Nursing Care of a Child with Special Needs - Term Paper Example

Nursing Care of a Child with Special Needs Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Name Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Course Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Instructor Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Date Introduction Care for children under the age of five years in Australia is a mandate given to the parents and the community as well. This responsibility is widely advocated particularly for families that have children with any genetic or congenital anomaly. Families have a duty to take extra care of such children to ensure their growth and development in society (Roden, 2005). Similarly, any nurse in the paediatric sector in Australia also bears the responsibility to collaborate with the family of the sick child, either directly or through an advocate to ensure that the best interests of that particular child are met. Any medical setting in charge of children has the best interests of the child as of paramount importance (Cline & Cline, 2007). Each and every child has health needs. Some of these needs are inherent and cannot be taken away as they are gotten by virtue of being a child. However, the health needs of children with a congenital or genetic anomaly sharply contrast with those of a child who is well and in a good health condition. Congenital disease means that the child is born with the disease at birth (Roden, 2005). Even though it is traumatising for the parents to learn that the children have congenital diseases, it has become more consoling with advances in technology that have made treatment and medical care improved. Indeed, most infants and children with these diseases now even live into adulthood. Similarities Any child anywhere has the need to feed well. It is of vital importance that any child is given adequate diet for their growth and sustenance. Children who eat balanced diet comprising variety of healthy foods have higher chances of living better lives and are protected from malnutrition diseases and health problems. A healthy diet is also essential for the growth and the development of the child. It also contributes to brain development and learning (Valentine & Lowes, 2008). Furthermore, children need to play regardless of their health status. Paediatrics recommend that play is crucial in promoting the health, the physical well being and the emotional well being of the child. Furthermore, it offers a good opportunity where the children can interact with the parents hence fostering the parent child relationship (Valentine & Lowes, 2008). In addition, every child has the right to receive love and emotional support from the family. This is the basic element that contributes to the comfort of a child in the community. Nonetheless, there is need for every child to undergo the necessary immunisation and screening procedures. Immunisation is vital as it prevents certain infections in children that may give rise to serious illnesses. Without immunisation, the children are likely to suffer from diseases such as polio, meningitis and tuberculosis. According to Roden, (2005) these are very fatal to the health of the children and nay even result in death. Screening and surveillance also monitors the development and the growth rate of the child. The child is also in need f an environment conducive for their growth and development. A favourable environment is coupled with a caring and loving family. Here, a child is able to develop in all spheres of life which include the social, religious, physical, emotional and even psychological aspects of life. A chaotic and harsh environment is very detrimental to the growth of a child. Love and care should be the first priority of the parents and other caregivers as well. Differences In view of the foregoing premises, there are a number of differences in the needs of a healthy child and those of a child with genetic anomalies. First and foremost, children with such genetic anomalies require to be given some extra care and attention. Special needs accrue such as the need to be given a special diet. A child with a congenital heart disease for instance requires foods that have less fat but with more minerals. Their diet and nutrition should be made of special foods. Even though many of the babies with a congenital heart disease become tired when feeding, it is encouraged of the mothers and the other caregivers to feed the child at constant intervals. They may grow smaller and thinner as they grow up but they gain weight after they have undergone proper medication and health care. Children with congenital heart disease also need special medicines that will help them cope with the problems associated with the heart defects. For instance, some of the medicines will help in keeping the heart strong and working. Others usually help in lowering the levels of blood pressure and at the same time maintaining it at a low harmless level. The medicines should be taken in the prescribed manner so as to avoid further complications. On the other hand, the healthy children may not need any special medication at all. Moreover, special care from a qualified professional is an added need. The parents to the children are usually required to get in contact with a heart doctor or a specialised cardiologist who will help in treatment of the child. The cardiologist should be present regularly in the life of the patient for the purposes of treatments, giving and prescribing medicines and also for