Patrice Starrett
February 2015
Patrice
Starrett
,
RN
NICU
Aurora Sinai Medical Center
Milwaukee
,
WI
United States

 

 

 

Patti remained professional and calm when a mother and father became verbally abusive and belligerent because their baby was being admitted to the NICU. Their child needed additional respiratory support as it struggled to breathe. They were hostile and inappropriate, unable to recognize the abnormal breathing and saying it was normal. They called for the supervisor and verbally attacked the neonatologist. (Security was alerted and on stand-by). The parents were relentless and would not listen to what the neonatologist was telling them and continued to deny their child's serious condition. Through it all Patti remained un-rattled and rational. She attended to the child and involved the parents in his cares. At the bedside with the parents, she patiently went step by step through her assessment and the monitored vital signs of the baby to support the diagnosis and medical concerns for the child. Through the night and into the morning, the parents slowly softened and recognized that their child needed the additional care he was receiving in the NICU.

The next day, Patti was assigned the patient. The family care plan that Patti and the parents discussed and established the night before had been followed. The parents were involved with all cares, with the assigned nurse calling the mom's postpartum room if they were not at the infant's bedside for his cares and feeding every three hours. As a result of this coordinated effort, the parents continued to be more respectful and appropriate at the bedside. Later that afternoon, a lab result came back positive for a substance that resulted in the baby not being able to receive breast milk. The mother had previously denied taking the substance when asked by the neonatologist. With this new result, Patti respectfully planned and carried out speaking with the mother privately, alone in her room, to discuss the lab result and its consequence. Despite Patti's professionalism and thoughtfulness, the mother became very angry and aggressive. Patti never wavered from being professional and kind to the mother and family. Patti continued to call the mother for every set of cares for the baby the remainder of the shift despite the mother's outward tension and indignation. The mother looked for the smallest thing to complain about and take issue with. It took the remainder of the shift, but in the end, it was evident that Patti's non-judgmental approach to the infant's care and involvement of the mother helped the mother calm down and focus on her son.

Patti recognized the psychological aspects of the volatile interactions of the family. She did not excuse their bad behavior nor give in to it and any unreasonable or irrational demands. Instead, she saw that their anger was displaced fear, disappointment, the feeling of loss of control and poor coping mechanisms in response to a very stressful situation with the unexpected NICU admission. When working with the mother and father, she focused on the essence of being a parent and showed them ways that they could continue to feel fulfillment in their role while maintaining the integrity of the medical needs and the welfare of their baby.

The baby was hospitalized in the NICU for 5 days. Patti took care of him several times and on the day he was discharged. As preparation for the baby's discharge was being completed, the mother respectfully apologized to Patti, thanked her, and stated she was grateful for the wonderful care she gave her son.