Extend Your Care
Extend Your Care
Extend Your Care
Children account for 40% of total population in developing countries and they
are more vulnerable for diseases because of their immature immune system and risk
taking behaviors. Children, who are not efficient enough to complain, often give
vague presentation for their many problems and discomforts. They may show
withdrawal, apathy, fear, sleeplessness and refusal to feed and many more. Parents
taking care of children easily identify that their child is not well.
These kinds of presentation may not be troublesome for nurses who encounter
thousands of similar children everyday, but it worsen the emotional status of parents
and force them to imagine various unwanted events that they try to ignore. Parents
may themselves present with various physical and mental symptoms. Nurses need to
identify the problems of parent for wellbeing of their little patients.
Think of the parents of sick child, waiting outside the ward of any hospital,
obviously their child is sick, they are out of their home leaving their other children at
home, who are taken care by others. Their job is at risk, and they have stopped
earning. As a whole their family homeostasis has altered. The situation further
worsens when child’s symptoms exacerbate or physician explains poor prognosis of
their child. They are scared of unexpected out comes of child’s disease. They find it
very difficult to adjust in new situations. Their decision making ability, coping ability
is challenged. They are unable to cope with all these stressors.
Here, all of us will agree that their problems are jejune and they are in need,
they need some one to listen, some one to support, some-one to guide them. But who
will do that? It’s none but the nurses. Nurses are been trained for providing
comprehensive care to the patient and their family members.
Hence, it is the times to refresh the idea of all of us that parents are integrated
part of child’s treatment; none can treat the child alone. Without participation and
wellbeing of parents, who used to take care of the child and will be caring here after
too, our nursing care plan will remain incomplete. Thus it is equally important to
develop specific strategies for the parents at the same time and practice
simultaneously.
It is understood that nurses have very limited time and lots of assignments to
accomplish in any work setting as we are not able to meet standard nurse patient ratio
in clinical settings. Nurses have many children to care at once, they can not
compromise the child care and most of the time they are juggling with many task. But
still it can not justify the ignorance of the parents.
We have preoccupied idea that parents of sick children always come with
economical problems and there nurses can not do anything. It is true that most of the
parents have economical problem as treatment cost is approaching higher and higher
day by day. Specially, when their child is admitted in Critical Care Unit or
hospitalized for longer periods, many parents encounter economic crisis.
In the most of the hospitals, it is the doctors and administrators who can avail
the financial support to the parents and nurses carry very limited authority. Nurses in
such condition should be able to assess the economical condition by asking selective
limited questions, observing their life style and living conditions. Here nurses are
expected to perform their role of advocate and liaison between authority and parents.
Nurses can aware the parents about various sources of economical supports,
institutional policy for such parents. Nurse can suggest parents to approach
appropriate channel for deduction or free treatment. Nurses can help parents to
approach the respective authority and assist in follow up. At the same time nurses can
teach the various methods of saving extra expanses. Guiding them to find cheap
accommodation in hotels near by or Dharamsala, guide them to find hotel which is
cheap and serves safe food, or advise if they can cook themselves, nurses can make
significant contribution. For these nurses have to have good orientation to hospital
policy, social agencies working in the same field and the facilities available in the
Hospital complex or outside the hospital.
It is always easy to work with the parents who are optimistic, helpful and read
to follow your instructions, especially when they appreciate your service rendered to
the child. Occasionally parents may become difficult who is demanding,
confrontational, angry, uncooperative, try to overlook contribution of nurses and
sometime blame the nurses for additional complication that child develops in the
course of treatment. In this condition role of nurse becomes more challenging.
Following some fundamental principles of therapeutic relationship and
communication nurses can prevent the crisis of parents as well as themselves.
Giving a verbal approval that we have understood their problem and that is
genuine to some extend, gives the relief to the parents that their complains are reached
and approved. They become more compliant to the treatment provided to the child.
TREAT PARENTS AS A PERSON
Everybody in this world is unique individuality of the human being remain
intact even after death. Parents are person before father or mother of child with hernia
or leukemia. Personal recognition of the parents’ sooths them and it shows our
concern towards child too. Realize that they have their own recognition; don’t give
them new state of being a parent of sick child. Recognition with their name, surname
or respective prefix decrease their feeling of guilt and incompleteness which all
parents develop, specially when the child is chronically sick and likely to have long
term morbidity.
BE EMPATHIC
It is an ability of nurse to identify and understand unexplained needs of
parents. Nurses keeping themselves in parents position identify how she/he would
have felt and reacted being a parent of sick child. It helps nurse to realize that parents
were not like this before and they need special attention and support. At the same time
nurses can formulate specific strategy to help parents by knowing what they aspect
and may meet their needs.
ALWAYS GIVE HONEST PRAISE
Parents working hard throughout day and night give you lots of opportunity to
praise them.
Parents, because of sickness of their child, real or potential limitation of child,
unexpected outcomes of treatment, they often blame themselves and develop feeling
of incompleteness, guilt and found themselves failed to become good parents. They
isolate themselves. These behaviors further constrain the parents to be good mother or
father.
Nurse giving some commend action and positive strokes like “You are very
caring parent, you really work hard”, “You made good decision to bring the child in
casualty on time, many parents fail to do so”, “Your child likes you so much” can
unite the hearts of parents. Praising the parents not only boosts the nurse parent
relationship but also makes parents more enthusiastic and helps them to perform
better parenthood skills.
On the contrary, false praising can damage relationship and shows nurse’s
incompletion. Parents may loose the faith on nurses.
AVOID BLAMING THE PARENTS
It is very easy to blame parents for not able to provide basic care, not being
compliant, bringing child late to medical service and so as for many other regions. But
we should not forget that all parents love their children and they do their level best for
the wellbeing of their children.
In this particular situation most of the parents are emotionally labile, find
difficult to set their goals and can not perform their tasks efficiently. Blaming parents,
even if they are suitable for the situation, it is not going to help anyway rather it will
demoralize the parents and enhance sense of guilt and frustration.
It the same time appropriate cheerful expression of the nurses can enhance the
feeling of support and caring to the parents and children.
Before discharge nurse should explain parents about medication, follow up,
side effects and emergencies, special precautious at home.