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Discussion

How should I respond?

I'm a new grad starting in the NICU and I'm afraid that parents are going to ask me a ton of questions that I don't know the answers to. What is the best way to respond to these questions without making them feel that I am not competent to be thier child's nurse? It also doesn't help that I look like I could still be in high school!

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One of the best ways to guard against that is to anticipate the questions that you're most likely going to be asked.

* How much does he weigh?

* When can she eat? (often there are unit-specific guidelines)

* When is he going home? (Again, sometimes you can give a general idea based on unit guidelines)

You won't be able to think of everything in advance, so don't be afraid to admit that you don't know and tell them you'll find out.

Dont forget the ever popular and all important "When can he have his circ?"

LOL! You think I am kidding, but that is often the 2nd or 3rd concern of parents/grandparents when they have a baby boy, no matter if he weighs 700 grams.

Doh! How'd I forget that one?

  • Author

And the answer to the circ question would be??.....haha that is one of the questions I don't know the answer to :)

The usual answer is "when he's ready to go home". Most of our circs are done the day before discharge.

I'm with you on looking young. A coworker and I once found out parents were taking bets on how old the two of us were. The funny bit was we were both older than all of the parents involved.

Many times you will find that the questions they are asking will be ones you already know the answers to. When you're on orientation, listen to how your preceptor talks to the parents. You'll pick things up as you go. And don't be afraid to say, "I don't know, but I will find out for you."

I agree that most of the questions asked are ones you will know the answers to after the first day or two. They are the basic ones about eating, sleeping, holding, etc. The circ one cracks me up - and they ask it without fail. I also get questions about prognosis all the time - "Will he need glasses?" "Do you think she will have a hard time in school?"

Sometimes you want to say, "Listen, people....airway, breathing, circulation....stay with me here. We'll worry about glasses when he comes off the vent, mmmkay?" But you don't. You say something very nursey and polite like, "There's really no way to know that at this point. Every baby is different."

Sometimes you'll get parents who are Googlers, and ask you every question under the sun. My standard response is, "That's a really great question that I'll find out the answer to in just a sec."

You can get a really long way by being confident in your role as the nurse, and just being polite.

  • Experts

Sometimes you want to say, "Listen, people....airway, breathing, circulation....stay with me here. We'll worry about glasses when he comes off the vent, mmmkay?" But you don't. You say something very nursey and polite like, "There's really no way to know that at this point. Every baby is different."

QUOTE]

I am a former NICU nurse who used to teach a lot of orientees. My "standard answer" to those questions was a lot like yours. However, I would also add something like .... "That's why it is important that you take your baby to the follow-up clinic regularly after he/she goes home. They will assess your baby's needs on a regular basis and make sure to address any future needs early."

We once had a grandfather asking why 850g baby boy member was so small.

I generally go with step by step strategy and parents seem to understand even though some like to call me " super extra cautious"

With experience there are things you will be able to give direct answers to. With other stuff, that you feel is out of your depth, then refer the parents to medical staff. Have faith in yourself, being able to look parents in the eye and give them your honest answers comes with time and always the back up of the team when needed. You are not alone! Good luck to ya !

I have quite a bit of experience being "new" in my short time, as I started straight nights, switched to straight days, and the trained in to a Level III from a Level II. My experience is that most reasonable parents respect you if you respond with something like..."That's a great question. Let me ask Susan...she is a real expert in that area." You will learn the common answers quickly. Parents don't need to know that you have all the answers to take care of their baby. What they do want to see is that if you are doing something new, you are willing to ask for help. When I encounter something new, I make sure another nurse shows me how and then watches as I walk through it myself. I don't go ahead alone with something I don't feel confident doing independently. Then they trust that you are committed to providing their child with quality care and are not afraid to find the help you need to provide it. I have rarely had a negative response to that, but parents understandably respond negatively when nurses try to fake that they know everything, and know what they are doing when they don't.

You are a highly educated health care professional. Most questions you are going to get are from laymen with little or no medical background. Most of the time there is a simple answer and a long technical answer- most people will do better with the easy one. My best advise is keep your ears open. Even though you may know most of the answers to the day-to-day questions, some of the more seasoned nurses have developed answers and ways of phrasing the answer that are clearer for the patients families to understand and accept. The last thing you want to do is increase thier stress. I had one nurse who tried to explain metabolic acidosis to the family of a patient. They went home and immidiately called the hospital administration, the attending doc (at home) and all the rest of thier family with the complaint that we had somehow put a lot of acid into thier loved ones blood and it was killing them!!! Always remember KEEP IT SIMPLE!, and expect to be missunderstood.

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