A commentary on:The importance of parental support when caring for the acutely ill child by Wheeler

Abstract

The epidemiology of critically ill children cared for in an adult intensive care unit (ICU) is not widely studied. In Wheelers’ ICU, an average of 20 children are admitted yearly. If these figures are translated to national level, the outcome might be significant. Essentially, we are talking about a large group of acutely ill children who should be transferred to a paediatric ICU (PICU) based on an agreed national standard. Unfortunately, various arguments seem to withhold these patients from the right of specialized care in a PICU. Ultimately, these children might experience a decreased outcome of their health status when staying on an adult ICU (Gemke, 1997). The impact of the physiological differences between children and adults on nursing care has been identified and discussed previously (Hewitt-Taylor, 1999; Gobréau-Kuijpers and Latour, 2001). However, less attention has been given to meeting the psychological needs of children and parents in adult ICU. Wheelers’ reflection of the current practice in her ICU was probably the reason to search for evidence to justify what she felt, she needed to improve; family-centred care. As family-centred care has several basic principles (Latour, 2005, discussed in this issue), one of these, as discussed by Wheeler is the need to be recognized as an important contributor in the child's recovery. This particular need implies that parents want to be partners in the care for their child. Indeed one would expect that both parents and health care workers have the same goal in the ICU, making our patient better. However, Wheeler discussed that addressing parental needs is based on the nurses’ individual perspectives. Therefore, she promoted to have adult critical care nurses trained in identifying parental needs and to be able to integrate these needs into daily practice while providing critical care support to the child. Essentially, this article contributes to critical care nursing in providing discussion on how to change practice to meet the needs of parents in an adult ICU. It is a way forward to family-centred care.