advice on special care and diet while back at home or in the case of emergencies. The doctor should also be there for routine check ups and surgery procedures. Another difference is that the sick child needs more of emotional and psychological support from the parents and the other caregivers than the healthy child. The degree of affection differs since the sick children tend o undergo some emotional traumas. The parents thus need to be there for them at all times. It helps in eliminating emotional trauma and anxiousness. Lack of good care and enough emotional support might have negative effects on the life of the child with congenital heart problem. Cultural considerations The nurse should take into account some cultural considerations that pertain the child and the family as well. Different cultural settings give different cultural meanings to children that are born with congenital diseases or genetic anomalies. For instance, nurses will observe that mothers who give birth to children with such diseases are sometimes overcome with an overwhelming sense or responsibility and the need to protect the child more. This is sometimes confused with over protectiveness in certain cultures. The experience of having one’s child diagnosed with a fatal disorder is quite frightening and may lead to discounting of certain cultural values. Some cultures may consider it a curse which may be too traumatising to the family. Similarly, some cultural considerations will also determine the manner in which the family members, the mother, and even the strangers will respond to the child. The nurse thus has to take special care and find the relevant resources address some of these concerns. Age Specific Considerations There are also some age considerations that ought to be put in place by the nurse providing treatment and care to a child with a congenital disease. For instance, good management in nursing entails knowing the amounts of medication that is to be administered to every child in relation to their age bracket (Williams & Davis, 2005). A child cannot be given medication that ought to be meant for an adult person. In the same manner, a three month old child needs lighter medication as compared to a five year old child. Moreover, the age of the child determines how a nurse is meant to establish a therapeutic relationship that will benefit the child. A nurse is supposed to establish a therapeutic alliance with the patient. This is necessary so as to establish a relationship based on mutual trust and respect. It is extremely important as the child ought to earn the trust of the nurse. It can also enhance the ability of the child to cope with the stress of the disease (Day and Levett- Jones, 2008 p. 497). A good therapeutic relationship gives emotional support to the child. Secondly, a nurse ought to establish good communication skills with the patient child. Communication skills are a significant part in the two-way relationship (Day and Levett- Jones, 2008 p. 483). The nurse is supposed to use effective communication techniques bearing in mind the different ages of the children. Children in early ages of 3 months to one year, say, have difficulties in understanding verbal languages. They cannot also communicate verbally. The problems can be a barrier to communication and the nurse must therefore possess the necessary skills on how they ought to communicate with the children. Another aspect of developing a good therapeutic relationship is the combination of an element of empathy in the relationship between the nurse and the child. Empathy encompasses characteristics such as observing, listening keenly, understanding and fully attending to the needs of the patient (Williams & Davis, 2005). It entails making the child feel the presence of the nurse, physically, emotionally, psychologically and even cognitively. However, the nurse should also differentiate it from sympathy in which case sympathy is about pity and unwanted compassion (Usher, Luck & Foster, 2005 p 360-361). Through empathy, the nurse gets to understand the patient’s emotions and feelings without getting emotionally involved (Rana & Upton, 2009 p.62 as cited in Maslow, 1943). The relationship between the nurse and the patient could be strengthened and also a good therapeutic relationship boosts the self esteem of the patient. Therefore, establishing good and appropriate communication skills with the child is absolutely essential. Moreover, the age of the child is an important factor for enabling the nurse to take rational measures regarding the safety and the security of the paediatric ward. Children ward accommodate minors who are not so well conversant with safety measures. Therefore, security measures taken may include supervision by an adult as they are playing (Valentine & Lowes, 2008). This helps in eliminating accidents. Dangerous things like blades and sharp needles must also be put in places that are out of reach for the children. In this manner, minor accidents are avoided. Nevertheless, small half doors will also prove helpful in barring the children from having access to places such as nursing bays and even operating rooms (Valentine & Lowes, 2008). All the surfaces must also be kept clean and safe free from any kind of contamination that may cause accidental poisoning. Clinicians must ensure maximum safety by maintaining an accident free ward for the children and also ensuring that the child avoids destructive and aggressive behaviours (Roden, 2005). Geographical Locations and Health Care Services