Is Palliative Care the Right Choice for the Neonate and the Family?
In the United States, approximately 2 million children are living with life threatening conditions and 18,000 new born die within the first 28 days of life due to prematurity/immaturity, infection, and congenital anomalies annually (Thibeau 2012). Globally 450 newborns die every hour (Eden 2010).
Neonatal Palliative Care should be considered for newborns with a debilitating or constraining condition, because the rate of survival for these extremely preterm and sick newborns are low. When palliative services need to be considered, parents and family members should be counseled and educated on the services, although making a choice of this magnitude to withdraw life sustaining measures will leave a void in the hearts of many. Potential is lost and dreams are torn apart which leaves parents and family members to lament the loss. Instead of endure the pain of the loss, the family wants to hold on to the infant, when the best thing to do will be to let go.
The Professional Organization is the National Association of neonatal Nurses which was chosen because they are the only nonprofit neonatal organization whose whole purpose is to support the professional needs of neonatal nurses throughout their career (http://URLNANN.org). NANN is the expert voice that shapes neonatal nursing through magnificence in practice, training, exploration and expert advancement, NANN is also the neonatal association with the strongest and most vibrant group of neonatal nurses (http://URLNANN.org).
Journal
The journal associated with this organization is Advances in Neonatal Care. This information was established through the website and the Co- Editors ...
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...r newborn child. The palliative care NICU nurse also furnishes organized sessions to help the staff with dealing with grief, which is supportive in lessening sympathy fatigue. This is a normal process for the healthcare team to go through when someone they have been caring for dies. (Thibeau2012).
Summary
The journey to the pearly gates may start with pain and suffering, but eventually the pain ceases and peace and tranquility sets in. Palliative care services are of the utmost importance for the neonate to have a quality life (Thibeau 2012). Pharmacological analgesics should be the only form of treatment at this stage of the life cycle (Thibeau 2012). Support for family and staff is of great importance (Thibeau 2012). Death is an inevitable piece of the circle of life, in the minds of most, it is really not the end, but the beginning of something new.
Mphahlele, R. R. (2007). Caring for premature babies - a clinical guide for nurses. Professional Nursing Today, 11(1), 40-46.
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).
Nurses are both blessed and cursed to be with patients from the very first moments of life until their final breath. With those last breaths, each patient leaves someone behind. How do nurses handle the loss and grief that comes along with patients dying? How do they help the families and loved ones of deceased patients? Each person, no matter their background, must grieve the death of a loved one, but there is no right way to grieve and no two people will have the same reaction to death.
From year to year, the number of SIDS deaths tends to remain constant despite fluctuations in the overall number of infant deaths. The National Center for Health Statistics (NCHS) report...
In the article Post – Traumatic Stress Disorder and Neonatal Intensive Care, written by Marissa Clottey, B.S.N., R.N. and Dana Marie Dillard M.D., focuses on the importance of recognizing the symptoms of Post-Traumatic Stress Disorder in parents whose infant has been admitted to a Neonatal Intensive Care Unit The article also addresses the importance of informing expectant parents of the possibility of developing Post- Traumatic Stress Disorder if their newborn were admitted to the Neonatal Intensive Care Unit.
There are more than 70% of premature babies that are born between 34 and 36 weeks gestation a year. When a baby is born early, or born with birth defects, the Neonatal Intensive Care unit is its first home. The nurse’s in the NICU have the difficult job of preparing baby’s and parents for a health life together. A baby who has been put into the NICU will stay there until it is healthy enough to go home.
Neonatal intensive care units are normally thought as a safe place for a neonatal to be, but there are instances where the neonatal develops an infection in their fragile bodies. This paper examines the ways that they could develop infections that harm them. The ANA states, “individuals who become nurses are expected to adhere to the ideals and morals norms of the profession and also to embrace them as a part of what it means to be a nurse.” (Code of Ethics, n.d.). German NICUs participated in a study of very low birth weight infants (VLBW) from 2006-2011 and found that an outbreak of severe neonatal infection occurred within a period of time in the same center in four different patients (Schwab, 2014).
