Family-Centered Care, Ethics, and Rehabilitation/Transition Planning
Family-centered care
Recognize parents as essential partners who know the child's baseline, communication style, and values. Practice clear, honest, developmentally appropriate communication with the child and family, shared decision-making, and support for siblings. Understand that family presence during resuscitation and procedures is increasingly supported with a designated facilitator. Address social determinants, interpreter needs, and cultural beliefs.
Ethics
Know the core principles: beneficence, nonmaleficence, autonomy (assent from the child, consent from guardians), and justice. Understand that best-interest standards guide decisions for children, that futile or disproportionate treatment discussions require team and ethics consultation, and that organ donation and withdrawal of life-sustaining therapy follow protocols. Recognize conflicts of interest and the nurse's advocacy role.
Rehabilitation and transition
Begin rehabilitation early, prevent complications (contractures, pressure injury, delirium), and plan for school re-entry, cognitive support, and family education. Transition planning for survivors of critical neurologic illness includes follow-up for seizures, hearing, development, and mental health, plus coordination with neurology, therapy, and community services.
Traps
Questions test that assent is not the same as consent, that parents cannot demand harmful treatment, and that discharge planning starts on admission.
Rule of thumb
Ask what the child would value, align the team and family on goals, and document the shared plan and the rehabilitation pathway from day one.