The geographical locations of the family may have diverse impacts on the choice of the health care services and the options that the different families may have when it comes to making such choices. The families’ access to the medical services or medical facilities determines whether a family with a sick child will seek for the intervention of the services. For instance in Australia, the population living in the remote and rural areas face a lot of difficulties as they cannot gain full access to efficient and better health care (Barnes & Rowe, 2006). Most of the families thus opt for homecare which is less efficient. Unless the rural workforce is strengthened and more services provided, this continues to be the trend over the years. Significantly, it has impacted heavily on the health status of the people in the rural locations. Rural communities are greatly disadvantaged by these difficulties. According to Cline & Greene (2007), there is lesser stability and continuity of the medical services that are provided in the rural areas and these affects the decisions that most of the families affected with a child suffering from a congenital disease or a genetic anomaly will have to make (Valentine & Lowes, 2008). Rural and remote areas are not also strategically placed to allow for facilities such as training programs and also health enforcement programmes. These programmes would have otherwise helped in creating awareness that would help the rural inhabitants in making informed choices regarding the health of their children. Likewise there is limited infrastructure and facilities for care in the rural areas such as clinics, health centres and elaborated community care services (Roden, 2005). Still, the remote areas have limited personnel that can offer advice to families regarding the health status of their children. To address the problem of location and how it impacts on the choices of healthcare services for families and their children, the Australian government must put in place several measures. Some of them include setting up of regional centres in all remote areas across Australia. In turn, the regional health centres will provide a range and a variety of medical services including care and community service for the young affected and the infants as well. Their first objective must always be primary health care. Unless the provision of medical services in the rural and remote areas is improved, most of the families with children born with congenital heart disease and other genetic anomalies will remain unattended to (Roden, 2005). The services must be improved so as to promote access to primary health care, medical interventions and treatment. In the same manner, the geographical location also impacts upon the decisions the parents will make regarding early checkups and screening requirements (Barnes & Rowe, 2006). Immediately a child is born, the mother normally has a duty to take the child to the clinics for early checkups and screening. These procedures help the doctors in diagnosis of any possible complications in the child. However, most parents will not opt for such measures if the geographical locations do not allow for them. It becomes very detrimental to the health of the child because any hidden anomalies that could have been discovered and prevented begin to develop. These in turn grow into complicated diseases that affect the child later in life. Most of these accrue out of the isolation determined by the geographical locations of the families (Roden, 2005). Competent and professional nursing care for the child Any registered nurse must have a grasp of the knowledge underpinning any nature of quality professional service. A child with a congenital disease or a genetic anomaly must receive competent and professional nursing care from the paediatric in charge. The paediatric cardiologist must have special expertise in the diagnosis and the management of the disease and any multisystem disorders that come alongside it (Cline & Greene, 2007). What is of paramount importance is that the nurse must be able to give quality patient care which extends across hospital services to even ambulatory services. Importantly, the nurse is supposed to give care that meets all the needs of the child and the family as well. They must ensure that they deliver cost-effective, efficient and safe services for the care of the child and the community through a well established health policy. The range of care varies from attending to newborn babies all the way to the five year old children. The nurse must therefore understand the challenges befalling in every category and the extent of care that every child and family will need. Furthermore, they also need to give support as a key element in the provision of care services which will primarily help in the emotional and psychological lives of the patients (Arnold & Boggs, 2007). One other aspect of competent and effective caring is that the nurse should bear in mind that nursing a child is not simply a question of caring. It encompasses understanding the gradual development of the child and the progress of recovery. The nurse must also have the ability to minimise on the impact that the illness is likely to have on the child (Arnold & Boggs, 2007). The periods of being admitted into the hospital can be a challenge to the child and the parents. The nurse here requires knowing how they can fully handle the situation. The process also involves working together with the parents or any caregivers that are in charge of the child