Negotiating Care in the Special Care Nursery: Parents' and Nurses' Perceptions of Nurse–Parent Communication

Abstract

The findings indicated a tension between providing family-centered care that is individualized and based on family needs and roles, and adhering to systemic nursery policies.

Parents' and nurses' experiences of partnership in neonatal intensive care units: A qualitative review and meta‐synthesis

“…Not feeling welcome (Cescutti‐Butler & Galvin, ), not feeling important (Gallegos‐Martínez, Reyes‐Hernández, & Silvan Scochi, ), experiencing dictating and controlling nurses and feeling disrespected and frustrated due to inconsistencies in information and guidance (Cescutti‐Butler & Galvin, ; Jones, Taylor, Watson, Fenwick, & Dordic, ), lacking acknowledgement of their emotional situation (Wigert, Dellenmark Blom, & Bry, ), and not feeling involved in critical decision‐making, where parents found their observations of the infant were ignored (Sudia‐Robinson & Freeman, ), were all barriers to parents feeling respected and listened to. Nurses were not always aware of how their interactions negatively affected the parents (Jones et al, ). When the infant was in a stable phase, nurses often withdrew from the family to enhance the parents' independence, not recognising that they needed ongoing support from primary nurses to develop confidence (Fegran et al, ).…”

“…Parents and nurses mutually found that sharing information on the infant's condition and what to expect was essential to maintaining trust and security (Jones et al, ), and this was identified as a characteristic of the category “Sharing knowledge.” Mutual understanding and shared decision‐making helped parents to keep control of the situation and to find time for their own recovery (Weis et al, ). Barriers to sharing knowledge encompassed staff communication skills, approach to nurse/parent collaboration and type of information.…”

“…This could be achieved through informal and formalised training of the parents in providing care for their infant, as well as providing opportunities for them to practice (Smith et al, ). At this stage, nurses were in the position to enable interactions between parents and their infant (Jones et al, ), so they could become familiar with the infant's signals, behaviour and needs. When parents truly participated in the infant's care, a partnership could evolve between nurses and parents (Heermann & Wilson, ); and a nurse/parent relationship characterised by negotiation of role boundaries enabled a partnership where parents were meaningfully involved in the care of their infant (Reis et al, ).…”

How do health professionals decide whether an interpreter is needed for families in neonatal and pediatric units?

“…Nurses describe having less communication, less informal communication such as chatting, more intergroup communication, and more focus on ensuring parents understood information with LHLP families [13]. This is inconsistent with parent preferences for nurse communication [4,14], although LHLP families in neonatal and paediatric units' preferences have not been examined, although a study in cancer care found migrant groups differed in their communication preferences [15].…”

“…Although medical care of the child is the primary focus, health professionals (HPs) are expected to involve parents in decision making and their infant's care [1,3]. Thus, staff use communication to empower parents, provide information about the child's progress, and build relationships [2,4,5]. However, for HPs engaging in FCC with families with low host language proficiency (LHLP), language and other cultural differences are barriers to FCC [6][7][8], with implications for quality of health care, including culturally competent care [8].…”