Nurses' Experiences of Caring for Children on Long‐Term Mechanical Ventilation

TL;DR

This study explores how nurses care for children on long-term mechanical ventilation in general pediatric wards, focusing on building trust with families.

Contribution

The paper highlights nurses' experiences of balancing their professional competence with parental expertise to build reciprocal trust.

Findings

Nurses build relationships with families despite feeling uncertain about their own expertise.

Collaboration with families is essential for effective care of children on long-term ventilation.

Establishing trust quickly after admission is crucial for successful care.

Abstract

The number of children with long‐term home mechanical ventilation (LTV) is increasing globally. Parents become experts on their children's needs and sometimes know more about LTV treatment than non‐specialist healthcare professionals. Nurses caring for LTV‐dependent children in intensive care settings adjust to a collaborative caregiving role; however, this interaction has not been described in general paediatric wards.

To describe nurses' experiences of caring for children and adolescents with established LTV at general paediatric wards.

We conducted individual semi‐structured interviews with 15 participants and analysed the data using qualitative content analysis.

The study resulted in three categories: ‘Building a relationship’, ‘Working hand in hand with the family’, and ‘Doing one's best despite the LTV’, interpreted into the theme ‘Working for reciprocal trust despite frail confidence’, which can be seen as foundational to nursing both the child and the family.

Reciprocal trust between families, nurses and the respiratory team could and should be established swiftly after admission with a discussion of each party's immediate responsibilities and back‐up roles.

What is known about the topic
○An increasing number of children and adolescents are treated with long‐term home mechanical ventilation (LTV).○Parents often perceive that their competence in LTV exceeds that of the healthcare professionals.
What this paper adds
○Nurses are aware of the conflict between their competence and parental demands.○By working hand in hand with the family, they strive to build a relationship in spite of a frail confidence.

What is known about the topic
○An increasing number of children and adolescents are treated with long‐term home mechanical ventilation (LTV).○Parents often perceive that their competence in LTV exceeds that of the healthcare professionals.

An increasing number of children and adolescents are treated with long‐term home mechanical ventilation (LTV).

Parents often perceive that their competence in LTV exceeds that of the healthcare professionals.

What this paper adds
○Nurses are aware of the conflict between their competence and parental demands.○By working hand in hand with the family, they strive to build a relationship in spite of a frail confidence.

Nurses are aware of the conflict between their competence and parental demands.

By working hand in hand with the family, they strive to build a relationship in spite of a frail confidence.