Melissa Racher
The joys of pregnancy and the birthing process can bring excitement and happiness to any parent novice or experienced. This joyous feeling may quickly turn into anxiety and stress if their infant is born preterm or ill and requires extensive specialized nursing care. With this comes an encompassing feeling of distraught felt by the parents because they lost their natural caregiving role.
Being in a constant stressful situation like this, parents look for someone for support and comfort. That’s where neonatal nurses come into play because they have the most interaction on a day-to-day basis with them. A positive encouraging nurse/parent relationship can help release the constant anxiety and stress to help the parents cope with the unfortunate situation. In order to have a good relationship, the nurse must be willing to go beyond her standards to provide the adequate amount of support and information that is needed to help ease the concerns that may arise from doubtful parents. The first thought when a parent’s infant is put into the Neonatal Intensive Care Unit (NICU) is fear or anxiety and may feel lonely on making tough decision making questions. It is crucial for a neonatal nurse to then step in and present themselves to the parents as not only a caregiver to their child, but as a supporter through the process. The parents should be able to trust and depend on the nurse for comfort and encouragement through the time their child is in the NICU.

Bruns, DA, and JA McCollum. "Partnerships Between Mothers And Professionals
In The NICU: Caregiving, Information Exchange, And Relationships."
Neonatal Network 21.7 (2002): 15-23. CINAHL Plus with Full Text. Web.
18 Oct. 2013. This article surveys mother, nurses, and neonatologists outlooks on the significance and operation of practices taking part in the
NICU. Both Deborah Bruns and Jeanette McCollum, equipped with PhD’s, released a questionnaire measuring quantitative and qualitative data in the three categories of care giving, the exchange of information and the theme of a family cared center. The study included 215 questionnaires sent to a professional staff and 157 questionnaires mailed to the mothers who have been through the NICU with their infant. The conclusion of the survey finds that mothers are willing and wanting to learn and participate in activities relating to caring for their infant as well as establishing a strong relationship with the nurses in the NICU. This articles relates to my conversation because it is showing that mother are moving from wanting support from the nurses to being active participants in the process of caring for their infants. This study shows that a positive parentprofessional relationship in the NICU is vital for a better overall experience in the process of their recovering infant.
Chinchilla, Mary, Knipe. "Patient Family-Centered Care: A Bedside RN's
Perspective." Neonatal Network 31.5 (2012): 341-344. CINAHL Plus with
Full Text. Web. 9 Oct. 2013. The author, Mary Knipe Chincilla, a

residential nurse with a bachelor’s degree, used personal experience in her work force as a neonatal nurse to explain what it feels like to go through such a horrific experience as having a premature baby. She explains how her and her co-workers see themselves as one big family and her main concern is whether or not the staff can make the patients feel the same way. The author illustrates how she went through different stages of communication with the infant’s parents; by at first not explaining to the mother how or why they cant do the things they would normally do to a healthy infant but instead stopping them all together. For example instead of her telling them the negative effects a simple touch would have on their premature infant, she would just simply tell them its not good to do that. A turning point in the author’s attitude towards the relationship between the infant and the mother is when she became a certified instructor in infant massage. She came to realize that the relationship between the baby and the mother is the most important thing and as neonatal nurses, they need to act as positive roll models to decrease the feeling of separation between the two. Her main job shifted from being in control of the health of the baby to becoming gentle patient teachers to the mothers. This is especially important toward my analysis on neonatal nurses attitudes toward pre mature infants parents. It shows a difference between how you should and shouldn’t act when it comes to dealing with parent’s interactions with the premature baby.

Fegran, L, and S Helseth. "The Parent-Nurse Relationship In The Neonatal
Intensive Care Unit Context -- Closeness And Emotional Involvement."
Scandinavian Journal Of Caring Sciences 23.4 (2009): 667-673. CINAHL
Plus with Full Text. Web. 9 Oct. 2013. The authors, Liv Fegran and Solvi
Helseth, both colleagues of University of Oslo as a doctoral student and assistant professor, uses this article to depict the relationship between parents and nurses in the NICU (Neonatal intensive care unit). They describe how a nurse needs to play both a social and professional role when it comes to dealing with the parents by giving them emotional support but at the same time maintaining a distance to keep control of the environment surrounding the patient. The presence of the nurse in the
NICU shouldn’t be to just be there, but to be with the parents as a supporter. In this case having a professional attitude isn’t always going to work. There was a study conducted in a Norwegian NICU, which allowed parents of neonatal infants to work along side of the nurse to study the effects of the relationship that was built between the nurse and the parents. The study confirmed that the importance of a strong relationship between the nurse and the parents had a substantial influence on a positive encounter of the entire process. Nurses who are successful at balancing emotional and professional support are the ones who give the greatest positive influence towards coping parent as well as providing the best care toward the infants. This fits into my analysis on neonatal nurses

