Establishing a trusting nurse-immigrant mother relationship in the neonatal unit

Nina Margrethe Kynø,Ingrid Hanssen

doi:10.1177/09697330211003258

Nina Margrethe Kynø, Ingrid Hanssen

Open Access

https://doi.org/10.1177/09697330211003258

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Abstract

Background:In the neonatal intensive care unit, immigrant parents may experience even greater anxiety than other parents, particularly if they and the nurses do not share a common language.Aim:To explore the complex issues of trust and the nurse–mother relationship in neonatal intensive care units when they do not share a common language.Design and methods:This study has a qualitative design. Individual semi-structured in-depth interviews and two focus group interviews were conducted with eight immigrant mothers and eight neonatal intensive care unit nurses, respectively. Data analysis was based on Braun and Clarke’s thematic analytic method.Ethical considerations:Approval was obtained from the hospital’s Scientific Committee and the Data Protection Officer. Interviewees were informed in their native language about confidentiality and they signed an informed consent form.Results:Trust was a focus for mothers and nurses alike. The mothers held that they were satisfied that their infants received the very best care. They seemed to find the nurses’ care and compassion unexpected and said they felt empowered by learning how to care for their infant. The nurses discussed the mother’s vulnerability, dependency on their actions, attitudes and behaviour.Discussion:Lack of a common language created a challenge. Both parties depended on non-verbal communication and eye contact. The nurses found that being compassionate, competent and knowledgeable were important trust-building factors. The mothers were relieved to find that they were welcome, could feel safe and their infants were well cared for.Conclusion:The parents of an infant admitted to the neonatal intensive care unit have no choice but to trust the treatment and care their infant receives. Maternal vulnerability challenges the nurse’s awareness of the asymmetric distribution of power and ability to establish a trusting relationship with the mother. This is particularly important when mother and nurse do not share a verbal language. The nurses worked purposefully to gain trust.

Highlights

For parents it is a worrisome and stressful experience when their newborn infant needs to be admitted to a neonatal intensive care unit (NICU).[1]
The aim of this article is to explore the complex issues of trust and the nurse–mother relationship in NICUs when they do not share a common language
The interviewed mothers spoke spontaneously about trust and how they felt safe during their hospital stay. This was reflected by the nurses who in the focus group interviews discussed the importance of trust and how they worked to achieve a trusting relationship with the immigrant mothers

Summary

Introduction

For parents it is a worrisome and stressful experience when their newborn infant needs to be admitted to a neonatal intensive care unit (NICU).[1]. Maternal vulnerability challenges the nurse’s awareness of the asymmetric distribution of power and ability to establish a trusting relationship with the mother This is important when mother and nurse do not share a verbal language. ‘This epistemic asymmetry is caused by one party having skills and knowledge that the other party does not have but needs’.6 This asymmetry becomes even greater when the parents are immigrants who do not have a common language with the nurses and cannot communicate verbally without an interpreter present.[7] The maternal vulnerability challenges the nurse’s awareness of the asymmetric distribution of power. To establish a trusting relationship with the mother, nurses need to be attentive towards the mother’s needs.[8]

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Discussion

Conclusion