma and neurological problems, as well as acute paediatric admissions. We offer a range of intensive care therapies. A child cared for on PICU will be looked after by a nurse or assistant practitioner who has no other patients to care for, who will be present at their bedside continuously. Admissions to PICU can be a stressful time for families, and we are keen to support the family as a whole: colleagues in Social Services and Clinical Psychology provide us with valuable support.
This can include children who have had high-risk surgery, or who need additional support. Children may be non-invasively ventilated in PHDU, or ventilated through a tracheostomy.
A recent increase in the number of publications on the high prevalence of burnout and moral distress in health professionals in general, and in critical care staff in particular, has led to a call for more research into the mechanisms by which burnout arises and into interventions to increase resilience in the workplace. As hypothesised, nurses reported significantly higher exposure to pain in their work and significantly more burnout and secondary traumatic stress.
Paediatric Intensive Care Nursing | Great Ormond Street Hospital
In addition, their pain ratings both for video cases and for themselves were significantly higher than those provided by the AHPs. However, the hypothesis that pain exposure would be inversely related to empathy was not found, with nurses reporting higher levels of empathy than AHPs, but also reporting more burnout and secondary traumatic stress.
These findings are consistent with the hypothesis that intensive care nurses become sensitised to pain by virtue of the fact that they witness more of it in their clinical work than other health professionals and that, while this may increase their empathy, it also leads them to overestimate pain in themselves and their patients and predisposes them to burnout and secondary traumatic stress.
Furthermore, the finding that higher rates of distress were found in nurses with less experience is not borne out by the literature 2 and although the groups were matched for age, gender and experience, the differences found may have related to other factors. Variables such as profession, number of deaths encountered, moral distress 3 or factors specific to neonates such as inadequate analgesia or intensive care could be controlled for in a larger study.
The finding that the nurses overestimated pain, in themselves as well patients, suggests a degree of maladaptive overidentification—a possible downside of empathy.
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It might, however, be possible to retain empathy without running this risk if resilience is maintained. Indeed, the relationship between empathy and burnout may be mediated by resilience, which was not measured in this study.
Nursing in PICU