• Use selective attention and selective ignoring to focus attention on the positive aspects of the situation, rather than the negative. Many children with disabilities have sensory processing issues, reacting in unusual ways to normal stimuli. The occupational therapist working with the child often provides a sensory diet, which is a list of prescheduled activities to provide helpful sensory input to overcome the child’s impairments. Parents may complain about the negative aspects of the sensory diet, such as "clutter" in the house or extra time to prepare the child for new experiences. Rather than re-explaining the sensory diet each time (the parents already know this!), the nurse can use selective ignoring for some of these complaints. Along with this strategy, she can use selective attention to praise the parents for creative sensory activities ("nice swing!").
  

• Support the family’s preferred coping mechanisms as they deal with stresses within the constraints of their resources. It’s not always easy to stand by when parents make decisions that the nurse believes to be less than optimal. The nurse may believe, for example, that the child would benefit from an extended school year, with several weeks of classroom instruction in the summer. From the parents’ perspective, however, that time is more valuable to allow the child some free play and for the family to "recharge." It’s okay to explore the pros and cons initially with the parents; once the family has clearly stated the need for a period of respite, the nurse needs to support that decision. No one, not even the most empathetic of nurses, can truly walk in the parents’ shoes.
  

• Recognize and monitor your influence on the family. Once the nurse has established an effective parent/professional partnership with the family, it can be tempting for stressed parents to rely too heavily on the nurse’s judgment and recommendations. The family may initially accept nursing recommendations without much discussion, but then fail to follow through or express anger with the nurse when the approach fails to bear fruit. Be clear up front that the decision-making authority belongs with the parents, and don’t take over the parent’s role. Unless specifically requested by the parents, don’t carry out the first step in a new process in the parents’ stead. If the nurse has recommended a particular adapted recreation program for the child, for example, it’s fine to provide registration information. However, don’t put the child’s name on the waiting list or complete the registration for the parents.
  

Within these professional guidelines, nurses enjoy the opportunity to establish meaningful and satisfying relationships with the families of children with disabilities. Although traditional wisdom would preclude a nurse from celebrating the child’s birthday or attending family celebrations, the newer guidelines provide a safe and appropriate structure that allows the nurse more latitude in such areas.

During the course of the nurse’s partnership with the family of a child with special needs, interactions may be face-to-face in professional settings or in the client’s home, over the telephone, or in writing in the form of letters, notes, or email. While most nurses are comfortable in traditional clinic, hospital or office settings, it’s wise to adopt appropriate guidelines for home visits, telephone contacts, and mail.