In July 2023, senior nurses in the Cairns Hospital Paediatric Unit were notified of a neonate being returned to our local special care unit with the intention of memory making with his family and ultimate compassionate extubation.
The small regional paediatric nursing team, worked closely with interdisciplinary specialist services across the state, to ensure the family were well supported from their return to Cairns. Memory making was undertaken with the family and a plan for a compassionate extubation was articulated. Aware that this had previously been undertaken in hospice settings and actually in the home by other palliative care teams, the paediatric nurses raised this as a possibility for this family and in agreement with the coroner's office, a plan was initiated to take the baby home and extubate him there.
The baby was taken home with the support of the medical, nursing and neonatal teams and his extubation took place when his family were ready. The baby surprised everyone and breathed spontaneously and over the subsequent 66 hours, a core group of paediatric nurses, with the remote assistance and support of the Paediatric Palliative Care Service, supported the family at home until their little one peacefully passed away in the arms of his parents, surrounded by love.
For this process to occur in a regional setting demonstrates the level of commitment and collaboration that the team had in ensuring a high standard of holistic compassionate and family centred care for the family. The team truly worked in partnership with the family in meeting their specific needs and there are many accreditation standards that can be referenced to formalise this activity. Additionally, the teamwork that occurred between the neonatal and paediatric teams, with the tertiary centre and also the coroner's office led to an almost seamless process coming to fruition. The family wished for their baby to meet his extended family at home, (especially his fur siblings) and this is what the work of the nursing team in particular allowed to happen. The staff involved with this process, but especially the paediatric nursing team are exceptionally proud of the work they accomplished alongside the family and hope their experience can encourage other staff to think creatively in providing truly holistic care.
