Trust as the foundation to care: Parents of Medically Fragile Infants' experiences of developing trust with nurses

BACKGROUND: Parents of hospitalized Medically Fragile Infants (MFI) experience high levels of stress and difficulty parenting their infant. They require support to help them navigate their new parenting role, which can be provided by nurses within relationships built on trust. OBJECTIVE: To explore how trust is established and maintained between parents of hospitalized MFI and nurses from the parents' perspective. METHOD: Using a qualitative Interpretive Description study design, 15 parents of MFI from inpatient care units at a pediatric tertiary care hospital were recruited. MFI consisted of (a) one or more chronic medical illnesses, (b) reliance on medical technology, (c) > 30-day hospitalization, and (d) discharge home with a chronic illness. Data were collected via semi-structured interviews, which were transcribed, coded, and analyzed. RESULTS: Parents described how parenting their MFI on inpatient care units was excruciatingly difficult. They had increased stress and struggled with their mental health. Parent-nurse trusting relationships led to a collaborative partnership, where they worked together to provide safe and nurturing care to MFI. Parents identified ten core elements that helped them develop trust with nurses. Mistrust could arise when the core elements were absent, medical mistakes occurred, or infants were transferred between hospital units. CONCLUSION: The establishment of parents' trust in nurses was crucial for the delivery of high-quality Family-Centered Care to hospitalized MFI and their parents, thereby supporting parents in coping with their stress. Instructions on how to establish trust with parents of MFI should be included in the nursing curriculum for both nursing students and practicing nurses. IMPLICATIONS TO PRACTICE: Nurses can support parents of MFI in coping with their mental health and emotions by developing trusting relationships. When relationships are built on trust, collaborative partnerships between nurses and parents form, enabling them to work together to provide safe and nurturing care to MFI within the hospital setting. Nurses can engage in the 10 core elements to develop trust, thereby establishing trusting relationships with parents of MFI.