When a common language is missing: Nurse-mother communication in the NICU. A qualitative study

To explore how communication in neonatal intensive care units (NICUs) between immigrant mothers and nurses take place without having a common language, and how these mothers experience their NICU stay.

Admission of infants to NICU affects both parents and infants. Immigrant mothers constitute a vulnerable hospital population in need of culturally, linguistically and individually tailored information.

The study had a qualitative design reported according to the COREQ criteria. Eight mothers who spoke neither Scandinavian nor English went through individual semi-structured interviews. Six mother-nurse interactions were observed, and eight nurses' experiences were explored through focus-group interviews. All interviews were audio recorded and transcribed verbatim. The analysis was thematic and hermeneutic in character.

Interpreters were present during the consultations with the physicians, but rarely during the daily nurse-mother interactions. Nurses focused on daily routines, infant care guidance and mother-infant attachment. The mothers learned through demonstrations and hands-on guidance. Language barriers made it difficult to assess the mothers' understanding, but the mothers expressed that they felt adequately included in the care of their infant and well informed and guided. Even so, both mothers and nurses expressed desire to use interpreters more regularly. The pictorial communication boards available lacked important vocabulary needed in neonatal nursing contexts and their use furthermore interrupted the mother-nurse conversation.

Body language, simple words, guesswork, trial and error characterised the nurse-mother interaction. The nurses adopted various communication strategies to help the mothers understand and give them a voice. Competent interpreters were used during meetings with physicians, but not during daily bedside guidance and information giving by nurses.

Knowledge of immigrant mothers' and nurses' communication strategies and how both parties think, feel and act to overcome communication problem is necessary to improve clinical practice and reduce communication barriers.