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Keywords:

  • closeness;
  • detachment;
  • family care;
  • interviews;
  • neonatal care;
  • neonatal intensive care unit;
  • nursing;
  • participant observation

Abstract

Title. Development of parent–nurse relationships in neonatal intensive care units – from closeness to detachment

Aim.  This paper is a report of a study to explore the development of relationships between parents and nurses in a neonatal intensive care unit.

Background.  As increasingly smaller premature babies survive, the prolonged hospitalization that follows makes relationships between parents and nurses crucial. A collaborative partnership in which all the family members’ needs are acknowledged is suggested as the best approach.

Method.  A hermeneutic approach was adopted, using overt participant observation (160 hours) and in-depth interviews to study interactions between parents and nurses. The participants were six mothers, six fathers, and six nurses from a 13-bed Norwegian neonatal intensive care unit. Data were obtained over 27 weeks from 2003 until 2004.

Findings.  A partnership between parents and nurses developed in three phases: the acute critical phase, the stabilizing phase, and the discharge phase. The stabilizing phase seemed the most challenging. As exhausted parents expressed the importance of maintaining the trusting relationship with their primary nurses to become confident when assuming more responsibility and adjusting to the new situation, nurses purposely withdrew and reduced their contact with parents, facilitating their independence and confidence as caretakers. Parents and nurses rarely seemed to discuss with each other the discrepancy in their understanding of the detachment process.

Conclusion.  Acknowledging the need for parents and nurses to discuss the processes of involvement and detachment may contribute positively to the development of family-centred care in neonatal intensive care units.