and their attitudes towards parents by showing a study that proves a close relationship between the nurse and the parents has a positive influence on the entire circumstance. It shows that the ideal behavior of the nurse is to be able to balance both professional and social attitude towards the situation.
Heermann, JA, and ME Wilson. "Nurses' Experiences Working With Families In An
NICU During Implementation Of Family-Focused Developmental Care."
Neonatal Network 19.4 (2000): 23-29. CINAHL Plus with Full Text. Web.
17 Oct. 2013. The article shows the transition of traditional nursing practices to family focused developmental care (FFDC) to be able to cope with the needs of parents who have a child in the NICU. Two residential nurses, Judith Heermann and Margaret Wilson conducted an experiment to collect data on this new type of nursing method by interviewing ten nurses who were part of a pilot study using this type of practice during their work. Four factors were calculated during the experiment; these factors include negative experiences of FFDC the transition from central nursing to partnering with the parents positive experiences of parental participation and the sources and organization needed to move to this type of modeling practice. Reports find that nurses feel the loss of the power of their title as well as seeing a positive result of parent’s interactions with their infants and their ability to contribute in the care of their infant. Ultimately for this type of method to work inside the nursing

field the culture of the NICU as well as the way the nurses perceive themselves will have to transition into a more family oriented workforce.
This article fits in with my topic of nurses and parents of infants in the
NICU by showing a real life example of parent participation within the infant care unit. This is important because it shows how nurses must change the customs to fit the needs of participating parents and become aware that the roles they play will change to becoming more open.
J Van Aerde, et al. "Developing Nurse/Parent Relationships In The NICU Through
Negotiated Partnership Reis." JOGNN: Journal Of Obstetric, Gynecologic &
Neonatal Nursing 39.6 (2010): 675-683. CINAHL Plus with Full Text. Web.
20 Oct. 2013.This articles main purpose is to retrieve the feedback of parents who have encountered a relationship with a neonatal intensive care unit to measure their experience and satisfaction with the care provided. Interviews were done to gain information through methods including in person interviews or over the telephone questionnaires, to parents who are close to being discharged from the hospital or as a follow up if they have already been released. Parents stated that the factor that created the most satisfaction was the relationship they established with their primary NICU nurse. Misty Reis, a nurse practitioner working in an infant follow up clinic, provides data that also shows that the parents saw the nurses fulfilling the roles of a teacher and/or guider and believed that this was the ideal parent/nurse relationship. The information provided by

this article is relevant to my topic because it reveals that parents believe the ideal role that the nurse’s play would be considered more of a teacher.
This is crucial in my conversation and to further NICU units to understand how to run a successful unit of nurses that can provide the best service possible.
Kavanaugh, K, and T Moro. "Reducing Risk. Supporting Parents After Stillbirth Or
Newborn Death: There Is Much That Nurses Can Do." American Journal
Of Nursing 106.9 (2006): 74-79. CINAHL Plus with Full Text. Web. 18 Oct.
2013.This article illustrates how those nurses who have worked with parents who have lost an infant in the NICU jobs become more demanding for support due to the fact that the grief on the parents is so great. The authors, Karen Kavanaugh and Teresa Moro, professors at the
University of Illinois in the college of nursing, illustrates how nurses have to be able to understand the parents’ reactions to a stillborn or a death of an infant because everyone reacts to that type of situation differently.
Nurses have to be able to read the parents attitudes who are mourning the loss of their infant and give the proper support they feel is most comfortable at the time. Proper language usage is vital when communicating to a parent who has just lost their infant. Nurses main responsibilities aren’t always going to be to care for the patient, they have other roles they can perform that are outside the description of being a nurse. In the instance of a death of an infant, the presence of being

there, helping to create and cherish memories, guiding parents in making tough decisions, and constantly following up on them are the little things that can truly mean the most to those dealing with a loss. This information is an important source to my topic because it illustrates the support that nurses give on the worst situation possible, the death of an infant. Even though nurses would never wish this have happened to them it eventually will. This article proves how important it is for a nurse to know how to handle themselves, as well as a parent in a situation like this.
Kearvell, H, and J Grant. "Getting Connected: How Nurses Can Support
Mother/Infant Attachment In The Neonatal Intensive Care Unit."
Australian Journal Of Advanced Nursing 27.3 (2010): 75-82. CINAHL Plus with Full Text. Web. 20 Oct. 2013. The objective of this article is to depict how neonatal nurses provide support to help establish the mother/infant relationship while going through the NICU. Hayley Kearvall and Julian
Grant, both having their bachelors in nursing, discussed that infant health and hospitalization causes a major amount of stress, which can affect the natural attachment bond between the mother and the infant. Nurses who offer psychosocial support, and engaged in deep conversations with the mothers seemed to establish a positive and trustful relationship. This type of help relieved mothers concerns, which boosted their assurance helping their interaction with their infant. Nurses working in the NICU need to

