Expressions of hope in paediatric intensive care: A reflection on their meaning

Abstract

Background: The bedside vigil maintained by parents of critically ill children is fuelled by faith, hope and love. While faith and love are generally accepted without question, maintaining hope in the face of almost certain loss can be seen as misguided, almost worse than no hope at all. Aim: The aim of this article is to reflect on the issues arising for health care professionals when parents' expressions of hope seem to cast doubt on their understanding of a poor prognosis for their child. Method: Using Gibbs' model of reflection (1988), an episode of care will be explored, with the intention of resolving this perceived conflict between expression and understanding. Conclusions: By demonstrating that hopeful statements do not necessarily conflict with an accurate understanding of prognosis, nurses and other health care staff can be freed from the emotional constraints this tension causes them and focus on meeting the needs of the patient and their family. Relevance to clinical practice: Despite the fact that communication skills are taught in clinical training, practitioners may feel underequipped to sensitively confront the challenges posed in caring for dying children and their families. In taking a closer look at what parents' expressions of hope might mean, we can remove barriers to understanding in the parent-practitioner relationship and provide care that meets their intricate needs.