the family" by accepting and blending in with the family system.
When nurses make an initial home visit to a child with disabilities, family
members are generally on their best behavior and the visit is given high priority
over the everyday activities in the home. As the nurse develops rapport with
the parents and children, visits may become less formal and many everyday
activities can take place during visits. Its important to accept a little
chaos, to wear comfortable clothing that can resist grimy fingers and soggy
diapers, and to allow a little extra time for interruptions from phone calls,
childrens demands, and the other minutiae of home life.
family members are not organized and prepared to sit down and talk when the
nurse arrives, this is a sign that they dont take the parent/professional
to know and respect the whole family rather than just the more active parent.
While its tempting to focus information and interactions on the family
member who is most involved in the childs special needs (often the
mother), this approach is counterproductive. A nurse can spend several sessions
over a years time convincing the childs mother to enroll him
in a special needs summer camp, for example. With a tentative "yes"
from the mother, the nurse may send the registration forms to the house
only to find that the childs father has vetoed the idea. Its
vital that the nurse spend at least some time with both parents; in some
cases, this means evening or weekend appointments.
working with families over a period of time, the nurse can safely assume that
the more active parent is voicing opinions that reflect the wishes of both parents.
each family members contributions.
Its easy to identify the accomplishments and efforts of the more visible
parent (again, usually the mother) and provide positive reinforcement. It
takes more expertise (and interaction) to delve into the role of less active
family members and compliment their efforts. Dad, for example, may be taking
his child to the park to slide, swing, and climb. Often, no one in the family
has identified this activity as therapy that benefits the childs gross
motor and sensory processing skills. The nurse is in an ideal position to
point out the fathers contribution, and encourage further participation
on the dads part.
family member needs positive feedback for their efforts on behalf of the child.
neutral, avoiding alliances with one family member at the expense of others.
While this sounds simplistic, its all too easy for the nurse to
identify with the parent whose values and beliefs echo her own. Once the nurse
has "joined forces" with one parent, there is an inevitable deterioration
in the relationship with the other spouse. Be clear that the parents have
a right to disagree, and outline the pros and cons of each viewpoint when
asked to provide feedback.
there is a difference in opinion, its important for the nurse to subtly
but clearly align herself with the parent who has the childs best interests