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Little
Things that Count
Discussion
Questions
- In this
case, the NICU is different from many others around the country.
How is it different and how may these differences contribute
to the well-being of newborns who are critically ill?
How might these differences affect the parents of these infants?
- Delivering
"bad news" is a common responsibility for professionals
in the NICU and other hospital environments. Is the delivery
of "bad news" about Megan handled appropriately? Should
this situation have been handled differently? What would you
have said if it were your responsibility to tell Megan's parents
about her enlarged ventricles?
- If you
were Megan's nurse, how would you have responded to Dana's comments
and tears when she said that Barry didn't want to deal with
rearing a child with disabilities?
- In general,
what responsibility, if any, should the NICU nurse have in providing
information to parents and helping them through such emotional
times?
- Was it
appropriate for the developmental team to get involved in Megan's
case when they did? Should they have been involved sooner? Later?
Who decides?
- Dana and
Barry did not appear interested in discussing the issue of Megan's
capabilities prognosis. Do you think they were denying that
she had problems? Was it appropriate for the developmental team
to decide that these issues should be addressed anyway?
- If you
were the psychologist, how would you have approached the topic
of administering the APIB with Dana? What words might you have
used? What would you have done if Dana said she didn't want
to have the APIB administered?
- Could or
should more have been done to involve Barry in administering
the APIB? Should more have been done to include him in
discussions about the results and conclusions following its
administration?
- Was the
joint effort of the psychologist and the physical therapist
the best way to handle the assessment of Megan's abilities?
Were there any distinct advantages or would as much have been
achieved if they had conducted their work separately?
- One of
the goals of administering the APIB was to increase the parents'
confidence in themselves and in Megan. What specifically
was said or done that might have accomplished this goal?
- As this
case demonstrates, a number of professionals have contact with
infants and their parents in the NICUs. If you were in
charge, what methods would you use to ensure that the efforts
of doctors, nurses, social workers, other specialists, and technicians
were well-coordinated and sensitive to families?
- Although
Megan is going home, her future development is far from certain.
What, if anything, would you do to further ensure a smooth transition
home and the availability of needed information or resources
in the months that follow? Who would be responsible?
Little
Things that Count Case Story
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