Original Article

Journal of Perinatology (2008) 28, 771–778; doi:10.1038/jp.2008.96; published online 3 July 2008

End-of-life experiences of nurses and physicians in the newborn intensive care unit

E G Epstein1

1School of Nursing, University of Virginia, Charlottesville, VA, USA

Correspondence: Professor EG Epstein, School of Nursing, University of Virginia, PO Box 800782, Charlottesville, VA 22908, USA. E-mail: meg4u@virginia.edu

Received 7 December 2007; Revised 21 May 2008; Accepted 22 May 2008; Published online 3 July 2008.



Objective: To explore nurses' and physicians' end-of-life (EOL) experiences in the newborn intensive care unit.

Study Design: A hermeneutic phenomenology of health-care providers' lived experiences with infant deaths in the newborn intensive care unit between January and August 2006 was conducted. Semistructured interviews were completed with individual providers. Demographic data were also collected. Analysis of themes and descriptive statistics were performed.

Result: Twenty-one nurses and 11 physicians were interviewed. Providers described their experiences largely through an overall theme of ‘creating the best possible experience’ for parents. To support this theme, three subthemes (building relationships, preparing for the EOL and creating memories) were common between physicians and nurses. However, nurses and physicians articulated their roles and obligations differently within these subthemes. Additionally, three subthemes through which the providers described their personal experiences were found and these included moral distress, parental readiness and consent for autopsy.

Conclusion: A primary finding of this study was that a common overall obligation among nurses and physicians was to create the best possible experience for parents. Despite this commonality, the two disciplines approached the EOL and accomplished their common obligation from different vantage points.


health-care provider obligations, relationships, hermeneutic phenomenology, moral distress