Navigating Pediatric Organ Transplant: Nurses' Perspectives on Challenges and Coping.

Abstract

Objectives: We aimed to explore the experiences, challenges, and coping strategies of nurses working in pediatric organ transplant clinics in Türkiye. We investigated emotional stressors, ethical dilemmas, communication challenges, and the effectiveness of institutional support to address these challenges.

Materials and methods: A qualitative descriptive study design was employed. Data were collected through semi -structured face -to -face interviews with 20 organ transplant nurses from various hospitals in Türkiye. We used a purposive sampling method to select the participants. We used qualitative data analysis software (NVivo; version 12 ) to identify recurring themes related to emotional distress, ethical concerns, communication issues, and coping strategies. Ethical approval was obtained from the relevant institutional review board, and informed consent was secured from all participants.

Results: Thematic analysis revealed 4 main categories: emotional challenges, ethical dilemmas, communication challenges, and coping strategies. Nurses reported experiencing high levels of stress and burnout due to prolonged exposure to critically ill children. Ethical dilemmas related to organ allocation decisions created additional moral distress. Communication challenges were primarily linked to breaking bad news to patients' families and managing unrealistic expectations from families. Coping mechanisms included reliance on peer support, use of previously established personal resilience strategies, and access to institutional psychological support.

Conclusions: Pediatric organ transplant nurses encounter important emotional, ethical, and communication challenges. Enhancing institutional support structures, providing targeted psychological counseling, and improving communication training programs could alleviate these concerns and thereby improve both nurse well -being and patient care outcomes. Future multicenter studies would expand the generalizability of these findings and identify best practices for institutional support of transplant nurses.