Family centred care (FCC) encompasses the concept of parental participation in their infants care (Franck and Callery 2004). It aims to place the needs of the infant in the context of the family (Saunders et al 2003). FCC is adopted within many neonatal units and is considered the gold standard of care aiming to underpin and guide neonatal care towards the partnership between health professionals and parents (Hutchfield 1999). Subsequent to the interruption of the bonding process between infant and family when a baby is admitted to the Neonatal Intensive Care Unit (NICU) it is suggested that the NICU provides an ideal opportunity for FCC practice (Allerman Beck et al 2009) as nurses and parents are compelled to develop an effective relationship in order to satisfy the infants care needs (Reis et al 2009). However a study by Higman & Shaw (2008) found that it appears to be more difficult to achieve on the neonatal unit as FCC is reliant on the family’s relationship with the child. In order to deliver effective FCC neonatal nurses need an understanding of parents needs and how to address them. Mundy (2010) in a study researching the assessment of family needs in neonatal Intensive Care Units found that assumptions of parent’s needs were often made by healthcare professional’s resulting in unfounded and inappropriate conclusions. The importance of treating each family as individual is paramount when assessing how best to involve parents in the care of their infants (Higman & Shaw 2008). Review of the literature shows a lack of research into these assessments and highlights that enhancing family centred care requires appropriate assessments of family needs and the incorporation of this into individualised plans of care. A study into nurse’s perceptions about the delivery of FCC by Higman and Shaw (2010) supports this view, throughout the study it is apparent that although nurses realise the importance of FCC it is not always consistent within their own practice. Peterson et al (2004) suggests reasons for these inconsistencies could be the deficiency of adequate training and, the stress implementing FCC can impose on nursing staff due to an already demanding workload, potentially creating negative attitudes towards the relevance and practicalities of its delivery. The consensus view of FCC is positive although limitations to its execution are manifested throughout the literature. Staff shortages are suggested to hinder the performance of FCC within the clinical area, creating time constraints with nurses having very little opportunity to build good relationships with the families (Higman and Shaw 2008).
Education regarding unit or group thinking is to be encouraged and reinforced. The fact that newborn Rosarie will be entering the home poses unique challenges that will require all members of the family to work together. Maria, Jamie, and Alice must be educated on the signs and symptoms of respiratory distress in the newborn and interventions that must be initiated when distress occurs. The nurse responsible for this teaching must require both verbalization and return demonstration of skills learned to ensure proper reception of the information. Once skills are developed by the adults within the home, the remaining children should then be educated on the signs and symptoms as well and actively participate in care. Involving the entire family will bring a cohesive thinking, and allow the family to work as a unit. A marriage counseling referral should as be provided to Maria and Jamie in order for them to work out their existing issues improving their likelihood of a successful marriage. Routine “check in’s” (phone calls, visits, etc.) should be in place for the family both by social services and pediatricians. In addition, community outreach programs (food banks, cultural organizations, etc.) are designed to support families like the Perez’s, nurses working within the community should tell these families about these resources
This allows the nurse to assess the patient’s pain and suffering related to the treatment plan in place (Settle, 2014). The ability to communicate well is essential for ethical decision making in the NICU (Monterosso et al., 2005). Nurses play a big role in supporting the parents while their child is in the NICU. Showing compassion and demonstrating caring actions when caring for the patient makes it more likely that the parents will trust the nurse and the information the nurse gives them regarding their child’s condition. This trust is important as it helps the parents feel confident in the decisions they are making about their child’s care. When the parents of an ill child in the NICU have decided to terminate treatment palliative care by the nurse and other healthcare providers comes into play. Palliative care is keeping the child comfortable by treating the symptoms and being there for the parents and child physically, emotionally, and spiritually (Eden & Callister, 2010). The patient and family should be placed in a private room that is dimly lit and has minimal noise. There should be enough room to accommodate other family members as well. All unnecessary medical equipment such as ventilators and monitors should be removed from the patient. IV access should remain in place to give adequate medication for pain. Supplemental
The Calgary Family Assessment Model (CFAM) is a well-known comprehensive and multidimensional template used by nurses to assess families. CFAM begins by having the nurse visit with the family and gain insight on the family’s functioning at a particular point in time. Interviewing the family allows the nurse to assess and identify potential issues. Furthermore, the CFAM consists of three main assessment categories, known as structural, developmental, and functional. Each of these categories contains several subcategories that allow the nurse to examine all aspects of a family’s functioning. The goal of the CFAM is for the nurse to openly discuss family issues, provide insight to families from an outside perspective and guide them towards their own problem solving tactics. CFAM allows families and nurse to develop a plan of care that is mutually agreed upon. The following paper illustrates a family assessment completed using the CFAM and applies nursing diagnoses and interventions relevant to the family’s current issues (Wright & Leahey, 2013).
