292 Vol. 41 No. 1 January 2011Schedule with Abstracts

The Lived Experience of Grief, Loss, andCoping Among Pediatric OncologyNurses (733)Nancy Kline, PhD RN CPNP FAAN, MemorialSloan-Kettering Cancer Center, New York, NY.Bridgette Thom, MS, Memorial Sloan-KetteringCancer Center, New York, NY.(All speakers have disclosed no relevant finan-cial relationships.)

Objectives1. Describe pediatric oncology nurses’ experi-

ences with both professional and personalgrief.

2. Discuss efforts toward developing interven-tions to minimize stress and distress in thispopulation.

Background. Pediatric oncology nurses face nu-merous and continual stressors, including sup-porting distraught families, understandingcomplicated protocols, and caring for childrenwith cancer, many of whom will die. The litera-ture suggests coping with the death of a pediatriconcology patient with whom the nurse has devel-oped an intense relationship places considerablestress on a nurse. In addition, pediatric oncologynurses may be faced with personal losses andgrief, which may contribute to their moral dis-tress, grief, bereavement, or burnout. Althoughthe stress involved in oncology nursing is welldocumented in the literature, there is a paucityof research identifying the specific determinantsof stress and support measures to effectively rem-edy the situation.Research objectives. The aim of this study was toassess inpatient pediatric oncology nurses’ livedexperience of burnout and bereavement andto identify the nurses’ perceptions about strate-gies to alleviate these negative outcomes.Methods. Using a phenomenological approach,the research team conducted semi-structured in-terviews with focus groups of 4-6 pediatric nursesat a comprehensive cancer center. Interviewswere audio-taped, transcribed verbatim, and re-viewed for accuracy.Results.Both the transcripts and the interviewers’notes and memos were included in the analysis,which sought to reflect on the essential themesthat characterize the central phenomena of grief,loss, bereavement, and coping. Data analysis oc-curred simultaneous to data collection; prelimi-nary results suggest nurses feel both personaland professional loss when a patient dies.

Conclusion. Once all interview data have beenanalyzed and specific themes and categoriesemerge, potential interventions targeting pediat-ric oncology nurses will be developed for testingin future studies.Implications for research,policy, orpractice. Inter-ventions such as grief-reduction workshops or sup-port groups have had limited success. Althoughthe literature acknowledges the stress, distress,and grief, oncology nurses experience, there re-mains a need to identify and implement effectivestrategies to minimize distress and relieve the bur-den of cancer on pediatric oncology nurse.

The Conversation Bank Cohort: AFeasibility Study (734)Susan Ladwig, MPH, University of Rochester, Ro-chester, NY. Sally Norton, PhD RN, University ofRochester, Rochester, NY. Robert Gramling, MDDSc, University of Rochester, Rochester, NY.Maureen Metzger, PhDc MS RN, University ofRochester, NY.(All speakers have disclosed no relevant finan-cial relationships.)

Objectives1. Discuss the need for longitudinal study of

communication as a major clinical ‘‘proce-dure’’ in palliative medicine.

2. Recognize important challenges, innovations,and benefits of studying conversations/com-munication using epidemiology methods.

3. Recognize the feasibility of studying conversa-tions in epidemiological palliative carecohorts.

Background. Communicating is a critical ‘‘proce-dure’’ for palliative medicine. However, very lit-tle research is available that describes thecontent, processes and outcomes of conversa-tions with hospitalized patients and families, inpart due to the challenges of directly observingand analyzing a sufficient number of such con-versations for epidemiological evaluation of sub-sequent outcomes. We developed and pilottested a protocol designed to directly observe,audio-record, and archive palliative care (PC)‘‘goals of care’’ consultations as the basis for cre-ating a large, sustainable epidemiological cohortin PC. Main criteria for the protocol includedsustainability, valid representation of the consul-tation conversation(s), and minimal impact onthe flow of clinical processes.