Parents' Perspectives on Navigating the Work of Speaking Up in the NICU.
Audrey Lyndon, Kirsten Wisner, Carrie Holschuh and 2 others
PMID 28774759WHAT IT FOUND
NICU parents often weighed whether to speak up about safety, sometimes choosing silence.
Most rated hand-hygiene lapses harmful, but fewer said they would tell clinicians, fearing confrontation or distracting staff.
Key findings
01Most parents saw a hand-hygiene lapse as potentially harmful, but fewer said they would speak up to clinicians about it, and some acknowledged harm yet rated themselves unlikely to ask for hand washing.
02Parents described speaking up as a deliberate social process, weighing their newborn's condition, their own capacity, clinician receptiveness, and possible consequences; some chose silence to avoid burdening or upsetting staff.
03A defined pathway for voicing concerns, clinician availability, friendliness, and responsiveness were identified as facilitators of parent speaking up.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted in one NICU with 46 questionnaire completers and 14 interviewees, so the findings may not transfer to other units or larger groups. Interviewed parents were English-speaking, able to spend considerable time at the bedside, and 74% identified as White, so parents who were absent, non-English-speaking, or from other racial or ethnic backgrounds may have different experiences. Parents tended to assume the researchers were connected to the clinical enterprise, which may have affected how freely they discussed negative aspects of care.
Declared interests
The authors reported no conflict of interest or relevant financial relationships.
The easy way to misread this
Do not read the hand-hygiene scenario as showing parents will reliably speak up about real safety problems. Many parents rated the risk as high, but fewer said they would speak up, and some chose silence because they feared burdening clinicians or negative consequences.