create responsibilities that involve the relationship with the mother as well as the mother-infant bond to support the development of natural attachment. The information obtained in this article is applicable to the topic because it continues to support the idea that a strong relationship with the nurse and the mother is highly important in the overall bond between the mother and the infant. It also shows that the nurses job goes beyond the role of just caring for the infant which is important for the mothers to be comfortable when they feel as if they are hopeless.
Mok, E, and SF Leung. "Nurses As Providers Of Support For Mothers Of
Premature Infants." Journal Of Clinical Nursing 15.6 (2006): 726-734.
CINAHL Plus with Full Text. Web. 17 Oct. 2013. This article shows a study that was conducted in Hong Kong that’s main purpose was to depict the experience that mother had with their premature infant and supportive nurses. Esther Mok, a associate nursing professor and Sui Foon Leung, a nursing officer conducted a study of a sample of 37 mothers who have had an infant in the neonatal intensive care unit (NICU) were chosen to conduct this research. The experiment covered four main parts that the mothers were asked to answer. These parts included, communication information support, emotional support, parental esteem support, and quality care giving support. Results show that all mothers rated these types of support to be crucial to get through this struggling event. The study also showed that the parents desire more support in the area of

communication and information giving than was actually received to them during the experiment. This source is an important part of the conversation because the experiment in the article shows what kind of support parents that have an infant in the NICU desire most out of their nurses. This is a great source of information for those nurses who work in the NICU to base their nursing practices towards parents struggling with their infant.
Tran, C, A Medhurst, and B O'Connell. "Support Needs Of Parents Of Sick And/Or
Preterm Infants Admitted To A Neonatal Unit." Neonatal, Paediatric &
Child Health Nursing 12.2 (2009): 12-17. CINAHL Plus with Full Text.
Web. 20 Oct. 2013.This article states that the unplanned delivery of a preterm infant comes with high levels of emotion from parents confirming that nursing support provided toward the parents is vital. Catherine Tran,
Alison Medhurst, and Beverly O’Connell, all researching registered nurses, conducted a study that was taken place in Australia’s NICU to measure the satisfaction of the type and level of support that the nurses provided towards the parents. A questionnaire was used to measure four categories that included: emotional, informational, appraisal, and instrumental support. The results show that the parents views of the nursing support provided was overall satisfactory however, they requested more information from the nurses on breast-feeding and parenting skills. This information is relevant in my topic because it shows that parents also

need guidance in how to take care of their preterm infant that deal with common things such as breast-feeding and parenting skills. Even though parents are going through this commotion, they still need the nurses inform them on things other than the conditions of a preterm infant.
Parents want nurses to advise them with information as if they had a healthy infant.
V Guddattu, et al. "Relationship Between Stress, Coping And Nursing Support Of
Parents Of Preterm Infants Admitted To Tertiary Level Neonatal Intensive
Care Units Of Karnataka, India: A Cross-Sectional Survey." Journal Of
Neonatal Nursing 15.5 (2009): 152-158. CINAHL Plus with Full Text. Web.
20 Oct. 2013.This article deals with stress levels of parents who have a preterm infant who is hospitalized and how neonatal nurses support is critical to relieving their stress. Vasudeva Guddattu et al, staff members of the medical statistics of India, conducted a survey to explore the relationship of coping and stress and to compare stress levels of mothers and fathers who are parents of preterm infants. Statistics shows that nursing support does in fact release the stress incorporated throughout the event but shows no commonality between stress and coping. The study also proves that the level of stress mothers experience is significantly higher than the fathers. This study is important in my conversation because it shows that mothers should be the main focus of nursing support because they tend to be more stressed than the fathers.

This study could be a great help to the practices in the future to ensure that the mothers who need the support the most will be given the proper amount.
W Petow, et al. "Neonatal Staff And Advanced Practice Nurses' Perceptions Of
Bereavement/End-Of-Life Care Of Families Of Critically Ill And/Or Dying
Infants." American Journal Of Critical Care 13.6 (2004): 489-498. CINAHL
Plus with Full Text. Web. 21 Oct. 2013. The authors, Wendy Petow et al. all certified registered nurses, designed a survey to measure the attitudes of neonatal nurses towards the mourning care of ill and/or dying infants.
This study was developed because parents need some form of sympathy care when an infant dies and nurses aren’t adequately prepared to handle that type of situation. The results show that the most important role of the nurses is to provide ongoing support towards those families involved in this type of situation. It also shows that caring for an infant that is dying or a family who has just lost an infant plays a major factor in their interactions with the family. The outcome of the survey brings it to the attention that bereavement/end of life care should be incorporated in the nursing curriculum in order to prepare NICU nurses to handle a situation such as this. This is especially important in my discussion on neonatal nurse/parent relationship because it shows the aspect of the worst possible outcome, the death of an infant. It also shows that nurses needs

to know how to properly respond to worse circumstances and handle the situation in a way that has a positive effect towards the parents.