Debra Stayer

Defense Date


Graduation Date

Summer 2013


Immediate Access

Submission Type


Degree Name





School of Nursing

Committee Chair

Joan Lockhart

Committee Member

Rick Zoucha

Committee Member

Betty Ferrell


Children, Palliative care, Pediatric, Pediatric ICU, Pediatric nurse


Caring for critically ill children who die quickly or whose condition progressively worsens is often overwhelming with the journey to the end justly stressful and difficult for all involved. Unequivocally pediatric ICU nurses spend a significant amount of time at the bedside attempting to meet and manage the palliative care needs of the children and their families during this arduous time. However, the literature lacks the perspective of the pediatric ICU nurse who provides palliative care to children with a life-threatening or life-limiting illness and their families. Therefore, a hermeneutic phenomenological inquiry to explore the essence of the experience provided by pediatric ICU nurses to children with life-threatening or life-limiting illnesses and their families was conducted. Semi-structured interviews were conducted with 12 pediatric ICU nurses who had experience caring for dying children and their families in a rural tertiary level, non-freestanding children's hospital in northeastern United States. Data were analyzed using a descriptive and interpretive phenomenological approach. Participants' descriptions revealed the following five major themes: journey to death, a lifelong burden, challenges delivering care, maintaining self, and crossing boundaries. Findings from the study revealed the intricacies involved in caring for dying children and their families can be demanding at times; however, the study's participants voiced a great deal of professional satisfaction in caring for these children and their families.

Especially significant were the rich descriptions of the nurses' stories regarding the death of the child, the after death period and the memories of children who had died. Future research is suggested to explore spirituality and nurses' experiences of caring for children with life-threatening and life-limiting illnesses and their families as this was not evident in the study's findings. Additional research to discover pediatric ICU nurses experiences in urban settings with a more diverse sample of participants, with and without a pediatric advanced care team (PACT) could further expand this study's findings.