Consistent nursing care could strengthen trust with parents

Nurse caring for a newborn in a hospital setting. © Speak Media Uganda / Pexels

Parents of medically fragile infants often face high stress in hospital, and changing nurses can make it harder for them to build trust. Consistent, trusting relationships with nurses can help parents cope and support high-quality, infant- and family-centred developmental care. A qualitative study from Canada explored this topic through interviews with 18 parents of medically fragile infants on paediatric inpatient care units. Parents described ten core elements that helped them trust nurses, including primary nursing with consistent nurses. However, trust could also break down after medical mistakes or transfers between hospital units.

Medically fragile infants are preterm or full-term infants who live with serious chronic illnesses and depend on medical technology and care. Many spend weeks or months in hospital, and their parents often experience high levels of stress, anxiety, and uncertainty. Nurses are well placed to support them through this time. However, trust is harder to build when parents meet new nurses, routines, and care settings, which makes shared approaches all the more important.

Researchers in Canada set out to explore how trust develops between parents of medically fragile infants and nurses, from the parents’ perspective. To do this, they conducted in-depth interviews with 18 parents on paediatric inpatient care units at a tertiary children’s hospital.

Why consistent nursing care builds parents’ trust

Parents described caring for their infant in hospital as extremely difficult, with frequent fear, guilt, and a sense of losing control. In this situation, trust in nurses often became a lifeline that helped them cope with their stress. From these experiences, parents identified ten core elements that helped them develop this trust. These included nurses making an effort to get to know the infant, nurses taking the time to teach and explain care, as well as witnessing nurses’ expertise, attentiveness, a caring attitude, and good communication. Involving parents in care and decisions, caring for parents, and primary nursing (where the same nurses care for an infant over time) also played a role, as did religious faith for one mother. When trust was in place, parents and nurses formed collaborative partnerships to provide safe and nurturing care.

Consistency in who cared for their infant mattered greatly to parents. When nurses changed often, trust was harder to build and parents’ stress increased. Transfers from intensive care also caused stress, as staffing changed from one nurse per infant to one for three. In addition, trust could break down after medical mistakes, but openness and an apology could help rebuild it.

What the findings suggest for consistent nursing care

For healthcare professionals, the ten core elements offer practical, shared strategies that fit easily into daily routines. The authors therefore recommend including education on building trust with parents in undergraduate nursing curricula and continuing education. In their view, this would help more families receive family-centred care in hospital.focus k

Paper available at: Journal of Pediatric Nursing

Full list of authors: MacKay, L.J.; Nickel, E.; Bahia, R.; Kamke, J.; Ragan, L.; Meyerhoff, H.

DOI: 10.1016/j.pedn.2026.01.030