| The relationships that develop between nursing staff and parents in child psychiatry units were examined using grounded theory methodology. Semi-structured interviews and participant observation were used to collect data over an 11 month period. Twenty-one pairs of parents and nursing staff who were interacting were interviewed separately. The researcher conducted participant observation in three settings and interviews were conducted at two of these settings.;The findings revealed that nurse-parent relationships have two stages during the child's typical 10-14 day hospital stay. The first phase of admission is a critical one from both the parent's and nursing staff's perspectives. The admission phase is influenced by the expectations of staff and parents and the routines of the unit. The second phase is the working phase. During the working phase, four patterns of interactions were noted: engagement, disengagement, failure to engage and working alliance. Engagement occurred when the parent and nurse were able to sustain interaction, including physical presence and emotional availability. Defining characteristics of engagement included honesty, caring, respect, trust and a sense of the others' competency. Failure to engage occurred when sustained interaction was not possible. Disengagement occurred if either the parent or nurse had engaged and were then unable to sustain interaction either due to circumstantial reason, such as a scheduled vacation, or an emotional disruption to the relationship. Working alliance seemed to be an extension of engagement that occurred when there was an unusual duration or intensity in the nurse parent relationship, where both parent and nurse had a sense of mutuality in the relationship and both were willing to go the extra mile for the child.;These interviews were transcribed verbatim. Field notes were made following each participant observation period. Both the interview transcripts and the field notes were analyzed using a computer program, NUDIST, to code data into categories. Data were then compared and then category reduction was used to integrate the categories and their properties. From the process a middle range theory was developed. |
