Vent: parents

[Coffee Nurse]

I'm sure just about every area of nursing deals with difficult family members at some point, but I just have to vent some spleen about conditions on our unit recently. I wouldn't dream of walking into a place where I am utterly unfamiliar with the work done and starting to tell the employees how to do their own jobs; why is it okay for parents to do that to us? Where do they come up with these ideas, like milk can only be taken out of the fridge ten minutes before a feed or a micropreemie has to be changed the second her diaper gets dirty even if it's only been half an hour since the last one, and why don't they listen to us when we try to use logic and rationality to explain why we do what we do? I educate until I'm blue in the face, but they put more stock in what another parent (of a baby whose history and clinical picture is completely different) has told them in the hallway. I'm spending more time every shift documenting about parent interactions than about the actual baby, and it's getting to the point where I'm feeling like -- what is the point, even, of trying to teach parents to do things correctly, when they're going to do whatever the heck they feel like anyway?

Thanks for reading, if you've gotten this far. It's just incredibly frustrating and demoralizing to feel like I'm stuck between doing what is best for the baby and not pissing off the parents.

[thenightnurse456]

Parents are the one thing that stops me from trying NICU nursing.

I feel for you as the nurse trying to educate, but at the same time I feel for the parents who probably just want to have some control in a terrifying situation.

I'm not sure what the solution is.

[Coffee Nurse, BSN, RN]

Thanks for the support, everyone. It's just tremendously frustrating because one of the best moments in my job is when I teach parents something and they get it, especially if it's something empowering like showing them how to calm their preemie or helping them take baby out of his incubator themselves for the first time. Not being able to get through to a parent is aggravating and upsetting. I've had a few days off now and gotten some sunshine in, so hopefully I'll be nice and refreshed when I head back in tomorrow

[champagnesupeRNova]

NICU is just a completely different world than what parents are used to. They often interpret many of their baby's cues wrongly (i.e. seeing the baby splay out their hands - "they need to stretch out" or repeated yawning from the baby "he's so sleepy."). When I have parents that don't understand low-stimulation care or the specific developmental cues their baby needs, I play an educational video for them that is about the premature baby in general and all their specific needs. The parents LOVE watching it because they learn so much and it in turn makes the baby's NICU stay that much better because the parents are on board. Do you have anything like this at your workplace?

[tinkerbell419]

I think this is something that every paediatric ward and neonatal/nicu unit deals with. It is a universal problem. Parents feel vunerable and understandably are worried. Mothers like to feel close to their babies. Ive had mothers constantly changing babys nappy or doing top and tail when baby has just had feed or is asleep. They like to busy themselves. Sometimes you have to let them do what they want even if you did try and advice them beforehand.

[tinkerbell419]

NICU is just a completely different world than what parents are used to. They often interpret many of their baby's cues wrongly (i.e. seeing the baby splay out their hands - "they need to stretch out" or repeated yawning from the baby "he's so sleepy."). When I have parents that don't understand low-stimulation care or the specific developmental cues their baby needs, I play an educational video for them that is about the premature baby in general and all their specific needs. The parents LOVE watching it because they learn so much and it in turn makes the baby's NICU stay that much better because the parents are on board. Do you have anything like this at your workplace?

That is a really good idea!

[tinkerbell419]

A bit of sunshine and a cup of tea or a caramel latte and im restored back to my glorious self. Until the next parents frustrates me its all good. :)

[NICURN29]

I am not sure why you are documenting in the medical record information about parents' interactions with other parents. It sounds like maybe it would be a CYA strategy, but I would think that, should a case go into litigation, that would be information that you might not want to be discoverable. I think that is instead something that should be discussed with your nurse manager and medical director so that they can approach the parents and encourage them not to share medical advice.

We do often have frustrating families, and I try to put myself in their place and remind myself that this is perhaps the most stressful experience they have ever had. I also have a nurse manager and a medical director who I can count on to intervene if there is something like this happening in our unit, and this is hugely helpful for me.

[Coffee Nurse, BSN, RN]

I am not sure why you are documenting in the medical record information about parents' interactions with other parents. It sounds like maybe it would be a CYA strategy, but I would think that, should a case go into litigation, that would be information that you might not want to be discoverable. I think that is instead something that should be discussed with your nurse manager and medical director so that they can approach the parents and encourage them not to share medical advice.

We do often have frustrating families, and I try to put myself in their place and remind myself that this is perhaps the most stressful experience they have ever had. I also have a nurse manager and a medical director who I can count on to intervene if there is something like this happening in our unit, and this is hugely helpful for me.

I'm documenting about my interactions with the parents, not the parents' interactions with others, although I can see how that could have been misread. I do get that it's probably the most stressful thing they've ever been through, but it still comes down to the question of how you get across tp them that some behaviors are simply unacceptable because of potential or actual harmful effect on the baby. We've had a mother who got it into her head that the nursing staff wasn't repositioning her preemie often enough and took it upon herself to do it, despite repeated requests to wait until a nurse was present, despite the baby being on HFOV. She ended up accidentally extubating the kid, and even after watching the scramble to get a new tube in and prolonged efforts to get HR and sats back up, still didn't understand how dangerous her actions had been. In the face of that sort of thing, I just don't know what else to do to get through to them.

[kitty29]

Darl'n this is called "Family Centered Care"...

[Baby Wrangler]

Darl'n this is called "Family Centered Care"...

Family "centered" not family "controlled" . There are limits.

[kitty29]

I was supposed to be a joke.... I agree with you!