Pediatric end-of-life palliative care (EOL-PC) has been recognized as an area in which nursing knowledge is deficient. Due to this deficiency, children and their families are not given optimal EOL-PC. The philosophy and principles of pediatric EOL-PC must be defined before any change in care can take place. The mean score for Philosophy and Principles for the nurses sampled was 59.64%. Elisabeth Kûbler-Ross’s (1996) theory on Death and Dying was tested and when examining Psychosocial and Spiritual Care the mean was 60.36%. Pain and Other Symptoms had a mean score of 67.86%. Also, overall knowledge of EOL-PC had a mean of 63.64% compared to the literature mean of 67%. These results provide evidence that nurses do not have enough knowledge to care for children and their families during the end-of-life transition.
Patricia Benner’s (1984) theory from Novice to Expert was validated that as education and experience increase so does knowledge. This is strongly supported by those nurses with a national board certification. A majority of the nurses in this study were either a novice or an advanced beginner based on the revised Benner classification scale developed by the researcher. They were also young, newer nurses, with less experience on the hematology/oncology floor and pediatric intensive care unit (PICU), and had no national certifications. All of the expert nurses were older, had greater experience on the hematology/oncology floor and PICU, and had a national board certification.
Pediatric EOL-PC can undergo reform if measures are taken to make a change. These changes must come from nurses, advanced practice nurses, administration, continuing education committees, and nursing programs and curricula.
