Negotiation of care for a hospitalised child: nursing perspectives

Family-centred care is essential in paediatric nursing and the effective negotiation of care is an integral aspect in achieving the family-centred care ideal. To meet parental needs, nurses have had to adapt their practice to include the family to their greatest extent, while still ensuring the needs of the child are met. It is important to seek nurses' attitudes on this aspect of their practice. The purpose of this study was to explore the clinical problem identified by nursing staff relating to potential discrepancies between parent and nurse perceptions of their role in the hospitalised child's care. A cross-sectional descriptive survey design was used to explore nursing attitudes in a tertiary metropolitan paediatric facility. Recurring issues and concerns identified through written narratives were grouped and analysed. Four categories relating to the establishment of communication, negotiation, care provision and attendance were explored. Participant responses supported the view that nursing staff recognise and support parental involvement in care but acknowledge that their practice does fall short of the ideal. Open communication and involvement of parents in care provision were highlighted and the negotiation of roles recognised as being important to the process. Identification of factors that may contribute to a gap between nurse assumptions and parent attitudes towards involvement in care provision for the hospitalised child provides the opportunity for strategies to be implemented that will facilitate the achievement of the family-centred care model.