Family-centered care

A hundred years ago virtually all decisions about how to care for sick children came from the child’s family. By mid-century, medical professionals—doctors and nurses—were making more and more of these decisions. Families were increasingly excluded from key decision-making. By the time I began my pediatric training in 1978, families were even excluded from the pediatric intensive care unit much of the time by restricted visiting hours.

Fortunately, the pendulum is swinging back with the increasing acceptance of what is called family-centered care. You can read more about it here and here. Pediatric intensive care physicians these days are encouraged to involve the sick child’s parents in everything, even including the parents in the formal bedside teaching rounds that are the hallmark of big university hospitals. I have become accustomed to doing all manner of procedures, from intravenous line starts to cardiopulmonary resuscitation (CPR), with the parents standing by.

Nearly all parents think this is a good thing. Many have told me their imaginings of what I am doing to their child is far more stressful to them than actually watching me do it. Some physicians are uncomfortable with this notion, since it lays bare some of our ignorance and fumbling. But we need to get used to it, both because it is the wave of the future and because it is the right thing to do.


One response to “Family-centered care”

  1. Well written article.

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