nurses are uncomfortable with the notion of home visits, feeling that they are
intruding on the familys privacy. Remember, parenting is personal and many
mothers and fathers feel that professionals are "peering over their shoulders"
as they interact with the child with disabilities. As time goes on, families of
children with special needs generally get used to having professionals in their
home; however, there are certain tips that nurses can employ to make home visits
more successful and comfortable for everyone (based on information in Turnbull
- Make an appointment for
the home visit and explain its purpose. Children with disabilities often have
very busy schedules, between school, medical appointments, therapy sessions,
and recreational options. When the nurse visits, there should be a defined
purpose and something of value for the family.
- Arrive and leave on time,
cancelling only when its unavoidable. Nurses who cannot keep to the
schedule send a message that the familys time is of little value, and
demonstrate a marked lack of respect. While delays happen from time to time,
theres no excuse for a series of cancellations or late arrivals
the child and parents are in their own home environment, there is no great harm
done if the nurse shows up without an appointment, or pops in a half hour early.
- Dress comfortably and
appropriately; expect to get messy or spend some time on the floor with the
child. Parents are acutely aware of the body language of the professionals
working with their child. When working with infants, its normal to hold
the baby and even participate in feeding or other care activities. Older children
who become comfortable with the nurse often climb up, hug, or want to play
on the floor. Wear loose clothing that can be easily washed; avoid scratchy
fabrics like wool that may be irritating for the child. Think carefully about
jewelry (necklaces, earrings, pins) that can be dangerous to the child.
- Be sensitive when food
or drink is offered. Some families equate hospitality with a drink and snack
and would be quite offended if the nurse declines. In other cases, the childs
parent is already busy enough and preparing food may be an imposition. It
can be helpful to bring your own bottled water to the home, sending a subtle
message that you have taken care of the issue.
the nurse makes a home visit, the parents have a social obligation to act as
- Expect distractions,
but bring activities for the children to minimize interruptions. Small, safe,
age-appropriate toys for the child with disabilities and/or siblings can distract
the child and allow uninterrupted conversation with the parent. Theyre
also invaluable when the nurse is waiting with the family in a crowded clinic
waiting room. Dollar stores, fast food restaurants, and therapy catalogs are
great resources for toys or craft materials.
- Be aware of your surroundings
and leave if safety issues arrive. Most parents have great respect for the
nurse working with their child, and will ensure that the environment is safe
and comfortable. Follow your instincts, however, if there are signs of impending
violence, substance abuse, or environmental dangers. A cell phone is invaluable
for calling ahead to the home (watchdogs can be an issue!) or explaining an
- Do not be judgmental
about parents participation in your work with the child. Its easy
to say, "The child would do so much better if the parents would just
do an hour of speech in the evenings," before heading home to your own
quiet environment. For the mother and father of four active children, that
hour just might not exist. One mother of an infant with Down syndrome and
severe congenital heart disease had this to say about her daughters
first year of life, "She was a year old before I was able to wash my
hair and shave both legs in the same day. Can you imagine thatshaving
one leg a day because thats all the free time you had?" Life with
a special needs child is NOT always life as we know it.
visits are costly in terms of nursing time, so its important for the family
to eliminate all distractions and focus on the parent/professional relationship.