Supporting the Healers: Debriefing After Patient Death in the PICU

Introduction: Clinicians who work in a pediatric intensive care unit (PICU) are at high risk for moral distress and burn out. At least some of this may occur from caring for children who die. After patient death debriefings are a strategy to mitigate clinician burnout and optimize multidisciplinary teamwork in the PICU.


Methods: Our PICU's end of life (EOL) multidisciplinary champion group conducted a needs assessment amongst physicians, nurses, respiratory therapists, social workers and child life specialist to better understand the opportunity for after death debriefings to mitigate burnout. All respondents strongly agreed or agreed that it was important to offer debriefings following a patient death. All surveyed reported an ideal debriefing session would occur within five days of a patient death and should be open to all multi-disciplinary staff. A confidential email called PICUdebrief was created to allow for any staff to request after death debriefings. A group of facilitators including a PICU social worker, physician, clinical nurse specialist and our institutional psychologist shared in the facilitation of the sessions. Facilitators used a standardized framework for debriefing that was adapted. Any proposed follow up strategies for improvement in care process or staff wellbeing were recorded and followed up on.


Results: In 2025, we conducted 11 multidisciplinary post death debriefings and discussed 16 patients who died. All 11 meetings were held virtually and used our adapted debriefing framework. 6/11 debriefings occurred within 1 week of a patients death. The number of staff that attended each session ranged from 17 to 35. All meetings included members from at least 4 disciplines including nurses, physicians, physician trainees, respiratory therapists, social workers and child life specialists. Several staff members have reported appreciation for these debriefings. Formal surveys assessing debriefings effect are pending.


Conclusions: After a structured debriefing process was developed in our PICU, we were able to offer post death debriefings after the majority of our PICU deaths so far in 2025. Post death debriefings have been well attended and multidisciplinary. We are hopeful post death debriefings with this structured process will expand to the rest of our children's hospital.