Encouraging parental participation in the NICU. According to Wigert et al (2006) the most difficult aspect of having a baby in NICU for mothers is being unable to take the important first steps to attachment: Haut et al (1994) states that family bonding

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Registration NO:   100252125

Module NO        :   SNM3115

Unit Leader        :   Angela Thurlby

Word Count       : 1649

The focus of this discussion will be to encourage parental involvement in the NICU. My motivation for choosing this subject is an experience that occurred when I nursed a baby, who was a surviving twin from a premature delivery. The mother refused to handle her daughter saying that she was frightened of hurting her. Unfortunately the other twin had died shortly after delivery. The aim is to analyse the factors that can affect the initial parental attachment, the complex psychological needs of families during this stressful time, and also to make recommendations for interventions which can be used for future practice.

According to Wigert et al (2006) the most difficult aspect of having a baby in NICU for mothers is being unable to take the important first steps to attachment: Haut et al (1994) states that family bonding within the neonatal environment is very difficult due to separation.  Affonso et al (1992) supports this, suggesting that separating a mother from her baby when in need of intensive care prevents initial bonding. According to Boxwell (2010) the early delivery of a baby may make parents feel guilty and think that they have caused the unwanted situation for the infant. Once the baby is admitted to NICU the parents lose the images of having a normal delivery and taking the baby home, holding, feeding, and changing nappies (Dyer 2005). Further stress was added in this case, because the baby is a surviving twin.

 According to Hazinski (2009)  and Shaw et al (2006) parents may display initial coping strategies which they describe as  serenity on entering NICU; performing a visual inspection of the machinery and layout, pulling out from the environment, over protectiveness, over focusing on small things like tapes or blood stains on sheets or clothing.

They then eventually move on to try and recognise how the machines work, interpretation of blood results and showing curiosity in the cause of the baby’s problems.

Reid (2000) describe that when a mother holds her baby it remains the most momentous event, along with feeding them for the first time. Turril (1999) and Cathern (2009) identified that neonatal nurses are in the prime position to provide support through the time of crisis. In my case, to encourage the mother to hold her baby, I asked her to help me with changing the baby’s sheets, showing her the best way to hold her baby, whilst taking care to support the CPAP tubing. I felt that the care of the baby should be nurse-led until she felt more confident overall, though I was happy to encourage her. Though very frightened initially when lifting her baby up, with support and assurance, the mother managed very well. Nethercott (1993) suggests that parental involvement in care is a precursor to family centred care as parents are enabled to be with their baby all the time, and be involved with basic care and some decisions. However the nurse remains in control of the family’s participation.

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Once the mother became more confident in handling her baby in the incubator, I broached the subject of taking her baby out for a first cuddle. I discussed with her the use of ‘Kangaroo care’ where a mother holds her baby between her breasts with a blanket draped over baby’s back. Research suggests its benefits include: improved parental bonding, enhanced weight gain, and an earlier discharge (Bohnhorst et al 2001, Furman &Kennell 2000). According to Crawford and Hickson (2002) it facilitates bonding, can enhance development and improve oxygenation. Merenstein& Gardner (2011) also suggest that successive sessions of kangaroo care has ...

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