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The leading text in pediatric nursing, Wong's Nursing Care of Infants and Children takes a unique, easy-to-understand developmental approach to describe the care of children at each age and stage of development. Childhood diseases and disorders are organized by age groups and body systems, and described through the nursing process framework. This edition includes updates on topics such as the new CPR guidelines, immunizations, and pain assessment and management.
- Wong’s Nursing Care of Infants and Children
- INFANT NUTRITION: Disaster Planning and Infant Nutrition
- Wong's Nursing Care of Infants and Children
It seems that you're in Germany. We have a dedicated site for Germany. This book intends to act as a resource for those caring for children. The children I nursed who experienced pain are the stimulus for both my interest in the issue of pain and latterly in writing this book. Some of the children I cared for stand out as milestones in terms of provoking thought and in questioning practice -James, Ralph and Felicity.
Wong’s Nursing Care of Infants and Children
Caring for newborns in the presence of their parents: the experience of nurses in the neonatal intensive care unit. I RN, Ph. E-mail: merighi usp. II RN, Ph. E-mail: cristina. E-mail: kasantin gmail. E-mail: deisemoura hotmail. Corresponding Author.
The nurse has a key role in involving parents in the care of newborns in the neonatal intensive care unit. The aim of this study was to comprehend how the nurses experience the care provided to newborns in the presence of the parents.
This is a qualitative study using social phenomenology, with the participation of seven nurses, interviewed between January and February The nurses perceived the needs of parents; had positive expectations regarding the care provided and acknowledge themselves to be the link between them, helping them to live with the hospitalized child.
However, in emergencies, the nurses had difficulties in caring for the neonate in the presence of the parents. The nurses positively evaluated the presence of parents in the neonatal intensive care unit, involving them permanently in the care of the newborn. In the Neonatal Intensive Care Unit NICU , the focus of the care has been the biological aspects, however this issue is being discussed between health professionals in order to transform this reality, expanding and focusing the care not only on the disease of the newborn, but also on the social, emotional and psychological dimensions of the family 1.
Nurses assume an important role in the context of the NICU, because they develop collaborative work with the physician in the strategies and decisions, provide direct care to the newborn and give support to the family 2. However, there are many difficulties that nurses face regarding the interaction, especially in relation to the needs of the parents of the newborn to expose their feelings.
Because of the characteristics of these sites, the nurses and other health professionals who carry out their activities there are almost always intimately involved in high-complexity procedures. In this sense, interpersonal relationships can be compromised 3.
The nurse has a fundamental role concerning the involvement of the parents in the activities of the NICU, particularly regarding guidance in the first visit. This professional should provide support in order to reduce the anxiety and fear that the parents of the newborn feel, providing minimum conditions of comfort, trying to respond to concerns and providing information on the health of the newborn, the treatment and the equipment used 4.
In the family circle, there is no stage that causes more profound change that the birth of a child and with the birth of an at risk neonate the family is faced with a challenging and exhausting experience 1.
It is necessary that the nurse use an approach centered on the child and the family, from a holistic perspective, identifying the family of the newborn as primarily responsible for the care of its members. Therefore, they should consider the problems, needs, interests, resources, capabilities and expectations of all of the family in the healthcare of hospitalized children 5.
Communication, knowledge and the comprehension of the family context, inserted into a physical, social and cultural situation, should be prioritized. Technical and scientific competence is not enough to address this integral comprehension of the human being. Nurses also need to improve their knowledge and skill in interpersonal relationships, as the art of caring is to find a way to let the sick person express their needs.
Thus, caregivers should be able to listen to people suffering from disease and respond to their health and well-being needs as widely as possible 6. What do the nurses consider when caring for the newborn when the parents are present?
Although several studies have addressed the participation of the parents of newborn babies hospitalized in the NICU 4, , the present study is based on the fact that, of the literature investigated, few studies emphasize the themes that seek to comprehend this experience from the perspective of the nurse. Therefore, this study aimed to comprehend how nurses experience the care provided in the NICU faced with the presence of the parents of the newborns.
Considering that, in a NICU, the presence of the parents is configured in a matricial anchor of care, it is fundamental to comprehend how the nurses of this practice scenario experience their care actions faced with the presence of parents, who also have needs that must be included in the planning and execution of the actions directed towards the neonate.
