Background: 

Integrating parents into the care of their infants in the neonatal intensive care unit (NICU) is vital for both parents and infants. Yet, parents are often not fully involved in important decision-making and care, even when practices are family- and patient-centered. Alberta Family Integrated Care (FICare) is a model of care designed to support integration of parents into their infant's care.

Purpose: 

The aim of this study was to describe and examine how mothers' work was coordinated by institutional processes when participating in Alberta FICare.

Methods: 

We used institutional ethnography to analyze written entries in Alberta FICare parent journals to show points of tension mothers experienced in the NICU.

Results: 

We illustrated the institutional activities that intersect with parental work of being present in the NICU. We argue that the journal text and the primary discourses that mothers are tuned to organize the way they knew and thought about their infant. Managing everyday NICU rules, navigating constant and unexpected changes, and the work of feeding their infant created tension. Mothers focused on milk supply, weight gain, and transition from gavage to nipple feeds. We show how mothers' activities were coordinated by practices that prioritize progression toward discharge rather than supporting them through the roller coaster of emotions and practical challenges of being present in the NICU.

Implications for Practice: 

This illustration of institutional systems and processes may assist practitioners to understand the barriers mothers face when caring for their infants in the NICU.

中文翻译：

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新生儿重症监护病房中的母亲工作：对艾伯塔省家庭综合护理家长期刊的批判性分析

背景： 

让父母参与新生儿重症监护病房 (NICU) 的婴儿护理对父母和婴儿都至关重要。然而，即使实践以家庭和患者为中心，父母往往也没有充分参与重要的决策和护理。艾伯塔省家庭综合护理 (FICar) 是一种旨在支持父母融入婴儿护理的护理模式。

目的： 

本研究的目的是描述和研究母亲在参与艾伯塔省 FICare 时如何通过机构流程协调其工作。

方法： 

我们使用机构民族志来分析艾伯塔省 FICare 家长期刊中的书面条目，以显示母亲在 NICU 中经历的紧张点。

结果： 

我们说明了与新生儿重症监护病房中的家长工作交叉的机构活动。我们认为，母亲们通过日记文本和主要话语来组织她们了解和思考婴儿的方式。管理新生儿重症监护病房 (NICU) 的日常规则、应对不断发生的意外变化以及喂养婴儿的工作都带来了紧张感。母亲们关注的是母乳供应、体重增加以及从管饲到乳头喂养的过渡。我们展示了母亲们的活动是如何通过优先考虑出院进展的做法来协调的，而不是支持她们度过情绪的过山车和在新生儿重症监护室出现的实际挑战。

对实践的启示： 

这种机构系统和流程的说明可以帮助从业者了解母亲在新生儿重症监护室照顾婴儿时面临的障碍。