Instructional Package: Training Parent Facilitators By Martha A.Q. Curley, RN, PhD, FAAN for the Cardiovascular Critical Care Nursing Program at Children's Hospital Boston
It took many years for hospitals to accept that allowing parents to be with their ill children at any time of day or night not only would not be disruptive of hospital procedures, but would in fact make staff's jobs easier, while providing vital emotional support to these young patients. The next frontiers for parent participation may be emergency and acute care units. While understanding the pain and frustration that parents experience at being parted from a child about to undergo an invasive procedure or cardiopulmonary resuscitation, many clinicians fear that allowing parents to be present will be distracting or disruptive.
How can hospitals accommodate parents' wish to be present and provide support to their child, while ensuring that clinicians are not prevented from delivering optimum care? A multidisciplinary group at Children's Hospital Boston have developed an innovative program to train selected staff members — nurses, therapists, social workers, clergy, or others — to support parents whose children are undergoing such treatments.
At the core of the training process shown in these videos are intensely realistic simulations of acute care situations in which staff members interact with specially trained actors who portray the parents. Following the simulation, a committee of staff members review the simulation with the trainee. The actors — still in their character as parents — provide supportive feedback. One says of the facilitator: "You were sort of like the parent whisperer."
One of the lessons stressed is that staff need to create respectful relationship in which parents, too, can do their jobs. Another is that being present may not be best for all parents, but that it needs to be the parents' choice — and that whatever they choose, they should not feel judged. The goal is to enable each parent to be the best parent they can be under the circumstances.
The videos also includes extended examples of the two training simulations. Scenario One (13 minutes) is the case of a five-year-old in intensive care, who is now experiencing increasing respiratory distress after choking while his parents were feeding him ice chips. The parents are upset, confused, and blaming themselves. In Scenario Two (10 minutes), a 6-weekold infant has been rushed to the hospital with a very elevated heart rate. His young parents are agitated at what seems to them a delay in receiving treatment and the father, in particular, begins his interaction with the staff in a somewhat antagonistic manner. Summarizing both, the Main Program (26 minutes) also shows the post-simulation staff discussions and includes actual parent testimonials to the value of the facilitation process.