Approximately 100 children die every year at Rainbow Babies & Children’s Hospital, and pediatric and medicine/pediatric residents are often a critical part of each of these deaths. Before beginning their postgraduate training, few residents have been intimately involved in the care of a dying child which can be an extraordinarily profound and intimate experience. Although patient death is ubiquitous in pediatric clinical care, no formal or organized venues exist for the discussion of these experiences. In the spring of 2006, thirty-four pediatric residents were surveyed regarding their experience with patient death. Of those, 82% reported involvement in the death of a pediatric patient. For those residents, 92% described the experience as “stressful” or “very stressful.” Although every respondent recorded the acknowledgement and teaching regarding residents’ experience with patient death/dying in their pediatric residency program as “very important,” only 30% felt that the current environment and curriculum prepared them “well” or “very well” for personally dealing with the issue of patient death and dying. The Resident Bereavement Curriculum outlined here has been developed in response to this perceived need.
Curriculum Structure
Resident Bereavement Conference
• Quarterly
• Review of all patient deaths during preceding months with opportunity for residents to discuss their involvement in the death experience as well as their insights and emotions and to share ideas for making residents’ experience with patient deaths more rewarding and educational
• Residents are encouraged to share stories, perspectives, poetry, or musical offerings
Voices of Bereaved Parents
• Semi-annual presentation by and open dialogue with parents and family members of a child who died
• Allows residents the opportunity to better understand the needs, experience, and perspective of family members
Celebration of Lives
• Gathering of families, medical caregivers, and staff of patients of Rainbow who have died in order to allow for a reunion and opportunity to celebrate the lives of the children
• Gives residents an opportunity to meet with family members alongside more experienced attending physicians and other care providers
Individual Meetings
• Residents who wish to privately discuss more about their experiences with patient death are invited and encouraged to meet with Dr. Lyren.