Family-Centered Care and Communication
Family-centered care assumes the family is the child's constant and the nurse is the visitor in the child's life. Items test whether you can share power, communicate at the family's health literacy level, and protect the parent–child unit during stress.
Core principles
- Treat the family as a partner in assessment and care planning, not a visitor to be managed.
- Share complete, unbiased information at every step; the family decides how much detail it wants.
- Honor cultural, religious, and language needs - use a trained medical interpreter, never a sibling or the child.
- Support family presence during rounds, procedures, and resuscitation when policy allows and a designated staff member supports them.
Communication skills
- Use teach-back: “Tell me in your own words how you'll give the inhaler.”
- Avoid jargon; use plain language and pictures.
- Sit at eye level, silence your phone, and ask open-ended questions.
- With children, use developmentally matched language and offer choices to build a sense of control.
Consent and assent
- Parents or guardians give legal consent; children give developmental assent. Assent is not consent and can be withdrawn.
- Minors may consent independently in situations set by state law - emancipated minors, STI care, contraception, some mental health and substance use treatment.
Worked example
A Spanish-speaking mother nods when told to give amoxicillin 5 mL three times daily. Nodding is not comprehension. Use a phone interpreter, show the oral syringe to the 5 mL mark, state the times in clock hours, and use teach-back. Document interpreter use and the teach-back result.
Traps
- Letting a 10-year-old interpret for a parent.
- Equating a signature with informed consent.
- Excluding parents from rounds “for efficiency.”
- Assuming silence means agreement.