Chapter 3 | Family Dynamics and Communicating With Children and Families 37
● Allow for repetition of what caregivers have heard to ensure understanding. ● Be empathetic and sincere (FEMA, 2018; Lederman, 2016).
Communicating With Families: The Nurse’s Role When communicating with children and their families, the pediatric nurse should: ● Identify his or her role. ● Provide appropriate introductions for the nurse, caregivers, and family members. Identify the stakeholders and the car- egivers, including the child in the process. ● Document all telephone calls during office hours and after, and log all incoming and outgoing calls, advice given, and questions answered. Include the date, time, and who was in- volved in the communication process. ● Establish an appropriate setting to communicate information. ● Ensure privacy when leaving patient messages. ● Provide anticipatory guidance, a critical communication strategy that improves care and supports competence in caregiving by of- fering information, guidance, and education for family caregivers.
CRITICAL COMPONENT Emergencies Critical components and interventions during emergencies include: • Provide clear and concise information. • Do not make promises. • Inform family members that the physician will speak with them as soon as possible. • If possible, give them a private environment. • Call clergy, child life specialists, and social workers, if available, to offer support. • Use technology to stay connected.
Communication in the Age of Technology
CLINICAL JUDGMENT Health Insurance Portability and Accountability Act
● Parenting in some areas is harder than it was for parents 20 years ago because of smartphones and social media (Auxier et al, 2020). ● Eighty-nine percent of parents indicate their children ages 5 to 11 watch YouTube. ● Eighty-one percent of parents indicate their children ages 3 to 4 watch YouTube. ● Fifty-seven percent of parents indicate their children less than 2 watch YouTube (Auxier et al., 2020). ● As a result of the pandemic of 2020, it was found that children forced to stay at home because of lack of in-person schooling communicated more often and used fewer tools than those not in family homes (McMillan & Feng, 2020). ● Technology can provide and connect families with health-care information and professionals. ● Technology can also be a source of unsubstantiated information. ● Parents and adolescent children need to be provided reliable health care sources from reputable sources such as the Cent- ers for Disease Control and Prevention (CDC), World Health Organization (WHO), Johns Hopkins, or Mayo Clinic websites.
In 1996 the Health Insurance Portability and Accountability Act (HIPAA) was enacted to protect the privacy of patients’ health records and information. The law protects “individually identifiable health information” (U.S. Department of Health & Human Services, 2017). It also limits access to health information in any format (e.g., written, oral, facsimile, social media) to authorized individuals who have a “right to know.” “Right to know” includes disclosure of a person’s health information to individuals who have a direct need to know on a specific date in which that health-care provider is caring for the client. For example, if a coworker has had a baby in your institution and as a nurse you are caring for newborns on that floor but not this patient, it is unlawful for that nurse to look up his or her coworker’s baby’s information. Deviations from this federal law have resulted in imprisonment and fines for the offending individuals or institutions. Recent updates to HIPAA are related to increases in transmission security, cybersecurity, auditing, workforce screening, and the encouragement of reports of abuse (U.S. Department of Health & Human Services, 2017).
CRITICAL COMPONENT How Much Screen Time Is Too Much?
Communication With Family Members During Emergencies
Madigan, S., Browne, D., Racine, N., Mori, C., & Tough, S. (2019). Association between screen time and children’s performance on a developmental screening test. JAMA Pediatrics, 173 (3), 244-250. doi: 10.1001/jamapediatrics.2018.5056 This study found that excessive screen time in children is associated with delayed development. These researchers studied 2,441 children, of which 50% were boys, and found that higher levels of screen time were associated with delayed development (Madigan et al., 2019). The researchers identified that excessive screen time affected physical, behavioral, and cognitive outcomes (Madigan et al., 2019).
When families are under stress during emergencies, communica- tion can be challenging. Nurses can help ensure their message is
received in trying times with these strategies: ● Provide a quiet environment for conversation. ● Communicate slowly. ● Avoid medical jargon. ● Sit down and face caregivers at eye level. ● Allow plenty of time for questions. ● Avoid giving false hope.
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