Family Centred Care

1. Family Centred Care Carol Hilliard NPDC 2007

2. Overview of lecture • Definition of ‘Family’ • Role of the family • Identify the members of a family • Family centred care (FCC) Carol Hilliard 2007

3. What is a ‘family’? Carol Hilliard 2007

4. What is a ‘family’? Carol Hilliard 2007

5. What is a family? • Several interpretations of a ‘family’ • Our interpretation often depends on our own experience of family • In today’s world we must be open to the many types of families we meet. • Ultimately the family is defined by itself • Therefore as nurses, we need to establish who is in the child’s family Carol Hilliard 2007

6. The Child in Hospital • Hospital can be new and frightening for children • Often, their families are the only familiar aspect • Hospital should not diminish the family’s role in children’s care. • FCC recognises that nursing care is most effective if done in conjunction with the parents Carol Hilliard 2007

7. Family-centred care (FCC) Broadly defined as promoting a partnership between the parents and healthcare professionals in the care of the child (Smith et al. 2002) Carol Hilliard 2007

8. The family Assess the family relationships: • Are both parents involved? • How many siblings in the family? • Are the grandparents etc. involved in the child’s care? • Any other important people? • Will someone stay with the child in hospital? Carol Hilliard 2007

9. Carol Hilliard 2007

10. The role of the nurse • Introduce yourself to the child & parents • Show the child & parents around the ward:- • tell them about the hospital facilities • Ask parents if they:- • slept well, • had breakfast, etc. • Explain the care the child will receive that day / night • Explain what you are going to do, for example, measure blood pressure, dressing change • Ask parents what they would like to do • Ask them if they have any questions Carol Hilliard 2007

11. Parents have a right to make decisions about their child Therefore: Parents need to have information about their child’s condition, treatment and nursing care Carol Hilliard 2007

12. Answering questions • Do not be afraid to say “I do not know” when a child / parent asks a question • Tell child / parents “I do not know but I will get that information for you” Carol Hilliard 2007

13. Negotiation • Helping parents to be involved in their children’s care is an important part of FCC • Nurses and parents need to decide who will perform the care the child will need, for example: - Showering the child - Changing a wound dressing - Feeding the child • How does the nurses’ routine suit the parents’ routine? Carol Hilliard 2007

14. Family-Centered Care (FCC) • Remember: Parents do not know that they can be involved in their child’s care • Therefore, nurses must explain to them • But nurses should not expect parents to be involved • Therefore, negotiate with the parents what they can do and what they want to do Carol Hilliard 2007

15. A common myth is that family centred care involves the parents staying with their child in hospital. This is not true • Family centred care means that we support the parents to be involved as much as possible in the child’s care Carol Hilliard 2007

16. Reasons parents may not stay with their child in hospital • Other children • Expense • Their job • Personal reasons • Others ……… Remember:it is not our job to judge parents Carol Hilliard 2007

17. The cost of staying with a child in hospital • Food • Parents’ accommodation • Transport • Possibly loss of earnings • Child-minders for other siblings • Telephone bills • Toys & treats for the sick child Carol Hilliard 2007

18. Important Points • Parents are not extra or unpaid nurses and should never be expected to replace nursing shortages • Parents should not be expected to be involved in their children’s care - Parents can decide if they want to be involved or not • Never assume that a parent will do something • Never judge parents because of your own personal opinions Carol Hilliard 2007

19. References • Battrick C. and Glasper E.A. (2002) The views of children and their families on being in hospital, British Journal of Nursing13(6), 328-336. • Callery P. (1997) Paying to participate: financial, social and personal costs to parents of involvement in their children’s care in hospital, Journal of Advanced Nursing25(4), 746-752. • Casey A. (1995) Partnership nursing: influences on involvement of informal carers, Journal of Advanced Nursing22(6), 1058-1062. • Children in Hospital Ireland (2002) The EACH Charter for children in hospital & annotations, Children in Hospital Ireland, Dublin. • Coyne I.T. (1995) Partnership in care: parents' views of participation in their hospitalised child's care, Journal of Clinical Nursing4(2), 71-79. • Dudley S.K. and Carr J.M. (2004) Vigilance: the experience of parents staying at the bedside of hospitalised children, Journal of Pediatric Nursing19(4), 267-275. • Espezel H.J.E. and Canam C.J. (2003) Parent–nurse interactions: care of hospitalized children, Journal of Advanced Nursing44(1), 34-41. Carol Hilliard 2007

20. References • Friedman M (1998) Family nursing: theory and practice, 4th edition. Appleton-Century-Crofts, Norwalk, CT, USA. • Lindsay B. (2001) Visitors and children’s hospitals, 1852-1948: a re-appraisal, Paediatric Nursing13(4), 20-24. • Lupton D. and Fenwick J. (2001) ‘They’ve forgotten that I’m the mum’: constructing and practising motherhood in special care nurseries, Social Science & Medicine53, 1011–1021. • Shields L. and Tanner A. (2004) Costs of meals and parking for parents of hospitalised children in Australia, Paediatric Nursing16(6), 14-18. • Smith L., Coleman V. and Bradshaw M. (eds) (2002) Family-centred care: concept, theory and practice, Palgrave, Basingstoke, Hampshire. • Valentine F. (1998) Empowerment: family-centred care, Paediatric Nursing 10(1), 24-7. • Wang K.W.K. and Barnard A. (2004) Technology-dependent children and their families: a review, Journal of Advanced Nursing45(1), 36-46. Carol Hilliard 2007