When Is It Too Much?
Where I work, we have a standard of family-centered care. We allow parents to help as much as they would like to as we take care of the babies. The question is: When is it too much?
Most of our families are good examples of what family-centered care should be, but there are some that fall into two other groups. Either the parents are not involved at all and don't do anything, or they assume way too much of the responsibility.
We had a family that was the epitome of the "way too much" group. They were given several treatment options for their little one but demanded more chest X-rays and cardiac ECHOs than advised. They were determined that they knew way more in how to treat their child's conditions than we did.
I'm a strong believer in the fact that a parent knows their child better than we do. They're connected by a bond that's unfathomable. Most parents can tell you when something is wrong long before vital signs start to trend in a dangerous direction. They can be an invaluable resource to the clinician.
However, there is a fine line between knowing best and dictating treatment plans against any informed advice. This family wanted us to try treatments that had never been used in children and insisted on so many gases and chest films that it would make your head spin. This child had at least five ECHOs in a two-week period, all unchanged.
Based on their demands, she had aerosols and CPT for weeks after her CXR was clear. If their every request was not met, there would be screaming matches directed at our doctors in the hallway. They would endlessly question each RT that had their child and try their hardest to trap a new RT in an answer that they felt was wrong. Nurses and RTs alike dreaded taking this perfectly sweet child because of the difficulty the parents presented.
Why was there never a line drawn in how much the parents could dictate in our treatment plan? Are we truly like a fast food restaurant where the customer is always right? You go into a store having a pretty good knowledge of what you want and a pretty good idea of the product. Should we really allow individuals with little medical knowledge to come in and dictate care over the advice of professionals in the name of family-centered care?
Let me know what you think. Until next week!
--Stephanie