Caring for newborns in the presence of their parents: the experience of nurses in the neonatal intensive care unit

Abstract

The nurse has a key role in involving parents in the care of newborns in the neonatal intensive care unit. The aim of this study was to comprehend how the nurses experience the care provided to newborns in the presence of the parents. This is a qualitative study using social phenomenology, with the participation of seven nurses, interviewed between January and February 2009. The nurses perceived the needs of parents; had positive expectations regarding the care provided and acknowledge themselves to be the link between them, helping them to live with the hospitalized child. However, in emergencies, the nurses had difficulties in caring for the neonate in the presence of the parents. The nurses positively evaluated the presence of parents in the neonatal intensive care unit, involving them permanently in the care of the newborn. The study evokes the emergence of a care context (nurse/neonate/parents) that precedes the proximity between the subjects and the demands presented by them. Cuidar del recién nacido en la presencia de sus padres: vivencia de enfermeras en unidad de cuidado intensivo neonatalLa enfermera tiene un papel fundamental en el envolvimiento de los padres en el cuidado al recién nacido en la unidad de terapia intensiva neonatal. El objetivo del estudio fue comprender como las enfermeras experimentan el cuidado prestado al recién nacido en la presencia de los padres. Se trata de una investigación cualitativa con abordaje de la fenomenología social; tuvo la participación de siete enfermeras, entrevistadas en los meses de enero y febrero de 2009. Se encontró que la enfermera percibe las necesidades de los padres, tiene expectativas positivas en relación al cuidado realizado y reconoce ser el eslabón entre ellos, ayudándolos a convivir con el hijo internado. Sin embargo, en situaciones de emergencia, tiene dificultades en cuidar al neonato en la presencia de los padres. Concluimos que la enfermera evalúa positivamente la presencia de los padres en la unidad de terapia intensiva neonatal, envolviéndolos permanentemente en el cuidado del recién nacido. El estudio evoca la emergencia de un contexto de cuidado (enfermera/ neonato/sus padres) que precede a la aproximación entre los sujetos y las demandas por ellos presentadas.

Meanings, beliefs and attitudes of the neonatal unit staff in México about the parents' participation in a neonatal unit: A qualitative approach

“…From the perspective of Gardner, the staff would teach and work closely with the parents to achieve care competency; therefore, they would be accompanied by the team and by other parents [34] . In addition, Merighi stated that nurses need to have interpersonal competency to care for a baby and his family [35] . In fact, NUs have attempted to expand parental roles by adopting unrestricted visitation rights and encouraging parental participation in care, based on the benefits of affectionate handling for the most fragile babies [36] .…”

Maternal representations about the provision of care to newborns at risk: a collective discourse

“…Another positive aspect apprehended in relation to maternal experience was concerning health teams, with the recognition of their fundamental role regarding the involvement of parents in the NICU activities, primarily from the guidance provided during the first visit. These professionals must provide ways to reduce the anxiety and fear that the parents of newborns feel, offering comforting conditions, trying to respond to their concerns, and providing information on the health status of the child, their treatment, and the equipment used (3) . It is important to emphasize that communication between professionals and families favors a bond of trust and respect, contributing to the quality of the care provided to the newborn.…”

“…It is important to emphasize that communication between professionals and families favors a bond of trust and respect, contributing to the quality of the care provided to the newborn. The received attention, the interpersonal relationship between the health staff and parents, the fact of being allowed to have contact with the children, and being informed about their condition, generate comfort and a feeling of security and confidence (3) . The scientific literature suggests that the approach to the mother/father provides positive incentives for clinical stability and evolution of the premature baby, a reduction in hospitalization time, and reduced readmissions of children (19) .…”

“…In the case of the birth of a neonate at risk, the family is faced with an exhausting and challenging experience, which leads to profound changes in family dynamics and extends to the hospitalization of the infant (3)(4) . The hospitalization of VLBW infants in the NICU can last for several months.…”

“…In this case, among the feelings experienced, anxiety, depression and fear on the part of mothers facing this situation stand out (9) . Besides such feelings, other difficulties are reported in scientific studies on the involvement of parents in the provision of care of the child admitted in NICU (2,3,6,7,8,9) , including the contradiction between the interest of health professionals in promoting this participation and in maintaining the care provision routines and technical procedures. Therefore, the following concerns have guided this study: how do mothers experience the moment of hospitalization of VLBW infants in the NICU?…”