Johnson K Taneille, Dahl Nicole
Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario.
Paediatr Child Health. 2023 Jun 6;29(5):303-305. doi: 10.1093/pch/pxad029. eCollection 2024 Aug.
Death and dying, while uncommon in day-to-day paediatrics practice, are becoming increasingly common occurrences as children with life-limiting illnesses are living longer. We reflect on our experiences with death and dying in our residency training and whether paediatrics, as a specialty, is uncomfortable with death. Paediatric trainees should be included in honest discussions about disease trajectories and participate in providing end-of-life care. Anticipatory guidance helps personalize care and can prevent unnecessary procedures or suffering that patients may experience. While trainees may not be present at the end-of-life for many patients, managing death and dying are important competencies for future paediatricians. Current paediatricians should reflect on their comfort with death and how this may impact their patient care.
死亡和濒死情况在日常儿科实践中虽不常见，但随着患有危及生命疾病的儿童存活时间延长，此类情况正变得越来越普遍。我们回顾了住院医师培训期间处理死亡和濒死情况的经历，以及儿科作为一个专业领域是否对死亡感到不适。儿科实习生应参与关于疾病发展轨迹的坦诚讨论，并参与临终关怀。预先指导有助于使护理个性化，并可防止患者可能经历的不必要的程序或痛苦。虽然实习生可能不会在许多患者的临终阶段在场，但处理死亡和濒死情况是未来儿科医生的重要能力。现任儿科医生应反思自己对死亡的接受程度以及这可能如何影响他们对患者的护理。