Theoretical methodological framework. This study uses the comprehensive approach of human phenomena from a concrete experience, experienced in the quotidian world. It proposes the analysis of social relations, viewed as mutual relationships that involve people. Social phenomenology is structured on the meanings of the intersubjective experience of the social relationship and focuses on the treatment of social actions that have a contextualized meaning and configure a social sense The intersubjective social relationship is essentially a form of communicative expression.
To capture the subjective point of view, it is necessary to refer to the interpretation that the subjects attribute to the action in terms of projects, available means, motives and meanings Social action is behavior directed toward achieving a particular purpose, and this action can only be interpreted by the subjectivity of the person, as only they can define their action project, their social performance.
In this sense, comprehending the social focuses on social behavior in relation to the reasons, on the intentions that guide action and on their meanings from the perspective of the author of the action Reason refers to a state of affairs, the objective to be achieved through the action.
The experienced type is reached through the analysis of social relationships Nurses who worked in the NICU of this institution, in the care of newborns, in the presence of their parents were included in the study.
Age, time taken to achieve qualification and duration of practice in this area were not considered, because the study sought the lived experience. Interviews were conducted with seven nurses from different shifts, aged between 24 and 43 years.
The number of participants was not predetermined and was defined by the moment at which the statements unveiled the phenomenon under investigation, the inquiries were answered and the aims achieved. Data collection took place between January and February , through semi-structured interviews, with the following guiding questions: what is it like for you, to care for the newborn hospitalized in the NICU, when the parents are present?
What do you consider when you care for the newborn and the parents are present? The discourses were identified with the letter D, followed by the numbers 1 to 7 sequentially.
The nurses were contacted at the hospital and the interviews were conducted on the premises, in a place and at a time suitable for the professionals. Category: Recognizing the needs of the parents reasons why. The nurses recognized the need for care for the parents and, thus, perceived the importance of guidance regarding the procedures and the health status of the child, valuing their presence, seeing them as participants and not as spectators:. The act of caring performed by the nurse is not only emotion, concern and attitude, it is wider, complex and requires concrete actions in the humanistic, social, ethical, biological and spiritual spheres, especially when providing care inside a NICU, involving not only the professional, but also the parents of the newborn In the world of common sense, the actors occupy the scenario of the reality of quotidian life, not as a private world, but shared with other people from the beginning: an intersubjective world In this scenario, nurses, parents and at risk newborns experience the action, the situation and the interpretation of their actions, equipped with perspectives, each with their baggage of knowledge and biographical situation.
The nurse clarifies the doubts of the parents and this action originates in the consciousness of this professional, is voluntary and is projected toward the purpose of reducing anxiety, facilitating the parents being with the child so they can feel confident and integrated into the role of father and mother in the recuperation of the child:.
When they are leaving, if I am present, I try to stay beside them. Did you see the baby? What will you call him? What are the questions that the parent has in relation to all this?
You end up forming a bond with this family [ Ways of communicating and interacting with the families of infants hospitalized in Intensive Care must be established, promoting the participation of the parents in the care, guiding and encouraging them to handle their children.
With this approach, a care process is constructed, preserving the uniqueness and individuality of the child and its parents As caring is essential for the humanization of the assistance, affection, contact with significant people, safety, responsibility, exchange and growth must be brought to the quotidian of the work. It was noticed that, to account for the participation of parents in the NICU, it was necessary to rethink not only their own interpersonal relationships in this context, but also the importance of the integral care.
In this sense, the typical action of nurses in relation to the parents of newborns hospitalized in the Neonatal Intensive Care Unit is shown in the perspective of interaction and family participation in the care of the child Reciprocity of perspectives between professional and family is perceived when the nurse cares with the aim of meeting the integral needs of not only the newborns but also of their parents:.
The theoretical assumptions lead the nurse to recognize the importance of the parents in the participation in the care of at risk newborns, but in a situation of emergency, prioritize the technical procedures in detriment to the humanistic attitudes, as evidenced in the following category. Category: Feeling difficulties in an emergency situation reasons why.
Some nurses were concerned about the presence of the parents in certain situations, especially in emergencies, and verbalized their preference that the parents are not in the NICU:.
It is a little difficult if the child is in a critical condition and the mother is very anxious [ The results of another study carried out in a NICU showed that the nurses mentioned that, faced with the parents of the newborn, they become tense, they do not feel comfortable in performing invasive procedures on the neonate in a serious condition and they believe that the parents are not prepared to accompany their child in a complex situation.
They could clearly distinguish between the situations that allow the presence of the parents, such as changing diapers, handling and others. Although they knew the importance of closeness between them, they did not feel the need of their presence full-time 7.
