My early lesson in advocating for patients and keeping them informed

By Alizah Alaman | 08/17/2017

The smile on the mother’s face made me proud.

Alizah AlamanA nurse from Pakistan shares an experience that reinforced for her the importance of sharing vital information with patients and advocating on their behalf while helping to promote mother-neonate attachment. 

Mother-infant attachment is an intimate human bond that is advanced via physical closeness and early interaction. This emotional tie is a crucial part of an infant’s development and helps initiate an affectionate mother-newborn relationship. However, this bonding process is sometimes hindered, particularly if the neonate requires incubator support and is shifted to the NICU soon after birth.

During my reproductive health clinical rotation as a nursing student at Aga Khan University School of Nursing, I encountered a 27-year-old primigravida who, three days earlier, had delivered a baby boy through cesarean section. Because of low birth weight, the infant was in the NICU. While taking the mother’s health history, I discovered she hadn’t met her infant following delivery. Upon further discussion, I learned that, although she had expressed milk regularly for her infant, she was unaware of her baby’s condition, and no one had told her about NICU visiting rules.

Immediately, many questions arose in my mind: Why was the mother unaware of the hospital’s NICU visiting policy? Doesn’t an infant have a right to meet his or her mother? Will the mother’s unawareness of her child’s condition interfere with the mother-child attachment process? These concerns bothered me a lot.

In communicating with the assigned nurse, I learned that, because of workload, she was not able to inform the mother about visiting rules. According to Mary Ann Friesen and coauthors, nurse workload in patient-care settings can negatively impact proper coordination and delivery of information to patients, resulting in detrimental outcomes. I did not want to see the normal attachment process disrupted. The literature suggests that nurses can play an essential role in facilitating mother-child attachment by encouraging mothers to meet, touch, hold, and care for their infants.

My early lesson in advocating for patients and keeping them informed I was feeling disappointed because, in nursing school, we were taught that conveying comprehensive information to the patient is a core responsibility of a good nurse and a crucial right of a patient. However, in clinical settings, the practice is sometimes entirely different. As an integral part of my commitment to my patient as her nurse, I decided to advocate on her behalf. My altruistic concern toward the patient and her needs motivated me to minimize her emotional strain and anxiety about her baby.

To address the problem appropriately, I consulted a faculty member. Based on her advice, I guided the mother so she could visit her baby in the NICU and, to promote attachment, even spend some time with him. The mother was so glad and, three days after giving birth, went to the NICU to meet her baby.

The grateful smile on the mother’s face made me feel very proud that I was able to advocate on her behalf. The faculty member’s advice also gave me confidence and assurance that I could tackle such issues in the future.

Reflecting on my experience, I identified positive steps to intervene on behalf of the patient. Observing the staff nurse’s failure to act on the mother’s behalf sensitized me to a patient’s right to have correct information, so I told the mother about NICU visiting rules and arranged for her to spend time with her baby. Through this experience early in my nursing career, I learned to be more supportive of my patients by keeping them well-informed and by advocating on their behalf when needed. RNL

Alizah Alaman, BScN, a 2015 graduate of Aga Khan University School of Nursing and Midwifery in Karachi, Pakistan, is now practicing as a registered nurse at The Aga Khan University Hospital

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