A 5-Months-Old Baby Requesting Immunization - Essay Example

Essay: Nursing A 5 months old baby requesting immunization Executive Summary Immunization in children induces the immune system to develop a long lasting memory for the fight against current and future infections. The importance of immunization to an individual is to help reduce the circulation of the infecting agent from reaching the unvaccinated individuals. Failure of an individual to receive vaccination exposes one to a wide range of both current and future infections that are a threat to life. Effective vaccination provides the most economical and effective ways of controlling morbidity, mortality, and disability of disease. Despite the awareness of these facts some children still do not receive immunization as recommended (GHAYE, 2010). Vaccine preventable infections continue to cause illnesses that were never expected to occur in the 21st century. This is a common happening among the un-vaccinated pre-school age children in various parts of the world. As a result, the U.K government has made it as a matter of policy for compulsory vaccination of preschool-aged children. This initiative has aided in most children completing their basic immunization series by their second year of age. Under-immunization among children of preschool-age is caused by factors ranging from parents neglect to lack of systems that ensures that every conception has its record at the health centre (Smith, 2008). Research studies have often shown that these failures are attributed to the provider associated characteristics and behavior in general. Due to certain religious and philosophical belief of some parents, some children still end up receiving immunization in time or not receiving at all. Such parents often focus on the adverse effects of immunization which make them fear for their children hence preventing their children from being immunized. Such children are always placed at a greater risk for disease attack. These and many other practices often leads to under-immunization. Therefore nurses in the primary care setting will need to focus more effort in educating parents on the importance of immunization to their children (Duff, 2007). Introduction Immunization towards control of childhood diseases protects and saves several millions of lives world wide. Studies have shown that world vaccination rates are at all times high. Illnesses and deaths from common diseases such as diphtheria, tetanus, pertussis, mumps, rubella, measles, and influenza are today at their all times lows. Medical reports have further shown that over 70 bacteria, viruses, parasites, and other microbes that cause illnesses can successfully be inactivated and rendered inactive through immunization. The World Health Organization’s goal of control of infectious diseases has been achieved through immunization. Effective immunization and control of infectious diseases is a function of proper communication and coordination between health providers and the parents. The existence of asymmetric information between parents and health care providers coupled with lack of prenatal knowledge results to the perennial delayed presentation of children for vaccination. During my operations, I have observed that there are critical incidents of delayed immunization of children due to their late presentation in the hospital for vaccination. This reason has led me to inquire of the causes of this perennial incident and find some of its causes (Silva, 2009). As a nurse, I believe that accurate observation and following of the immunization schedule is the best way of protecting a young child. The administration of immunization at the right time and at the recommended ages provides the best possible chance to make the child immune to diseases before they are exposed. This is because every vaccine is tested to be effective at their recommended ages of administration and a healthy child’s immune system is capable of handling all vaccines at the recommended ages (GIBBS, 2004). Scientific analysis has provided that today children can be protected from 14 potential serious diseases with vaccines. As such, every dose of vaccine is useful in protecting a child against infectious diseases that are threats today. These diseases are dangerous for infants, and the parents might not have the knowledge of some of the available vaccine that enables the prevention of such infections. Vaccines such as Haemophilus influenza type (b) prevent mental retardation while Pneumococcal controls meningitis. Beside the preventable diseases there are several other serious diseases that are not preventable through immunization. Being a health care professional, I have been engaged in treating very ill children which always raise the desire for more life-saving vaccines. The benefits of vaccines have been enamors considering the statistical evidence of the number of children that have been saved through immunization. Failure by some parents to take their children is a discouraging act. All children can be safely vaccinated with exception of a few with allergies. Therefore no child should miss immunization except on conditions of weak immune system due to medication. The only way to keep children safe is by ensuring that they all undergo immunization. Following a delayed vaccination schedule has no beneficial output to children. Therefore the schedule should be kept since delay puts children at the risk of being ill with preventable diseases (Gastmans, 2008). The assessment of immunization coverage among 45 randomly selected states has portrayed varying trends in the rate of accurate immunization uptake. The average levels .of immunization has been found to be low with a median level of 54%b for the basic series at 24 months of age. The lower coverage levels have been shown to prevail highly among children undergoing immunization in private hospitals than those from public hospitals. This has been estimated to be below the Healthy people 2000 goal of 90% coverage on all 24months old children in across the globe. The highest level of success in this analysis has proven to be with children who visit hospitals less frequently. As such, it encourages putting emphasize on the use of recall and reminder systems that would encourage their parents to bring them to the nearby public hospitals. This will enable the elimination of the missed opportunities among such children and encourage routine immunization. The risk of being partially immunized or