P3.117: Dealing with Death: Health Care Professional Perspectives After Pediatric Patient Death

Background: Pediatric health care professionals (HCPs) are at the forefront of caring for sick children and helping families cope in the moments following patient death. Yet, HCPs are often overlooked as those who experience grief and may need support during the coping process. This study aims to identify the variety of ways HCPs cope and the resources they utilize after a patient death.

Methods: Purposeful sampling was utilized to recruit a wide range of HCPs. Participants included medical decision makers, treatment implementers, and those who provide psychosocial support; they work in critical care units, medical units, emergency room, and/or outpatient settings. One-on-one semi-structured, audio-recorded interviews were conducted with HCPs to explore their experience after pediatric death. Interviews were transcribed verbatim. Two researchers independently coded transcripts using Atlas.ti qualitative analysis software. Discrepancies were reviewed and consensus on coding was reached. Recurrent and novel themes were identified.

Results: 22 HCPs completed interviews at the time of this submission. Roles included physicians, nurse practitioners, nurses, respiratory therapists, occupational therapist, pharmacist, interpreter, social workers, and child life specialists. Health care experience ranged from < 1 year to >30 years. HCPs universally described the professional community as a necessary source of support. They describe a sense of purpose in focusing on fulfilling their duty toward patient families and their professional colleagues with occasional burden of setting aside their own grief to address others’. Debriefs are valued by some but not all HCPs find them beneficial; debriefs should be offered, inclusive, and optional. Quality of communication between colleagues and with patient families can impact coping after patient death. HCPs describe that having a framework for thinking about death and grief can be helpful; this is often gained through experience although many desire more structured education. Few have received occupational training on death and dying; HCPs earlier in their career describe more formal training than those later in their career. HCPs often seek out education on their own. Institutional support programs exist but difficulty with access is a barrier to utilization. Additionally, HCPs wish for accessible mental health, palliative care, chaplaincy, and bereavement services.

Conclusion: These findings can help leaders and institutions improve the supports for HCPs after pediatric death. Not only does the presence of a professional community help HCPs cope, HCPs desire more education around death and grief. Programs that already exist may benefit from improved accessibility or increased resources to stimulate more robust utilization.