Experiences of nurses involved with neonatal deaths in Neonatal units in a Saudi Arabian Hospital

Dlamini, Prisca Sithembile (2019-04)

Thesis (MNur)--Stellenbosch University, 2019.

Thesis

ENGLISH SUMMARY : Background: Nurses who care for patients in neonatal intensive care units (NICU) address all their efforts to care for seriously ill newborns and their families. The death of a newborn and the grieving process is profound for families and the emotional involvement experienced by the nurses can be complicated. Many nurses do grieve when their patients die yet this is not often acknowledged or discussed. A need was identified in a NICU in Saudi Arabia where the researcher observed that some expatriate colleagues were struggling to come to terms with a neonatal death in the study setting. The aim of this study was to explore and describe the nurses’ experience following the death of a neonate in their care in neonatal units in a Saudi Arabian hospital. Methods: An exploratory descriptive qualitative design was applied to elicit the participant’s psychological experience of neonatal loss in their care. Fifteen participants who had experienced a neonatal death in their care were sampled from the staff establishment (N=56) in the research setting to participate in individual interviews conducted by a field worker. Consent to conduct the study was obtained from the Health Research Ethical Committee of Stellenbosch University and from the institution where the research was conducted. Informed consent was obtained from the participants at each interview including the use of a recorder. Interviews took place at a location of the participant’s choice, were audio-recorded, transcribed verbatim and member-checked by a field worker. The interviews were analysed thematically according to the Terre Blanche, Durrheim and Kelly method and the themes that emerged were emotional grief, support available for the staff, colleague or family support, spiritual or other rituals, religion and spirituality. Results: Findings show that the neonatal care nurses in this study experience a range of emotions, including professional self-doubt and protracted grief. A need for support and clear communication channels from the employer emerged that could assist with the development of coping strategies. Cultural training could be provided during orientation at the commencement of the employment contract on the needs and expectations of the parents.

AFRIKAANSE OPSOMMING : Neonatale intensiewe sorgeenhede voorsien sorg aan pasgeborenes in lewensbedreigende toestande met baie lae geboortegewig, infeksies, geboorte trauma, veelvoudige komplekse aangebore afwykings en misvorming. Die effek, reaksie en rouproses van verpleegkundiges wat so intens en nou betrokke is by hierdie eenheid, kan ’n baie langdurige, pynvolle en stresvolle verlieservaring wees, insluitend affektering van verhoudings tuis en met hul medewerkers. Hierdie studie het plaasgevind in ’n Saoedi Arabiese NICU-eenheid en ICN waar 657 babas in 2017 toegelaat was. In hierdie NICU het die navorser waargeneem dat verpleegpersoneel sukkel om hul ervarings uit te druk of te deel wat dikwels sosiale onttrekking van ander spanlede tot gevolg het. ’n Verkennende, beskrywende, kwalitatiewe navorsingsontwerp wat semi-gestruktureerde individuele onderhoude gebruik het, is aangeneem om te verken en te beskryf hoe neonatale verpleegkundiges die dood van ’n neonaat in hul sorg ervaar en hul hanteringstrategieë. Die totale populasie met die aanvang van die studie was N=56 neonatale spesialis-opgeleide en ervare verpleegkundiges wat in hul lande van herkoms geregistreer was, wat Saoedi Arabiese burgers en buitelandse verpleegsters van Fillipyne, Indië en Suid-Afrika was. Etiese goedkeuring is verkry van die Gesondheidsnavorsings-etiekkomitee van Stellenbosch Universiteit en die Institusionele etiese hersieningsraad. Ingeligte skriftelike toestemming was verkry van die deelnemers, insluitende die gebruik van ’n elektroniese stemopnemer en notas opname. ’n Veldwerker het 15 Engelssprekende vrywilligers ondervra en hulle van anonimiteit, vertroulikheid en geheimhouding verseker aangesien hulle aan die navorser bekend was. Die Terre Blanche, Durrheim en Kelly-metode is gebruik om die data uit die woordelike transkripsies te onttrek, te organiseer en te analiseer. Die analise het aan die lig gebring dat die deelnemers ’n verskeidenheid emosies ervaar – van ’n gevoel van prestasie om hul beste te doen tot gevoelens van professionele onbevoegdheid geweldige hartseer, wanhoop en verwarring; veral onder uitlanders van verskillende kulture. Die gebrek aan erkenning, en in sommige gevalle vir wie die bestuur blameer het, het hul nood vererger. Dit word sterk aanbeveel dat professionele ondersteuning vir die individu en die verpleegspan in die NICU-eenheid oorweeg word, insluitende outentieke medelydende mentorskap wat gereeld met indiensopleidingsessies aangebied word.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/105988
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