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Melissa Racher
Professor Wolcott
ENC 1102
23 October 2013
Annotated Bibliography
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. This is where neonatal nurses come into play because they
have the most interaction on a day-to-day basis with both the parents and the
infant.
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
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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. It is important for the nurses to be able to
understand the parent’s supportive needs and be able to act accordingly to
diffuse any issues that the parents may be experiencing.
Most of the articles used in this annotated bibliography are academic
journals, which include data collection, case studies, and personal experiences.
Most of these journals are written by professionals in the health care work force
or by professors who have knowledge in the neonatal nursing field. This type of
information can be extremely important to any parent who is going through the
struggles with a preterm or ill infant as well as nurses and current NICU staff
members who can relate to these struggling circumstances.
Today in the NICU, the staff has started to adapt to the change in the
family oriented settings within their unit to be able to provide not only care to
the infants, but care to the families affected by the circumstances. This
annotated bibliography focuses mainly on the importance of a positive
relationship established between the nurses and the parents, which influences
the overall outlook on handling the situation.
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Aagaard, H, and EO Hall. "Mothers' Experiences Of Having A Preterm Infant In
The Neonatal Care Unit: A Meta-Synthesis." Journal Of Pediatric Nursing
23.3 (2008): e26-36. CINAHL Plus with Full Text. Web. 21 Oct. 2013.
This article discusses the roles of the neonatal nurses not only for the
caring of the infant but also for the consideration of the mothers who feel
uncertainty about motherhood. The authors Hanne Aagaard and Elisabeth
Hall, both who are active residential nurses who have acquired a
doctorate degree, have conducted qualitative research on the experiences
that the mothers endure when having an infant in the NICU. This study
was conducted to help understand nurturing when a preterm baby is sent
to the neonatal care unit and to help the nurse to obtain more knowledge
about the type of treatment that is needed when a preterm infant needs
intensive care right after birth. The expertise given by both the nurses and
physicians is highly commended by the mothers in the NICU. The nurses
are a vital reassurance to the mothers by helping them get to know their
infant and letting them know that their infant is doing well. The mothers
want the nurses to share their knowledge and expertise they have
obtained about their infant rather than just informing them. This is
important in my conversation because it shows that it is one of the nurse’s
main objectives is to build a bond between the parents and the infant to
give them the sense of parenthood.
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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 academic journal
contributes to my topic 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 also shows that a positive
parent-professional relationship in the NICU is vital for a better overall
experience in the process of their recovering infant.
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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 can’t 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
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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. 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
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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 conversation 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
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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. It also shows how
nurses must change their 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 such as 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
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was the relationship they established with their primary NICU nurse. J Van
Aerde, et al., nurse practitioners working in infant follow up clinics,
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 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, illustrate how nurses have to be able to
understand the parent’s reactions to a stillborn or a death of an infant
because everyone reacts to the 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
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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 would 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 serious 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
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bond between the mother and the infant. Nurses who offered
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 academic journal 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.
Marianne Baernholdt, et al. "Parents' Perceptions Of Continuity Of Care In The
Neonatal Intensive Care Unit." Journal Of Perinatal & Neonatal Nursing
27.2 (2013): 168-175. CINAHL Plus with Full Text. Web. 21 Oct. 2013.
This article measures three aspects of interactions between the nurses,
the infants, and the parents. The authors Marianne Baernholdt et al.,
professors at the University of Virginia School of Nursing, conducted a
study measuring the parent’s perception of the number of nurses taking
care of their infant during treatment, and to portray the relationship of the
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parent’s perception with the type of interactions the nurses had with their
infants. Questionnaires and medical records were both used to gain
information from both the parent’s perception as well as information on
nursing interactions. The poll shows that the amount of nurses taking care
of an infant plays a crucial role in establishing the parents overall
perception. This article is important to my conversation because it shows
that parents have a positive outlook on the nurses if the interaction by the
nurses towards the infant and themselves is strong.
McAllister, M, and K Dionne. "Partnering With Parents: Establishing Effective
Long-Term Relationships With Parents In The NICU." Neonatal Network
25.5 (2006): 329-337. CINAHL Plus with Full Text. Web. 21 Oct. 2013.
This article states that the neonatal intensive care units have become
somewhat of a home for critically ill newborns that demand extensive
long-term hospitalization. The authors, Mary McAllister and Kim Dionne,
both neonatal nurse practitioners, stated that the NICU’s experienced a
challenge for both the families and the health care personnel because
they never thought that the NICU would become a home setting. The
value of connections between the health care professionals and the
parents became a crucial factor towards the coping of the parents who
are struggling in such circumstances. The article also discusses how health
care professionals must be able to comprehend the parent’s perceptions
and be able to come up with solutions to establish an efficient relationship
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with the families of the ill infant. The information obtained in this article is
vital to my conversation because it portrays the transition of the settings
that neonatal nurses have to work in, from a heath care provider to
working in a family care center.
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, an 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 NICU. 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 (1). 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 on
neonatal nurses and their attitudes towards parents because the
experiment in the article shows what kind of support parents that have an
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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.
Rowe, J, and L Jones. "Facilitating Transitions. Nursing Support For Parents
During The Transfer Of Preterm Infants Between Neonatal Nurseries."
Journal Of Clinical Nursing 17.6 (2008): 782-789. CINAHL Plus with Full
Text. Web. 21 Oct. 2013.
This article shows the importance of nurse’s support towards parents
when their infant is transferred between neonatal units. Reasons for
transfers can be anywhere from not having enough room in the hospital
to not being able to provide the proper treatments the infant needs. The
nurse’s major role in this type of situation is to be able to understand the
transfer process in order to comfort any anxiety that the parents might be
experiencing. The authors, Jennifer Rowe and Liz Jones, both professors
at Griffith University, composed a design to question a group of nurses
aimed to discover the current practices they used to develop a plan
promoting proper practice and understanding of the transfer process. The
studies main purpose was to gather the nurse’s personal perspective of
parent’s experiences and relate it to the needs that the parents have
conveyed in earlier studies. The outcome of the study shows that there is
a need for investing in the transition process as well as the nurses who
are responsible for that process. This article is important in my discussion
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because it demonstrates the importance of neonatal nurses to parents
during the transition process from one neonatal unit to another. A strong
relationship between the nurse and the parents is imperative during the
transitions to continue to give support to the parents who may start to
become doubtful.
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-
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feeding and parenting skills. Even though parents are going through this
commotion, they still need the nurses to 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 article 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
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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
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to know how to properly respond to worse circumstances and handle the
situation in a way that has a positive effect towards the parents.