Impact of personal experiences on career path, clinical practice, and professional endurance among hospice nurses caring for dying children

Abstract

Context and objective: The multifaceted demands of pediatric hospice work often discourage nurses from pursuing the career route and may overwhelm nurses who choose to do the work, risking burnout. The relationship between nurses’ personal experiences and their decisions to pursue this difficult work, as well as their ability to sustain it, has not been studied previously. The study objective was to explore the influences of pediatric hospice nurses’ personal experiences on their career trajectories, their clinical approaches to caring for dying children, and their endurance in doing so. Methods: From the 551 community hospice nurses in Tennessee, Mississppi, and Arkansas who completed a survey as part of a previous study, purposive sampling was used to select a cohort of 41 nurses. Semi-structured interviews were conducted, recorded, and transcribed. Content analysis of interview transcripts was performed. Results: Nurses described three types of personal experiences that shaped their professional practice: 1) personal illness, 2) personal loss, and 3) parenthood. We identified two major themes characterizing how personal experiences influence their work: 1) leading them into the hospice field (“career trajectory”) and 2) strengthening their clinical practice (“clinical approach”) through four mechanisms: a) identifying tools for patient care, b) connecting with pediatric patients, c) connecting with bereaved families, and d) finding balance between competing priorities. Conclusions: Personal experiences of illness, loss, and parenthood influence hospice nurses’ career trajectories and how they care for dying children. Normalizing these influences and integrating reflection on them into hospice training may empower nurses to pursue pediatric hospice nursing, find meaning in the work, and build professional endurance.