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Pediatric nurses’ narratives regarding working with families they perceive as obstructive Crompton, Victoria Alice

Abstract

The experience for nurses working with families perceived to obstruct care in the context of Pediatric hospitals is a phenomenon largely ignored in the literature. Much of the research has focused on the causes of difficult working relationships between RNs and families from the parents' perspective, without exploring the experience for RNs in any depth. Families increasingly expect that care will be provided in a family focused manner and pediatric nurses strive to meet that standard. However, the reality of successfully engaging with all families to provide such care is complex and not always successful. In this qualitative study, narrative inquiry was used to explore the meaning for RNs of their experience in working with families who they perceived obstructed care. Eight RNs participated in this study, they had been qualified for at least five years and were currently working in a tertiary pediatric setting. In-depth interviews were analyzed to explore the content, structure and interpersonal factors within the RN's stories. The study findings suggest that the RN's experience working with these families has a personal and professional impact, which is not acknowledged formally or addressed in a proactive manner. Four main narratives were identified in this study: Anticipating the worst, Questioning of self, Failing to connect and making sense of the hurt. In addition, one sub-narrative emerged from the data titled Avoidance. The findings that emerge from this research are important to practitioners, educators, researchers and administrators and suggest that RNs require increased support in order to provide quality care to the "obstructive" family.

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