No second chance: the experiences of junior neonatal nurses in providing end-of-life care for babies and families in the NNU

Background

An infant’s death is acutely stressful for parents and professionals. Little is known about junior nurses’ experiences providing end-of-life care in Neonatal Units (NNU).

Objectives

To better understand junior nurses’ experiences providing end-of-life care in NNU, the study explored the challenges and opportunities inherent in their practice relating to providing such care to babies and their families.

Methods

Neonatal nurses (n=12) with less than 3 years’ experience who were undergoing a neonatal education programme participated. Two focus groups were convened each with 6 nurses. The Ethics Committee at the relevant University approved the study. Nominal Group Technique (NGT) was used in the focus groups to build consensus around the challenges faced by junior nurses, alongside suggested developments in improving future care provision. Primary analysis involved successive rounds of ranking and decision making whilst secondary analysis involved thematic analysis.

Results

The study identified the pressures these nurses felt in having only one chance to ‘get it right’ for the infants and their families. They perceived the need for further ‘education and training’ highlighting that improved education provision would include both additional courses and internal training sessions. Greater ‘support’ from mentors themselves more experienced in this aspect of care within the NNU was identified as important in addressing issues around confidence building and skill development.

Conclusions

The results highlight junior nurses’ need for specific education and mentorship around end-of-life care for babies. This presentation will outline the implications for practice, education and further research.

Seasonal changes in broodstock spawning performance and egg quality in ballan wrasse (Labrus bergylta)

Sea lice continue to be one of the largest issues for the salmon farming industry and the use of ballan wrasse (Labrus bergylta) as a biological control is considered to be one of the most sustainable solutions in development. Broodstock management has proved challenging in the initial phases due to the significant lack of understanding of basic reproductive physiology and behaviour in the species. The aim of the study was to monitor captive breeding populations throughout a spawning season to examine timing and duration of spawning,quantify egg production, and look at seasonal changes in egg quality parameters as well as investigate the parental contribution to spawning events. A clear spawning rhythm was shown with 3-5 spawning periods inclusive of spawning windows lasting 1-9 days followed by inter spawning intervals of 8-12 days. Fertilization rate remained consistently high (> 87.5%) over the spawning season and did not differ significantly between spawning populations. Hatch rate was variable (0-97.5 %), but peaked in the middle of the spawning season. Meanoocyte diameter and gum layer thickness decreased slightly over the spawning season with no significant differences between spawning populations. Fatty acid (FA) profile of eggs remained consistent throughout the season and with the exception of high levels of ARA (3.8 ± 0.5 % of total FA) the FA profile was similar to that observed in other marine fish species. Parental contribution analysis showed 3 out of 6 spawning events to be single paired mating while the remaining 3 had contributions from multiple parents. Furthermore, the proposed multiple batch spawning nature of this species was confirmed with proof of a single femalecontributing to two separate spawning events. Overall this work represents the first comprehensive data set of spawning activity of captive ballan wrasse, and as such and will be helpful in formulating sustainable broodstock management plans for the species.