Nursing in neonatal Palliative Care

Objectives: 1) to explore how nurses can provide their best in physical, emotional and spiritual newborn and family needs in neonatal palliative care; and 2) to examine the perceptions of neonatal nurses concerning their roles and coping strategies during their work with dying newborns and bereavement. Material and method: a search of articles was performed in IME, INDEX, PUBMED and CINAHL, between 1997 and 2007, in Spanish and in English, using the key words "cuidados paliativos, duelo, neonato, enfermeria neonatal, toma de decisiones, competencia cultural" AND "palliative care, end-of-life care, hospice care, grief, bereavement, newborn infant, neonatal nursing, making decisions, cultural competence". Also in websites and specialty books. Results: of the many papers found in English we chose those interesting from a nursing point of view, and explored them. Finally, we described four PC components: PC nursing perspectives, nursing role (environment, comfort, family support), transcultural and spiritual care, and follow-up of families after patient death. Conclusions: to make palliative care dimensions explicit is necessary to improve nursing practices. Although nurses have difficulties in approaching neonatal palliative care, they do accept their role and identify themselves as newborn "advocates" and primary family supporters.