As wonderful as the third stage of partnership is, it is not possible to reach this level in every parent/professional relationship. Nurses in some settings (acute care or schools, for example) may not have enough interaction or time with the parents to reach this level. However, It is a reasonable goal for nurse case managers, home health nurses who work with the family for a long period of time, and nurses in a variety of public and private organizations.

Many factors can intervene to preclude effective partnerships, including family stressors, changes in personnel, transitions to a new program, or a new diagnosis for the child. Inevitably, there are personality conflicts and a nurse may find herself unable to form an effective partnership with a particular parent or family: "We will not be able to dance gracefully with everyone. Sometimes we have to ask others to do the dancing for us when we encounter someone with whom we feel at a standstill. This type of intervention need not be seen as a failure, but rather as a creative way to deal with personalities that may clash or with circumstances which need more time or a fresh approach."

Remember, conflict is inevitable in parent/professional partnerships and can even result in better solutions for the child. However, when the nurse/parent interaction has deteriorated to the point that the child no longer benefits from the nurse’s work, it’s time to arrange for another nurse to work with the family.

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If a nurse is professional enough, he or she can find a way to establish effective working relationship with even the most difficult families.

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