Dealing with family.

[gingersdad]

Any one online that's in HH and currently dealing with some pt family issues? Parenting probs. I need some ethical advice such as when to intervene when the approach/actions toward the patient by the family is considered too aggressive. This is probably not the place to discuss this topic but my alternatives are few.

[TheCommuter, BSN, RN]

Any ideas for intervention will be dependent upon your personal definition of "aggressive parenting," so please define it for us.

One person might regard parental spankings, yelling, corporal punishment, taunting, withholding of food, hovering, and other tactics as "aggressive" or "abusive," while another person might think they are perfectly fine methods of keeping children in line.

Since it is still legal to spank children, holler at them, make cruel statements to them, and punish them by making them go to bed without supper, it is unlikely that an entity such as CPS (Child Protective Services) would intervene.

Not all parents know about developmental stages, especially the undereducated moms and dads, so perhaps the "aggressive parents" might be served by some education.

[Virgo_RN, BSN, RN]

I am not in HH, but I am a parent, have observed many parents in public, and we do have a lot of "worried parents" bringing children to the ED. I am not sure what you mean by "aggressive". I have certainly witnessed my share of what I consider aggressive parenting tactics, but unless it's plainly a case of abuse, I tend to butt out. Since you are in a position of being a care provider for the child in question, I think it would be reasonable provide some type of educational materials on the topic of child development for the parents, maybe a referral to some type of support group or parenting program, etc. As far as when to intervene, I think that is a touchy subject. Obviously, if the child is in immediate danger of harm, you intervene. But if it's just disagreement on parenting style, you're definitely skating on some thin ice there. Is there anyone at your HH agency that you feel comfortable taking to about this, like a more experienced nurse who's maybe experienced anything similar?

[gingersdad]

My devotion lies solely to the 8 yr/o MD pt. Any action against the parent will devastate the pt. I think the parent is under so much social scrutiny that he is on the verge of collapsing mentally as a result of trying to meet his own and his family's demands. Quite possibly he is more than ready for some education on how to handle situations that baffle him. At this point the only way it seems he can respond to many situations is to be the loudest, because the loudest is always the best. I would like to educate him, instead of just saying it, about how his son wants and needs his personal care to be done by his dad whenever he is at home. Thanks for the direction to go. I think it can be done.

gingersdad