having delayed immunization schedule is associated with the location of the immunization centre. Children from relatively far residence will often be at the risk of being under-immunized. This is common when proper communication systems are not put in place to ensure that information reaches the parents (CROUCH, 2009). Johns’ Model of Reflection Description A five month old baby who has never received any immunization since birth is presented to the clinic for the first time to be immunized. The baby’s medical records cannot be traced in any hospital a round which means that the mother did not attend the prenatal health services. The midwife who assisted the mother never reported the case to the clinic for medical attention and as such there has been lack of communication and responsibility on the part of the midwife. Therefore it is in the knowledge that this baby has not had any medical history and is in need of urgent follow ups and administration of the necessary schedule of immunization (Raymond, 2005). Even though, the baby does not exhibit any tendency of infection or illness, it is not predictable of how the condition is going to be in the near future and as such it is necessary for quick consideration and scheduling of immunization before it is late. The child’s mother does not provide a concrete explanation as to why the child has not been immunized. This necessitates the need to determine the mother’s condition of living to ascertain the medical safety of the child and to inquire the kind of help necessary for the family. The mother of the baby is a single parent and does not have a permanent place of residence and she is a first time mum (ATKINS, 2005). The address was provided by the baby’s mother for contact shows she is currently within the reach of the nurse and therefore the baby can be scheduled for current and future immunizations. Despite the fact that the child is behind schedule with immunization, scientific evidence potent that the administration of vaccines for the past time is still feasible in case the baby does not have any form of allergic reaction to vaccines. As a result, a good communication and contact schedule was established and the Datix incident form filled with an appointed given to the mother through her address for the next visitation at home on the next day. When the mother was contacted on the second day and found to have moved to another undisclosed location, an effort to meet her was made through the address provided. The address of the new venue was taken and the mother and the child were both were referred to the nearest health visitors (HV) team in that area. This was followed by a telephone call to the HV team in that area to ensure that they conducted a home visit for the baby to be immunized. The visitation was made on the following day and the baby found well (Duff, 2006). Reflection The knowledge of these fundamental patterns in the life of the baby is geared towards the development of abstract and theoretical explanations of how to schedule an immunization program. This action will enable the determination of the action to be taken in providing the patient with requirements to restore the ideal situation. This is to enhance the improvement of the esthetic quality of life required by the child through an active transformation of the mother’s behavior. The act is aimed at determining the attitudes of the mother of the child so that proper correctional actions can the adopted to aid in helping the child (HADDOCK, 2007). These actions resulted into the baby receiving the intended immediate immunization schedule without failure. The subsequent immunization schedule in the life of the child will be administered in time and therefore the child will be safe from preventable illnesses. Accurate following of the recommended schedule is aimed at ensuring the protection of the child and other children with whom they interact by providing immunity early in life before they are exposed to potentially life threatening illnesses. It is found that falling behind schedule of immunization of children, parents and healthcare professionals can use the catch-p immunization schedule which quickly gets the child up to date with the schedule. This is the method employed in the 5 month old baby behind schedule and the initiative is trusted to advance the child’s health positively (Moch, 2000). In accomplishing this schedule, also ensures other children in the area are equally safe from illnesses that can lead to hospitalization. Delay in vaccinations always subject children to known risks of becoming sick with illnesses that can be prevented. Research postulates that nearly all children can be safely immunized and vaccines do not often cause adverse effects on the lives of children or immune system. However, there are some noticeable exceptions that I have observed in my practice and this case is just one of such including cases of allergies for some vaccines made with traces of chicken egg protein. Children with such allergies are recommended not to be given flu vaccines (Sorrell, 1999). This also applies to children with weak immune system as result of medical treatment such as chemotherapy or other illnesses. Children before 2 years of age must be ensured the recommended number of immunization dozes against the 14 potentially serious illnesses with vaccines. Every doze of such vaccines will be important to the 5 month old baby because they will protect him against the infectious illnesses that are threats today. Such diseases are especially dangerous to infants of lower ages of less than one year. Such protections will save the mother from unnecessary spending on the medication and hospitalization that would also eat into her time for other economic activities. A healthy baby ensures happiness in the family due to availability of quality time for interaction between family members, mother and the baby. The family will be able to avoid unnecessary spending on the baby’s healthcare which will also save on finances. Health is a vital element, on the lives of everyone in the modern society. Despite the fact that the mother has been inactive in ensuring that the baby’s health, with the new move by the HV in the new location of residence will ensure that the baby’s is well taken care of as recommended (Lauterbach, 2006). Influencing factors The mother’s ability to take care of the baby was assured by the HV personnel in the nearby centre through the assurance that the baby was fine