What do you tell parents when...

[mason83]

I've worked as a nursing assistant in the PICU for about 2 years, and hope to work there as an RN once I graduate...10 more months!

Frequently, while nurses are getting a pt settled, I'm the one tending to the parents; getting their information, telling them the basics, answering any questions that I can, etc.

Often, this is a period where parents are really distressed and emotional, which is absolutely understandable (I'm pretty sure I would be barely able to function if I were in the same spot.)

What do you say to parents at these times to be as comforting and calming as possible, while not instilling false hope?

Sometimes I just focus on the practical and matter-of-fact information about what is going to happen and what I can do for them (food, coffee, logistics, etc), but occasionally a parent will give me a question or comment that requires me to go further.

Today, after I asked a Dad if he had any questions, he said in tears, that he was just really worried and scared for his son (in a much more elaborate and genuine way than I can articulate here). He had every right to be: his preschool aged son had a complex diagnosis with very rapid change in condition over the course of the day that led them to where they are now - unsure of the cause and exactly what to do next.

What do you do and say in moments like these?

[SoldierNurse22, BSN, RN]

Sometimes there is nothing you can say. I tend to sit and listen to patients/family members like that because often, they just need to be heard, specifically by someone who is a member of the healthcare team and has seen the problem(s) they're confronting.

[umcRN, BSN, RN]

Agree that sometimes there is nothing to say. You can validate their feelings and stress that the medical team is doing everything in their power to take care of their child. Does your hospital allow family presence during resuscitation? This is something we have adopted in my unit and we always try to have a trained family presence facilitator available when a child is decompensating. These people are usually RN's or social workers who know what is going on and what info to relay to the parents. When possible we try to get the parents to the child's bedside if they can do so without interfering with care. Sometimes just being able to touch a hand or a foot while the medical team is working brings comfort to the parents.

[mason83]

Yes, I'd agree with you both in that there is sometimes nothing to say, however in this situation I had to respond in some way. There are definitely those times where staying and being present will do more than any words, this situation in particular required that I respond in some way. I guess I was searching for some magic phrase that would be the perfect response, and it's actually reassuring to hear what you think, umcRN. That's pretty much what I said, which was "I can only imagine what you're going through, but it sounds like this has been an extremely traumatic experience. I can tell you that we're going to do everything we can and that this is the best place for your son to be right now."

Our hospital does allow family to be present for resuscitations and encourages it in just about every situation. I'd be interested to learn about the training that is given to RN's or others. Usually someone fills that role but no one has had any formal training.

[HangInThere, BSN, RN]

Validating their feelings is essential.

Sitting in a waiting room is tough for people who relieve stress through activity, so I ask what they usually do to relieve stress in difficult situations. If they say they exercise, I suggest they stretch their arms over their head or walk around the room or down the hall. I also ask when they've last eaten or slept, which are often the last things on their mind, and help them take steps toward their self-care.

Some people respond to that, and some don't.

[merrywhiterose]

Just tell them the complete truth. As a mother that watched her infant die from a life-threatening illness, I can tell you that they want to know EVERYTHING no matter how devastating.

[Our.Inn]

Thank you for that tip, HangInThere. I like the idea of asking people how they usually relieve stress and then trying to find a way for them to do so.