at home. A competent nurse also ought to provide the necessary information and support that the mothers of babies with special needs will require. Such information may include any vital preventive measures that will help eliminate other accompanying illnesses. Whenever a baby is born with a congenital disease or a genetic anomaly, mothering must occur in a special context. This involves an environment that caters for the special needs of the baby (Cline & Greene, 2007). The mother and the whole family at large may also require some special needs that will give enough support to the sick child. In order to achieve this, the caregivers must be provided with all the relevant information. This role primarily lies with the nurse in charge. For example, a good understanding on the part of the nurse of the potential implications and the outcomes of the congenital disorders will help the nurse to provide the mother with the necessary information on the topic (Barnes & Rowe, 2006). Moreover, they should also provide the necessary information regarding the physical and the emotional consequences that the disease might have on the life of the mother and the rest of the family members. This will help the nurse to give the support that is required even when breastfeeding services are unavailable (Arnold & Boggs, 2007). A nurse must be aware that the nature of the mother’s breastfeeding patterns may also have some implications. Conclusively, the nurse and other physicians ought to provide the appropriate guidelines on how the parents can effectively take care of the child. Different needs are tailored towards every individual child (Valentine & Lowes, 2008). The news of having a child born with a congenital disorder or a genetic anomaly is very heartbreaking to any parent. However, with adequate care and sufficient support from the nurses and other involved physicians, it has become very possible to see the children grow into adulthood. In any case, nursing for the child should encompass both a collaborative partnership between the medical practitioners and a well established family-centred care (Cline & Greene, 2007). Section C. How and why the geographical location of the family affects their choices It’s true that geographical location of the family impacts on the choices and options for health care services for a family with a child with a congenital or genetic anomaly. The location of the individuals greatly affects the equity of services in health care and unavailability of sub-specialist and the specialists who are well equipped with dealing with Childs with congenital anomaly such as chronic disorder as noted by Humphreys ( 2004) The difference of geographical location is observed when there is a wide gap between those living in urban centers and the families living in rural and remote areas. The families living in the remote areas continue consistently to be affected by poor health services due to the inequity of health care services as stated by Humphreys ( 2004). Therefore the analysis in this context is the importance of geographical on the health care services, the outcome in the two different locations of people in the Australian community. It helps to explain notion of the different families having access, sustainable health care services and the impact on their choices in attending their children. The statistics show that a larger percentage of Australian people live in remote areas and from the study there have been a high record of infant’s deaths that are below the age of five years. Health equity of services is a major issue that is observed in the Australian families. The research showed that the rural-arbun health inequality shed light that remote areas are very much disadvantages and their rights are looked down on as borrowed from Wakerman (2004) Therefore these families are subjected to depression and they end up using drugs. These enable them to forget all the family problems i.e. their children suffering from the congenital diseases. Wakerman (2004) said that rural and remote areas model the way the delivery of services is instilled in the community. The so many accidents happening in the roads during due to poor roods and the long distances makes the access of health services difficult and this makes the rural residents to be indigenous. The unavailability of specialists and the subspecialist services were seen to be absent or limited in the remote and rural areas borrowing from Wakerman ( 2004) From the research is that a plenty of funds were distributed to enhance the distribution of health care services to the remote areas to cater for children with congenital or genetic disorders. But the specialists centralized the services in major cities of Australia forcing the people to travel from upcountry to the city where the services are available. Humphreys said that for health care services to be sound the transport system should be sound. Due to long distance the families make arrangement early enough to depart to take their ill children to the hospital and these alters their daily tasks. Most of the congenital and genetic anomaly needs a lot of attention from the specialist. Chronic which is one of the ill of the kids requires effective treatment from the doctors. Wakerman (2004) said that there evolves a problem in the transport i.e. when there are heavy cost burdens on the provider of health services and the family, the family is left to cater for the cost and they may end up disposing their property to raise funds for the child. Therefore