Parent talk at intensive care unit rounds

Abstract

We analyzed verbatim transcriptions of audiotaped rounds in a large pediatric intensive care unit to determine how physicians refer to families of critically ill children. In almost 4 hours of rounds recorded on 3 days in 1 week, the doctors mentioned the families of 11 of the 25 different patients discussed. There were 19 discreet references to parents or an average of 1 reference every 12$\text{1}\text{2}$ minutes. Nine references were made during the formal presentation of the patients' medical histories. Three references to parents involved discharge of chronically ill children. The 7 remaining references were about the families of 3 children with grim prognoses.

Parental references which occurred in presentations and discharge plans had a ceremonial character. Other references to families were infrequent and only occurred when physicians believed medical measures were no longer efficacious. We conclude that doctors do not consider family matters in the systematic way they discuss technical concerns.