and there was no safety concerns identified on the parental and environmental issues. The mother’s inability to disclose her new address was influenced by the previous experiences of insecurity a rising from being a single mother. These causative factors prompted a physical home visit that established that the mother was happy to see her baby grow into a strong and healthy person and assured the HV that she will take full responsibility in ensuring that the baby will get all the schedule of immunizations since she had dealt with the external and emotional factors that led to the delay of vaccination of the baby (Sanford, 2000). The decision for the follow up was influenced by the fact that the mother of the baby at the time of her first visit seemed worried about the baby and her own condition of living. The decision making to follow through phone calls and ensuring that the baby was immunized was informed by the knowledge that it would be much worse for the baby to go through without having been immunized as this would lead to the baby’s vulnerability to diseases and infections that would be prevented easily controlled through immunization. At this point in time due to the patient’s change of place of residence, the only alternative strategy that was left was to connect the mother and the baby to the nearest HV team who would then ensure that the baby underwent through the immunization process. This in turn ensured that the mother and the baby were both living in good conditions of environmentally and physically. This strategy enabled the mother to understand the need for antennal care that the baby required which in turn influenced her appreciation of the efforts of the HV team in the two canters from which they were served (JOHNS, 2009). Even though the baby had missed the 6-8 weeks check, medical research had proven that it was possible for the baby to given those missed immunization through the process of catch up system. All these decisions together with the support of my fellow HV team led to the success of the initiative of the child’s immunization process. The situation could have been made better than it went if the mother and the baby were still staying in the original place of residence. This would have enabled my personal attention in the administration of the immunization schedule. The presence of the baby at the original HV clinic would have enabled the administration of vaccination to be better and efficient. The choice to have the baby at the original centre would have resulted into the mothers’ lack of co-operation and the engagement in the facilitation of the home visit was initiated. The factors that led to the baby missing the initial immunizations would have persisted since the mother would still maintain her initial residence. This would have promoted the baby’s vulnerability to the infectious preventable diseases that would have resulted into hospitalization. Hospitalization of the baby would have caused more trauma and stress to the first time mother who in turn would have been more insecure (Moch, 2005). Learning The experience of under immunization together with late immunization that is still experienced in our society provided me with the opportunity to enrich my esthetic knowledge. This aided in the realization of the meaning of caring in my practice through the reflection of the career caring narratives. With this experience, the analysis of context and process of the practice was also achieved which led to the realization of how important the caring is an important activity in the well being of humans in general. It led to the knowledge of the need for self care, recognizing caring as a moral responsibility, knowing that emotional attachment can be dangerous, and the reflection on caring which allows one to define caring (Carper, 2005). The main theories that enhance learning and knowing have been identified as, empirical, esthetic, ethical, and personal knowing which all unite to formulate learning structure in care giving. The process enabled me to learn from the empirical knowledge that comes from the theory, research explanations and predictions. Ethical knowing is mainly concerned with obligations of the care giver. It involves the formulation of moral choices made on the basis relational and situational relevance of decision-making. The aspect of ethics is shown to involve being sensitive to the value systems of others, reflection of justice is an important aspect of ethics (White, 2007). Interactions between the nurse and the client often lead to esthetic knowledge through an experience of a specific unique situation. Its relationship to nursing has been described to be far from the in between description of Sorrell. It is not something merely observed but a live and active in the conscience of a nurse. According to Smith, it is “an all at once glimpsing of the beauty in nurse-client process.” Esthetic knowledge is not an intuitive personal knowledge which integrates experience in a context of discovery. It often overlaps with personal knowledge due to the intuitive knowledge proving the fact that patterns of knowing are never exclusive. The interaction between the mother and the child led me to the discovery of self and others through a reflection, connection with what is known, and synthesis of perceptions. These led to personal knowledge about self, the nurses and the patient. An expanded personal knowledge include, interpersonal, intuitive structures, and experiential. The process of acquiring an experience and relating it to an existing knowledge strengthens the development of experience and knowledge. Frequent nurse-patient contact fosters the awareness of being in the world which represents a reflection in action, apprenticeship learning, and the openness reflection to learning by doing (JARVIS, 2002). In the model of reflection, one gets to employ intuitive knowing which does not involve conscious reasoning especially when dealing with an urgent case scenario. The practice of care for immunization enabled me to experience the nee of a practitioner to be a humanistic in nature. This would enable a nurse to serve as a value model who can acquire knowledge through empathy and engage in the therapeutic of self as a contribution to therapeutic knowing. As such the practice of caring during the period of catch-up immunization played a great role in the provision of a reflective process as a means of self-learning (Schon, 2011). This experience has made me feel