It is also important to note in this context the performance of a study that sought to understand the beliefs of nurses regarding the presence of the parents of newborns in high risk neonatal units.
The results highlighted that, for this professional, the presence of the parents in certain situations, is configured as a factor that has implications for the development of certain actions by the team and that can interfere with the running of the service 8. Conversely, it was observed that the presence of parents could also be seen from another perspective, which involves the recognition of this presence as therapeutic for the neonates.
In this sense, the nurses of the present study expected to perform actions that favor the proximity of the parents and children and they felt responsible for this proximity, as is explained in the next category. Category: Being the link in the proximity of parents and children reasons for. The nurse facilitates the early contact between parents and premature babies, aiming to establish the bond and commitment, bearing in mind that this is a gradual process that can take days or weeks of the postnatal period:.
Care based on the comprehension of the other, in the social interaction, sharing the anguish of the parents who have their babies hospitalized in the NICU, is what shows the action of the nurse in the formation of emotional bonds between children and parents 7. The discourses of the NICU nurses show that allowing the parents to stay together with the NB - giving affection, handling, following the child closely - are actions that can help these parents to strengthen the emotional bond with the child:.
The need for the formation of a bond between the newborn and the family in the NICU is recognized in other studies that emphasize the care to the parents and the participation of the family in the hospital care of the neonates in the neonatalogical services. The long period of hospitalization of the babies and the deprivation of the environment increases the stress of the parents, which may detrimentally affect the establishment of the bond and attachment.
However, the nurses have difficulties in the care of the newborn in emergency situations when the parents are present in the NICU. The results of this study show the importance of the nursing action in the NICU as a factor of parental involvement in the care for the newborn, emphasizing the relationship of care identified and established between the nurse, the newborn and the parents.
The comprehension of the experience of nurses directed towards the newborn whose parents are present in the context of the NICU draws attention not only to the importance of maintaining them together with their children, but also to recognizing them as potential subjects that need to be perceived and cared for by the healthcare team. Therefore, from this context of care emanates an emotional relationship that links the triad of subjects described, who exert mutual actions and reactions that permanently reconfigure the scenario of assistance and, therefore, their own relationships.
The study allows the elucidation that the nurse perceives the presence of the parents in the NICU in a mainly positive way, permanently involving them in the care of the newborn. This denotes the need to think that the apprehension of this experience indicates new directions to consider regarding the care in the NICU, considering all the subjects involved.
It is hoped that this study will inspire other studies that can address, from the most diverse perspectives possible, the vision of this context of care. Barriers to provision of developmental care in the neonatal intensive care unit: neonatal nursing perceptions. Am J Perinatol. Campos ACS. Rev Bras Enferm. Schmitz EM. A enfermagem em Pediatria e Puericultura. Promoting affective attachment at the neonatal intensive care unit: a challenge for nurses.
Esc Anna Nery.
INFANT NUTRITION: Disaster Planning and Infant Nutrition
Study Guide for Wong's Nursing Care of Infants and Master pediatric nursing concepts and apply them to the practice setting! Spartak Zoltun. Search this site. Karyl McBride Ph. Ebook Online PDF.
Join NursingCenter to get uninterrupted access to this Article. One only needs to think of Hurricane Katrina to realize that no one is immune to the possibility of disaster. Consequently, knowing what to do when disaster strikes is paramount, particularly for healthcare professionals. One of the best sources for information about disaster planning and infant nutrition is the World Health Organization WHO. WHO has developed a set of principles related to infant nutrition to assist with decision making during emergencies.
Wong's Nursing Care of Infants and Children
Children need preparation before and accurate information about any procedure that is performed. This information is essential to promote a sense of security, decrease fear, elicit cooperation, and improve coping skills. Parents also need preparation because their anxiety about a procedure may be transferred to the child. Teaching before performing procedures increases the knowledge base of the child and family.
Caring for newborns in the presence of their parents: the experience of nurses in the neonatal intensive care unit. I RN, Ph. E-mail: merighi usp. II RN, Ph. E-mail: cristina.
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Беккер повернулся и увидел человека в красном одеянии. Тот вскрикнул и испуганно посмотрел на Беккера. Как кот, пойманный с канарейкой в зубах, святой отец вытер губы и безуспешно попытался прикрыть разбившуюся бутылку вина для святого причастия. - Salida! - крикнул Беккер. - Salida. Выпустите .
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