Paper
Friday, July 15, 2005
This presentation is part of : Assisting Children With Stressful Procedures
The Dilemma of Care -- Doing Procedures to Children
Tineke Water, Dip, CPN, Dip, (cardio), GD, PGD1, Elizabeth Smythe, BHSc, PG, PhD2, and Annette Dickinson, BA, MSN, PhD2. (1) School of Nursing, Division of Health Care Practice, Auckland University of Technology, Auckland, Waitemata, New Zealand, (2) Division of Health Care Practice, Auckland University of Technology, Auckland, Waitemata, New Zealand
Learning Objective #1: Explore how dilemma shows itself in the everyday experience of doing procedures to children
Learning Objective #2: Understand the fit between phenomenology and the findings of the study in this presentation

This paper presents part of an interpretive phenomenological study that examines the question, “what are health professionals and families experiences of dilemma in paediatric practice?” This paper will present findings from the study, which relate to how paediatric nurses experience dilemma in the everyday practice of doing procedures to children.

The focus of this study is how health professionals and families encounter and experience dilemma in practice. The aim is to understand what ‘is' dilemma in paediatric practice rather than to describe what ‘are' dilemmas in paediatric practice.

The methodology used for this study is Heideggarian Phenomenology. The part of the data that will be presented was collected from 7 in-depth unstructured interviews with 7 participants who were paediatric nurses. Stories told by participants were analyzed using a thematic analysis as outlined by Van Manen (1990).

Three themes will be discussed: ‘Scary People', ‘For Their Own Good' and ‘Growing Distress'. ‘Scary People' relates to how paediatric nurses embody themselves and children as a result of doing everyday procedures such as IV and naso-gastric insertion. ‘For Their Own Good' relates to how nurses rationalize these practices, but how this causes personal and professional tension. ‘Growing Distress' is the result of not being to rationalize doing to procedures to children any longer and the consequences of this.

In conclusion, the themes show that although paediatric nurses ‘care' for children, paediatric nurses may perceive the experience of ‘doing procedures' to children as ‘non-caring'. The dissonance in the modalities of care that paediatric nurses work in may contribute to a sense of personal and professional conflict and contribute to a loss of paediatric nurses from the profession.