the geographical location of the family plays a big role in choices and options for health care services for a family with a congenital or genetic anomaly because it needs a lot of attention. Section D. The requirements of a registered nurse to provision of competency and professionalism in the health care services According to ANMC a registered nurse must meet the objectives of the organization and the competency in the provision of health care services to a child with a congenital or generic anomaly must be highly appreciated. Competence in a registered nurse is the combination of skills, integrity, the core values, and the ability to show superiority over the other nurses in his or her duties. They must also show professionalism by offering the services and carrying on with their duties while they can be held accountable and responsible (Crowder 2000) A registered nurse has got various roles that should be accomplished. They should promote and help in prevention of illness to the children with congenital or genetic anomaly and they should provide counseling to the families affected to end emotional pain and suffering. The registered nurse should join hands with the multidisciplinary health care teams to make assessments of the kids who are affected by the disorders, make a good plan of reaching out to the patients and aid in the implementation of the same. Therefore there are a number of requirements that a registered nurse should have in order to provide competent and professional nursing care for a child with congenital or genetic anomaly and their family. The ANMC recognizes the requirements of the registered nurse as: Professional practice which shows the ability of the nurse to be held accountable of the actions, showing an intellectual knowledge which is outstanding and the ability to protect Childs rights (Shin 2006) The second requirement is that the nurse should embrace critical thinking when dealing with a child who is below the age of five years. Then the nurse should be the frontiers in the provision and coordination of health care. The last but not the list is that the nurse should collaborate with other stakeholders in the hospital to be able to build a team that will help in the achievements of their goals and objectives. Since the presence of a child shows that the future is bright. Therefore they should be handled with a lot of care especially in cases where they have been infected with a disease or a certain disorder during birth. The nurses are required to carry out their practices in accordance with the regulations that govern them in the nursing care of the child and its family. The chronic disorders are very much complicated and the surgical operations should be done according to the legal requirements and the nurse should be aware of preventing any harm i.e. giving the proper medication and be able to recognize the unprofessional practices in the context. In order for the nurse to be able to expound on the rate of infants with a congenital or genetic anomaly increase or decrease, he/ she must employ critical thinking to reflect on the findings and the consequences of the analysis made. The nurse should identify the complications from the study and should be able to provide an effective solution to the families (Shin 2006). In cases of emergences where a patient requires urgent attendance and the other nurses are not able to understand, the nurse should provide clarification from their findings. The nurse participatory factor aids in the improvements of health outcomes and after treatment as he participates in clinical audits to help in reducing the death rate of infants because of congenital or genetic anomaly. For competency and professionalism the nurse should provide and coordinate all the health care services .Allen stated that health is a family phenomenon where it cannot be assumed from the course of treatment. The nurses should provide care and treatment to the ill child while the family members are watching to prepare them psychologically (Narramore 2008) The family will be able to take over from the well coordinated, planned direct care from the nurses. Wise said that care coordination happens effectively when the implementation is well organized by the health care service provider i.e. the nurse. Every registered nurse is required to produce the best out of the health care services. One thing is that no man is an island and therefore the nurses are not the exceptional to only depend on their own decisions. The best care today is tomorrow’s highest standard. Nurses have held so many forums involving other professionals from other hospitals providing health care services. They collaborate and exchange ideas with each other for improvement of clinical services and innovation of new technologies. Finegan( 2000) said that collaboration will always result to an admirable outcome because we all share a common goal of improving health care to children with congenital or genetic anomaly. Therefore after the registered nurse has embraced the above requirements, provision of competency and professionalism nursing care is credited. Bibliography Arnold, E., & Boggs, K. U. (2007). Interpersonal relationships: professional communication skills for nurses. St. Louis, MO, Saunders-Elsevier.pg 37-43 Crowder. (2000). 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Nursing Care of Children and Young People with Chronic Illness. Chichester, John Wiley & Sons. Pg 21 http://public.eblib.com/EBLPublic/PublicView.do?ptiID=351312. Read More