Nursing Care For Dying Children - Essay Example

Nursing care for dying children PART There are a lot of things living in the world and each one of them has a life time that once its end comes around, there is little that even science can do; a phenomenon which has led to the shifting of blame to the failure of science (Morgan,2009). With this in mind, human beings have accepted the fact that one has to die to complete the cycle of life. According to Morgan, when a child dies, this cycle seems unnatural; it’s so sudden that the human potential is lost, and dreams quickly become shattered and vanish while its regarded as a loss to not only the parent, but to the society. (Morgan, 2009). The parents, siblings and the health care providers are only left to grieve the loss of such a young life. The primary philosophy behind palliative care is to assist the patients and their families in achieving the best quality of life and to die peacefully and comfortably with dignity. For children, it is the active total care of the child’s body, mind, and spirit, as well as a means of providing support to the family. Part one of this paper will address the kind of nursing care needed for children who are dying and things to be taken into consideration for dying children. There are common diagnoses that affect the length of life of children including prematurity, chromosomal defects, cancer, AIDS, congenital anomalies among others. However among the diseases considered to be life-limiting, the one ignored most and considered not to be palliative care is the wound care. Though contradictory, child patients nearing their death can benefit from the curative aspects of wound healing. A wound can have a devastating effect on the child patient’s quality of dying thus one kind of care that I would engage as a nurse. Dying is a natural part of life and is usually filled with mixed emotions and times of reflection for both the dying person and the caregiver. However when a child dies, it seems like a massive failure that such a young life had to be lost. Seated next to her bed, my niece could barely talk. It was difficult to accept the fate of our beloved child; letting go of the hopes for a long-term future with her. As a nurse and her caregiver, I had to accept what was happening including my role as a caregiver with new demands and duties; making her comfortable. It became obvious that taking care of a child or teenager with such a life-limiting condition is a daunting and challenging task emotionally and practically as it requires specific support and skills, unlike for an adult suffering from such conditions. Challenges exist which include the fact that the conditions that the children suffer are often quite rare. This may pose a challenge for the professionals whose expertise is confined to the care of adults. The nature of some of these life-limiting conditions means difficulty in predicting prognosis. Their physiological resilience and thus prognostic uncertainty can make the decision on proper therapy difficult. The primary focus of palliative care includes minimizing pain and other symptoms. The age of a child may limit the understanding of death but they are acutely aware of the seriousness of their illness (Hockenberry & Wilson, 2013). Emotional support for these patients forms the foundation for proper care. The children also require nursing services from professional nurses as well as nutritional counseling being given to the ones who are involved in day to day caring of the child. It is also important to avoid letting the patient sink into the feeling of loneliness and alienation because this may cause the situation to worsen. Therefore art, music and play therapy will help the children and families explore and express their feelings about one another. It will make both parties forget about their situation for a moment and reduce pain, suffering, fear and anxiety. The school environment is more than a place of learning, providing important relationships for sick children, their parents and siblings. School may also provide a reassuring rhythm to life and a sense of normality amid chaos and upheaval. This kind of care will not only focuses on dying peacefully, comfortably and with dignity as possible, but also on living as fully as possible until death occurs. The location where medical care should be provided is very important both to the child and the family of the child. Children requiring palliative care need to be in a familiar environment in order to maintain a normal life for as long as possible. They require to be given an opportunity for education and structured play as well as have access to the services of a multi-disciplinary care team to address their physical, psychosocial, emotional and spiritual needs. Some even require having access to information and being involved in decision making about their health though this is determined by age, understanding and circumstance. Most families choose to spend as much time as possible, as parents commonly feel this is the last thing they can do for their child. To them palliative care represents an extension of the care they would normally provide and the smaller physical size of the children makes home care a realistic option. The home environment provides families with the security of a familiar environment which is free from the disruption of hospital routines. Children generally prefer to be at home among their own toys, pets, family members and friends. PART 2 As a qualified nurse with skills and knowledge, it’s important to realize and understand the role to play in the profession such as when providing services in palliative care. Working in partnership with the family in planning, co-coordinating and delivering individualized evidence-based care to the dying child will form the basis for my duty. As a pediatric nurse, I will support the philosophy of family centered care. For a dying child, pain management is an integral part of nursing care. Through the understanding that pain has physiological and psychological attributes, employing both pharmacological and non-pharmacological methods is essential in order to achieve effective pain management. Of importance is the nutrition that the child needs to be provided. By offering nutritional support, as a nurse I will have to empathize with the parents as they cope with the nutritional changes and experience limitations in trying to fulfill their role of nourishing their child (Chan & Webster, 2013). The parents often require time to accept that their child’s life-limiting illness results in reduced intake of food and hence require my advice and directions. Also getting directly involved in persuading the child to take some nourishment and helping during oral care is important as it will promote comfort and relieve. As a nurse establishing and developing effective communication with the family and between the dying child, parents and siblings will be important and will help allay unnecessary fears and distress about the approaching death (Chan & Webster, 2013). This is to ensure that the child and family experience the best quality of life possible. In order to provide quality end-of-life care as a nurse I must seek the understanding of the cultural, religious and the other values and beliefs around death that the individual child and family hold. Any gaps witnessed in my knowledge and skills should be bridged by seeking education or support. In conclusion, a child’s death may seem like a long, scary pathway. As a nurse, I have the power to create a brighter journey for these patients and families, as well as for themselves. However challenging emotionally and sometimes psychologically it may be, palliative care for children can be rewarding. The satisfaction of doing great service, even when there is little hope brings a great feeling and leaves the best of impression with the family members of the departed. References Chan, R., & Webster, J. (2013). End-of-life care pathways for improving outcomes in caring for the dying. Cochrane Database System Rev, 1. Hockenberry, M. J., & Wilson, D. (2013). Wongs Nursing Care of Infants and Children Multimedia Enhanced Version. Elsevier Health Sciences. Morgan, D. (2009). Caring for dying children: Assessing the needs of the pediatric palliative care nurse. Pediatric nursing, 35(2), 86. Read More