Nurses' perspectives on working with families in the paediatric intensive care unit (PICU)

Family centred care (FCC) is considered a core concept in paediatric nursing. Despite significant research into FCC in a general paediatric environment, limited research has been conducted in a paediatric intensive care (PICU) setting, with no prior research examining nurses' perceptions in a mixed adult/paediatric unit. This study addressed the question "What is it like for registered nurses who work in a mixed adult/paediatric Intensive Care Unit (ICU) to work with families of critically ill children?" A descriptive qualitative design was utilised to explore nurses' perceptions. Ethics approval was gained from both the health facility and Monash University. The study setting was a 26 bed mixed adult/paediatric ICU, with 6 dedicated paediatric beds but no nurses employed exclusively in the PICU. Five registered nurses from the PICU participated in individual semi-structured interviews. Data were analysed using thematic analysis. Member checks, peer review and the development of a reflexive audit trail were utilised to enhance the rigour of the study. Data analysis elicited three interrelated themes - Role delineation and confusion, Information sharing and The PICU environment - and one overarching theme - Competing Values. The findings identified that FCC was not universally espoused as an important philosophy and was not readily translated into the nurses' practices. A theory-practice gap was revealed in relation to the concepts of FCC. The findings suggest that this gap can be addressed through policy, education and practice. Highlighted is the need for FCC education, both for nurses and medical staff, and a written policy to guide staff in their daily practice and facilitate a change in culture towards provision of FCC.