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

[eeffoc_emmig]

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?

[SDALPN]

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).

I think that applies to some families, but not all. There are families out there that use nursing to raise their kid while they collect a check. I've had parents admit that to me. I even had one parent tell me she didn't want any kids and her kid was an accident. And that if it wasn't for nursing and the check, she would have given the kid up.

[llg, PhD, RN]

I think that applies to some families, but not all. There are families out there that use nursing to raise their kid while they collect a check. I've had parents admit that to me. I even had one parent tell me she didn't want any kids and her kid was an accident. And that if it wasn't for nursing and the check, she would have given the kid up.

Sure. There are bad parents everywhere. Just as their are bad nurses ... bad doctors ... bad plumbers, etc. But it is wrong and unfair to assume that these parents are bad without a thorough assessment. This type of problem is not uncommon in long-term NICU families who take children home with significant disabilities.

[Not_A_Hat_Person, RN]

One common denominator in my peds cases (with 2 exceptions) was a father who completely checked out. Sometimes it happened the day the disability became apparent, sometimes it happened later on. Some would visit now and then, some sent occasional checks, some just disappeared. The mother wasn't detached so much as completely overwhelmed.

[meanmaryjean, DNP, RN]

I agree with the observation that the child's care has always been within the domain of nurses. Parents CAN be made to feel like 'intruders' at times. And I cannot even BEGIN to imagine what it must be like to have strangers/ nurses in one's home for the better part of the day or all night.

I have been blessed to care for some kids in marvelous families, and I've also cared for some kids in families like the OP described.

[SDALPN]

I agree with the observation that the child's care has always been within the domain of nurses. Parents CAN be made to feel like 'intruders' at times. And I cannot even BEGIN to imagine what it must be like to have strangers/ nurses in one's home for the better part of the day or all night.

I have been blessed to care for some kids in marvelous families, and I've also cared for some kids in families like the OP described.

I agree with that. Its important to try to involve the parents. Though so many push it all on us. I get that its our job while we are in the home. But its the parents job to bond with the child and be the consistency that the child needs. But the type of parents the OP has don't seem to be the type to be a part of much in their Childs life.