I don't understand this...(vent)

Published

I've worked a good number of pediatric private duty cases. Most of them have been older kids (teenagers). The parents spent a decent amount of time with the patients.

My current patient is 3. He's cute as can be. Dad spends no time at all with him unless a nurse calls off. Mom might spend 10 minutes per shift with him. I thought maybe it just happened on my shifts, but the other nurses say it's the same way with them. The kid starts making all kinds of noises when they cone into the room - as if he's begging for their attention.

For the life of me, I cannot wrap my mind around this. If he were mine, nurses or not, I would be reading to him, rocking him to sleep or just sitting and cuddling up with him. He's had private care since he was born (after a 6 month initial hospitalization), so it can't be that they feel uneasy around the nurses.

It's like taking care of him is a burden if a shift isn't covered. Dad doesn't work and Mom has a Mon-Fri 9 to 5 job.

I sit there at work missing my children so that I can take care of theirs. When I'm not at work, I spend every available moment with my kids.

Is it just this family? Is this normal?

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Specializes in Peds(PICU, NICU float), PDN, ICU.

I see it all the time. I wish I understood it. Each situation is different, but I have guesses about why they do it. I'd love to see each case we have assigned to a psychologist to help the family work through issues. Plus we could work as a team with the psychologist to help us to help the family plus to help us better understand what we don't understand. It seems the issues we run into on a daily basis are really complex and very different from family to family.

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Specializes in Pediatric Private Duty; Camp Nursing.

As a former teacher, I saw the same thing go on with typical children and their families. Some parents are too preoccupied w their own lives for whatever reason- from busy professionals to World of Warcraft addicts to parents passed out all day on the couch from drugs, to simple disinterest- there are too many situations which keep a parent from spending quality time w their kids. It is alarming, the number of people that simply do not have their act together.

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Specializes in Peds, developmental disability.

Most of "my parents" have not been like that: distant and broken. When they are, I can see that they are in a lot of pain, sadness, or over-whelmed. It usually takes a strong spiritual component and/or a great marital relationship to enable the mom and /or dad to be strong parents.

Being selfish is natural. There has to be a reason NOT to be!

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Specializes in Pediatric.

I see this a lot. The parents on many of my cases don't interact with their child whatsoever.

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So sad...

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Specializes in Pediatric.
So sad...

It really is.

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Specializes in Pediatric.
So sad...

I've cried after work before.

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Specializes in Med-Surg/Telemetry.

I understand completely Why you question this behavior, yet Keep in mind that unanswered questions lead to judgement of behavior and that will certainly begin to affect things. It can be hard to change the subject in your own head, but I feel it is necessary to do this job well and with boundaries intact.

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Specializes in retired LTC.

I don't do the kiddos and I have none of my own. It's been a loooong time since I did Child Psych way back in the dinosaur days. But I do remember that parents always hope for (and expect) the perfect child when childbearing happens. To then have the non-perfect child can be life-shattering for the expectant parents.

I don't know the ages of your pt's parents (my guess is they might be the younger generation who haven't dealt with life's normal disappointments due to their own upbringing by THEIR parents). They are probably of the mindset who would be devastated if they weren't homecoming queen, or the starting quarterback, or didn't have the BMW when they started to drive or the six-digit salaried corporate Vice President job fresh out of school. Then to have a less-than-perfect child is crushing.

Even if I'm all wrong with my guess, I do know that not everyone is a perfect loving parent (A/E/B the statistics on child abuse/neglect issues even with healthy children). The not-perfect child (by birth or by accident or disease) poses problems in acceptance and tremendous care issues for which the parents may NOT be capable of undertaking.

I think what I'm thinking of is they don't have the TROPHY child they always wanted & expected. Such a disappointment! They just cannot adjust. And they just may not want to. This phenomenon happens also with adults whose spouses experience tragic accidents with injuries or illnesses. The remaining spouse cannot adjust either. Their love is not unconditional. To them, life is NOT fair.

The overwhelming abundant lovingness is just not there. For many, the love IS there regardless of whatever life throws out. But for many others, it is NOT. And I think that's the group OP's pt's family falls into.

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Specializes in Peds(PICU, NICU float), PDN, ICU.
I don't do the kiddos and I have none of my own. It's been a loooong time since I did Child Psych way back in the dinosaur days. But I do remember that parents always hope for (and expect) the perfect child when childbearing happens. To then have the non-perfect child can be life-shattering for the expectant parents.

I don't know the ages of your pt's parents (my guess is they might be the younger generation who haven't dealt with life's normal disappointments due to their own upbringing by THEIR parents). They are probably of the mindset who would be devastated if they weren't homecoming queen, or the starting quarterback, or didn't have the BMW when they started to drive or the six-digit salaried corporate Vice President job fresh out of school. Then to have a less-than-perfect child is crushing.

Even if I'm all wrong with my guess, I do know that not everyone is a perfect loving parent (A/E/B the statistics on child abuse/neglect issues even with healthy children). The not-perfect child (by birth or by accident or disease) poses problems in acceptance and tremendous care issues for which the parents may NOT be capable of undertaking.

I think what I'm thinking of is they don't have the TROPHY child they always wanted & expected. Such a disappointment! They just cannot adjust. And they just may not want to. This phenomenon happens also with adults whose spouses experience tragic accidents with injuries or illnesses. The remaining spouse cannot adjust either. Their love is not unconditional. To them, life is NOT fair.

The overwhelming abundant lovingness is just not there. For many, the love IS there regardless of whatever life throws out. But for many others, it is NOT. And I think that's the group OP's pt's family falls into.

Very interesting. That makes a lot of sense. I guess the next question is how to help the parent through those issues. This is such a common problem. I also see parents distance themselves to avoid being as hurt when the child passes if the child has a very short life expectancy.

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Specializes in Nursing Professional Development.

Don't be so harsh on these parents. There has been tons of research on parent-infant bonding and attachment -- and how interruptions in the "normal" process can disrupt the development of those parental/nurturing feelings you all seem to think should be automatic. When NICU's first developed, parents were not allowed into them to visit with their babies. A few months later, when it was time to send the kids home, health care workers were surprised that parents didn't really want them. They babies didn't "feel like theirs." Thus began a new field of research on maternal-infant bonding.

We still see this sort of thing happen in NICU's today. When parents can't spend a lot of time in direct contact with their baby, they sometimes "grow apart." Sometimes, the parent might really love the child, but just not feel as if the care-giving role is "their job" because that has ALWAYS been the role of the nurses -- not them. They probably don't feel comfortable/competent in their abilities to do much for their child because there have always been more competent people around doing them.

This child spent his/her first 6 months in the hospital. The parents didn't get the "normal" opportunities to bond with their baby -- they have NEVER been the primary care-givers for this child. It might have been a couple of months before they were even allowed to hold the baby. Even touching the baby may have been dangerous and discouraged. And they were probably NEVER alone with the baby during the first few weeks/months of life.

Instead of judging these parent as bad parents ... treat THEM as you patients, too. They are parents who have the nursing diagnosis of interrupted or ineffective parental bonding probably due to the circumstances of the child's birth and intensive care requirements. (I forget the proper NANDA wording.) Treat that diagnosis and THEM with skill and compassion. Research that diagnosis and develop a care plan appropriate for this family.

Also consider their culture. In many cultures, nannies do many of the tasks that middle-class American parents do for their children. That might enter into this situation, too. Don't forget to be sensitive to that as you develop your plan of care for the FAMILY (not just the kid).

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