TABLE 3

Examples of Communication Crises Experienced by Parents and HCPs

• Parent refusal of care recommended by HCPs (ie, processes of care, treatments, procedures, taking the child home, or leaving hospital against medical advice)
• Parent medico-legal threat or action against HCPs
• Parent perception or witnessing of repeated trauma, discomfort, pain inflicted on their child as part of care (ie, fasting, multiple intravenous line insertion, or phlebotomy attempts, etc)
• Parent perception or witnessing of unrelenting or inadequately treated discomfort, pain, or symptoms experienced by their child due to medical issues and/or disease
• Differing expectations of processes and/or outcomes of care between parent and HCP
• Parent threats or action to involve the media regarding dissatisfaction with HCPs or patient care
• Parent seeking, valuing, and adhering to alternative opinions regarding patient care (ie, preference of or belief in the opinion or recommendation of a family member, friend, alternative HCP, the Internet, etc)
• Interruption or lack of support regarding physiologic and emotional needs of parents (ie, exhaustion, physical separation from family members, lack of proper nourishment, etc)
• Parental feelings of abandonment, loss of control or hope due to lack of clarity and assurance regarding a plan moving forward as a team
• Perceived parent display of aggressive behaviors such as yelling, swearing and physical threats
• Parent demand of therapies, tests or procedures that were not recommended (ie, perceived to be harmful or unnecessary by HCP)
• Parental perception that their knowledge and expertise of their child was disregarded or disrespected by HCP
• HCP’s lack of ability to truly listen to and validate parent’s input or concerns with an open mind
• HCP’s lack of humility or ability to apologize during times of uncertainty or when an error occurred