Neonatal nursing is a field of nursing designed especially for both newborns and infants up to 28 days old. The term neonatal comes from neo, "new", and natal, "pertaining to birth or origin”. Neonatal nurses are a vital part of the neonatal care team. These are trained professionals who concentrate on ensuring that the newborn infants under their care are able to survive whatever potential life threatening event they encounter. They treat infants that are born with a variety of life threatening issues that include instances of prematurity, congenital birth defects, surgery related problems, cardiac malformations, severe burns, or acute infection. Neonatal care in hospitals was always done by the nursing staff but it did not officially become a specialized medical field until well into 1960s. This was due to the numerous advancements in both medical care training and related technology that allowed for the improved treatment and survival rate of premature babies. According to the March of Dimes, one of every thirteen babies born in the United States annually suffers from low birth weight. This is a leading cause in 65% of infant deaths. Therefore, nurses play a very important role in providing round the clock care for these infants, those born with birth defects or other life threatening illness. In addition, these nurses also tend to healthy babies while their mothers recover from the birthing process. Prior to the advent of this specialized nursing field at risk newborn infants were mostly cared for by obstetricians and midwives who had limited resources to help them survive (Meeks 3).
Since neonatal nursing is my special interest and field, I chose to write about the health care options which are available to parents having children in different hospitals throughout the world. With the state of the art technological advances in the neonatal units, there are so many options available for the care of newborn babies. I reviewed the neonatal units in Australia, Saudi Arabia, New York, Tokyo, Ireland, and California, and I have learned what It takes to run a neonatal intensive care unit all around the world.
This birthing plan is often documented in the patient’s medical record which aids the health care staff during the birthing event. Documentation and discussion of these events is often necessary to ensure all the needs of the family are met. Too often all the potential needs are not discussed and the opportunity to meet the needs of the new family is missed. These missed opportunities can result in emotional and religious conflicts within the family unit and toward the health care staff. For the nurse leader these missed opportunities in care could result in unfavorable patient satisfaction scores and reports within and outside the institution which necessitates follow up. The most important missed opportunity is how this affects the family unit itself. Depending on the missed opportunity the family unit may be affected for years based on questions not asked or decisions made with poor information. Some cultures must bury the placenta after birth and if this was not discussed and the placenta discarded the religious implications could be devastating for this family. Application of Henderson’s need theory guides the nurse in the educational plan for the patient-family unit to ensure all basic needs are covered and questions related to those needs are posed in advanced of the birthing
...based research will provide a means to implement changes in the way we care for neonates in the NICU. These changes will promote growth and development for the neonate and facilitate positive paternal bonding experiences.
The importance of skin-to-skin care for the childbearing family is that every newborn can benefit. Skin-to-skin is valuable because it promotes thermoregulation, cardio-respiratory stability, breast milk supply, and mother-infant bonding (Hugill, 2015; Baker-Rush, 2016; Gregson, 2011; Pigeon Turenne, Héon, Aita, Faessler, & Doddridge, 2016). The nurse’s role in skin-to-skin is to educate women and their families of its benefits. The nurse will be able to implement the carative factors of a teaching-learning experience with the parents, develop a helping-trusting relationship, as well as tend to basic human needs of the patients (Watson, 2008).
American Academy of Pediactrics. (2003). Family-Centered Care and the Pediatrician’s Role. Available: http://pediatrics.aappublications.org/content/112/3/691.full. Last accessed 23/01/14.
The intent of this interview was discussed with the family, namely, how the data would be used to discuss family experiences for an assignment in Family and Societal Nursing for RNs at State University. Most importantly, I mentioned to the family that I hoped to provide them with interventions and support to...
I think the most important quality for a NICU nurse is thorough knowledge, or the drive to obtain more. I want to share knowledge with parents to make it easier for them to learn and know everything they can about their child’s medical condition. I can help translate between the parents and the doctor’s medical jargon to make parents feel more as ease and understand their
Nursing should focus on patient and family centered care, with nurses being the patient advocate for the care the patient receives. Patient and family centered care implies family participation. This type of care involves patients and their families in their health care treatments and decisions. I believe that it is important to incorporate this kind of care at Orange Regional Medical Center (ORMC) because it can ensure that we are meeting the patient’s physical, emotional, and spiritual needs through their hospitalization.
Also, the whole family needs to come to term with the health condition, make change in priorities and schedule, and keep the family. For example, it can be much more stressful for a young or a newly married couple because they may have more experience to overcome life's difficulties. As a result, as with individual maturation, family development can be delayed or even revert to a previous level of functioning (Hockenberry, p 762.) Therefore, health care providers need to apply family development theory while planning care for a child and family with chronic health condition. Indeed, family centered care should be a part of that intervention. Parents and family members have huge and comprehensive caregiving responsibilities for their chronically ill child at home or at hospital. Moreover, the main goal taking care of chronic ill child is to “minimize the progression of the disease and maximize the child’s physical, cognitive, psychological potential” (Hockenberry, p 763). Therefore, it is essential to family being part of the child care to give highest quality of care. On the other hand, we are as a part of the health care provider need to give attention to all
Duvall’s Family Development and Life Cycle Theory states that families follow a predictive and individual process of development that is dependent on the family’s circumstances and interactions. Though families today are more diverse than in the past, this theory still guides nursing approaches because it examines families’ experiences and how they adapt when becoming parents (Rowe Kaakinen, Padgett Coehlo, Steele, and Tabacco, 2015). In this discussion, I will choose one of the development tasks from Duvall’s theory and discuss how I would apply it to a family in my nursing practice.
...be aware of the signs when education is needed for a family. Unfortunately, all families have barriers and may not be able to attend parenting classes to receive the education that may be necessary before the birth of their child. At that point, it then becomes the nurse’s responsibility to recognize the impairment, put interventions into place, and evaluate the family before discharge. For successful childrearing, parents need knowledge about raising children. Parenting classes and health-care professionals working with parents can contribute to raising children (Campbell,1992).