whole as a medical professional and increased my responsibility through the esthetic knowing. The esthetic knowledge has increased my ability to respond to an internal drive to care for patients. The relationship that grew between the patients’ family and I, involved not just care but also respect and trust. I learnt that honesty among people facilitates smooth running of duties and allow efficiency in care delivery. I learnt of caring through listening to stories about the lacking of caring which encouraged my focus through better understanding of what the patient really needed. I also came to learn that even though emotional attachments can be dangerous when one is giving care, there are times this becomes hard to avoid in the course of the practice. I came to discover that emotional attachment sometimes fosters the genuine care that is necessary in certain situations. I also realized that emotional care can sometimes provide the needed attachment for those people whose families does not provide for the necessary support and protection. The knowledge gathered during this proc has enabled me expand my understanding on the need for care in the society (White, 2007). Summary The administration of immunization is one of the fundamental ways of caring for our society. As a nurse I potent with the fact that caring is a moral responsibility. It is the unique ability of an individual to make choices aimed at bringing an improvement in the life of another person. Being a nurse in the field of immunization involves the shift of energy and focus from oneself to the service of the general public for the good of the society. Seeking to provide services to others calls for understanding others and being motivated towards good activities, regarding the patients’ feelings, appreciating the patient’s situation, feeling drawn to the present condition of the patient, and giving hope to the patient despite the situations they are faced with (GHAYE, 2010). Despite the great effort by the HV teams in the country, it is still observable that some babies still do not receive immunizations as scheduled. This caused by many reasons ranging fro internal and external factors faced by their families. The point in question her is that all of the children should receive immunization so as to protect our babies from unnecessary infections by illnesses that can be controlled. Those children who are behind the immunization schedule can be helped by the administration of catch-up procedures. Caring often provides nurses with a sense of self-discovery which advances the importance of ethical knowing in practice. The nurses’ ability to respond to an internal drive is a result of esthetic knowing that the nurse has earned through care giving. Reflection on care activities gives one the knowledge about caring through experiencing the real situation of the patient. The reflective process provided me with an opportunity to learn about my own caring activities. Caring process involves many other subsidiary duties including patient advocacy. It called for the proper knowledge of my patient through frequent interaction and sharing in many perspectives which led to her understanding of the need for immunization (BOUD, 2000). The persistent question that kept lingering in my mind was the difficulty it often takes to know ones’ patient in a transparent manner. My continual on the reflection of my practice criteria was motivated by the attitude of questioning. Continued reflection enabled the expansion of my understanding of caring and the meaning of my practice. Reflection helped me in imagining on how I could improve my care in future. I came to discover that through the reflection of interaction, the patient could become better when the matter disturbing the patient is discussed at length with the mother or the patient. As such, I came to know that real occurs through being there physically and engaging on matters of importance to the patient or guardian. Use of John’s model of reflection enabled me to reflect on the critical issues that revolve the caring. The enhanced my realization of personal learning as a nurse which enabled me to perform my duties better through the employment of empathy in working with my patients’ current state. It aided in the understanding of critical issues of concern in the application of care as well as the need to apply the modern techniques of learning through apprenticeship. The model provided specific channels through which analytical approaches can be followed in the assessment of a patient (Carper, 2006). Recommendations The practice of nurses presents a practitioner with situations that requires one’s ability to employ the virtue of empathy in order to understand situations. This can only be achieved through the application of the understanding of the four major learning processes of empirical, esthetic, ethical, and personal learning. This enables the adoption of caring as amoral responsibility that helps in making unique decisions that impact positively in the lives of patients. Sharing caring practices among nurses and HV teams enabled me to accomplish the task of overseeing that the immunization schedule was followed for the through the commitment of the mother and HV team members within her locations through home visits. In conclusion, for effective immunization of all babies to succeed, there should a concrete adoption of home visits by HV team members through proper facilitation as a matter of policy. Midwives who assist mothers in delivery should be encouraged to report those deliveries to health institutions so that medical records for such babies can be established and follow ups made for effective immunization schedule to be adopted. Parents should be made aware on the importance of timely immunization so that under immunization is discouraged among the children. It is a fact that the unorchestrated act of caring impacts many people not only the patients but also the family members who often most thankful to the providers. As such, it is a noble practice that should be encouraged and endured by all practitioners for the benefit of the society (CHESNEY, 2010). List of References ATKINS, S. and MURPHY, K. (2005) Reflective practice. Nursing Standard, 8(39), pp.49-56. BOUD, D., KEOGH, R. and WALKER D. (eds) (2000) Reflection: Turning experience intolearning. New York: Kogan Page. Bishop, A.,& Scudder, J. (2001). Caring presence. In A. Bishop & J. 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