The Series of Processes Undergone by Nurses before A Child’s Condition Deteriorates

Abstract

Objective: To ascertain the series of processes that nurses have undergone before a child’s condition deteriorates.

Methods: Unstructured interviews were conducted with nine nurses who experienced the deterioration of a child’s condition, and their responses were analyzed using a grounded theory approach.

Results: In an “Uncertain situation” in which a nurse is unsure what happens, nurses undergo a process of “Conveying the child’s thoughts and feelings” to avoid a crisis, but the process of “Having doubts,” i.e. the doctor has not responded to the nurse’s concerns as expected, leads to different consequences. The process that leads to those consequences consists of the following steps: “Put out an antenna,” “A sense that something will happen,” “Overcoming the hurdle of sharing the child’s plight with the doctor,” “Commitment to giving a voice to patients without one [children],” and “Involving others.” The outcome diverges depending on whether or not a nurse was able to share a child’s condition with the doctor.

Conclusion: Results suggested the importance of lowering the hurdle of sharing a child’s condition with the doctor and the importance of making the entire medical team aware of the nurse’s expert perceptions.