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 childs 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!").
parents complain consistently about a concern, the nurse should patiently outline
the rationale behind the current approach to that concern.
the familys preferred coping mechanisms as they deal with stresses within
the constraints of their resources. Its 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." Its
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.
parents of children with special needs are under great stress, they often make
incorrect decisions and the nurse has a responsibility to encourage more dialogue
about the outcome until it is changed.
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 nurses 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 dont take over the parents
role. Unless specifically requested by the parents, dont 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, its
fine to provide registration information. However, dont put the childs
name on the waiting list or complete the registration for the parents.
family members accept nursing recommendations readily but then consistently
fail to follow through, they may be silently protesting the extent of the nurses
influence on the family.
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 childs 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
nurses partnership with the family of a child with special needs, interactions
may be face-to-face in professional settings or in the clients 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,
its wise to adopt appropriate guidelines for home visits, telephone contacts,