Emily is a neonatal intensive care unit (NICU) nurse of 11 years. Emily routinely provides care for babies as small as 800 grams (about 1 and ¾ pounds), babies born with drug addictions, and the routine twins and triplets born as a result of fertility medications and assisted reproductive technologies (ART). As a strong Christian woman, Emily wasn't sure she could fulfill the tasks required of her when she first came on. Nor did she think she could cope with the occasional “expiration” of a young life. However, after more than a decade, Emily continues to provide exemplary care to babies, and parents alike, in the first few weeks and months of life. Throughout her decade long career, Emily has seen much change and continues to see the landscape transform within her small part of the nursing community.
Overall the need for a better based end of life care strategy is warranted globally. More of a focus should be given on care and high quality service for patients. As of now too much decision lies with the healthcare professionals and this can lead to faulty decision making because the health care providers are doing what they believe is in our best interest. In reality the patient or ourselves only have the true idea how we would like our final days to be carried out. By developing and carrying out an end of care plan we can take the decision making out of the family and doctors and place it on the patient. By all counts the need for change is apparent within the healthcare industry in regards to end of life care. By considering this unique change a great deal of improvement can be derived from this decision making process.
There is a whole new approach to those who have chosen the path of death, where in 80-90% of cases patients change their minds. Palliative care is an approach to euthanasia that improves the quality of life of patients and their families facing the problems associated with a life-threatening illness through the prevention and relief of suffering, by means of early identification and treatment of pain and other problems, physical or emotional. However, in Belgium, this technique is disregarded as Belgium lawmakers vote for the “right to die” to be passed down to children. Through this bill, many questions are arising of whether children have the capacity to understand and make this final decision of their life. Sonja Develter, a palliative nurse specializing in end-of-life care for children, believes that “giving children a choice would mean they made decisions based on what they thought their families wanted to hear, and that it would be a terrible strain for children who may already feel they are a burden to their caregivers” (Smith-Spark and Magnay). Take Izabela Sacewicz for example. She is a young 18 year old girl with Huntington’s Disease, a neurological disease that reduces the life expectancy of children, but in adults, it results in uncontrolled movement, loss of thinking ability and death of brain cells. One day, her mother explains the process of euthanasia to her, asking if it is good or not good. Maybe shocking to advocates of euthanization for terminally ill patients, she replied with not good. Being a mother who has experienced life with a terminally ill child, Iwona believes that “Belgium lawmakers should focus on providing better support for families caring for children with terminal illnesses, rather than extend the right to die to children as five years old who
Neonatal resuscitation is intervention after a baby is born to strengthen it’s breathe or to boost its heartbeat. Approximately 10% of neonates require some assistance to begin breathing at birth, but only 1% require serious resuscitative measures. Informed consent regarding neonatal resuscitation is a constant ethical debate. This discourse ordinarily occurs between doctors and parents; parents often feel that the decision has been made for them, believing that they were not fully informed of any consequences that may occur before making their final action plan, or thinking that their opinion was not taken seriously; however, doctors see the procedure in a different light, that the parents can’t choose the best option for the child regardless of counseling, or performing as the parents wished but believing that the result could have differed if the parents had known all the effects that it will have further down the line, or convinced that they would have made a better
The subject of death and dying is a common occurrence in the health care field. There are many factors involved in the care of a dying patient and various phases the patient, loved ones and even the healthcare professional may go through. There are many controversies in health care related to death, however much of it roots from peoples’ attitudes towards it. Everyone handles death differently; each person has a right to their own opinions and coping mechanisms. Health care professionals are very important during death related situations; as they are a great source of support for a patient and their loved ones. It is essential that health care professionals give ethical, legal and honest care to their patients, regardless of the situation.
1. The neonatal intensive care unit clinical setting provided a calm and cooperative environment to ensure for the well-being and stability of the high acuity patients. The waiting area for the patient’s family was private with moderate lighting. The lighting throughout the unit varied depending on the stability and comfort of the neonate. Noises in the NICU were relatively low and the smells provided a clean fragrance. The temperature throughout the facility was comfortably warm and radiant warmers were provided to accustom to each patient’s thermoregulatory needs. Personal items for each patient were stored within their specific area and privacy was achieved using curtains. Artwork throughout the facility was pleasant and compliments the
A neonatologist has many tasks and responsibilities before, during, and after the birth of an at-risk newborn. If there is reason to believe there are going to be complications with a birth that would cause negative side effects for the infant, a neonatologist will be brought in to help. In these high-risk situations, a team effort is required and the neonatologist takes the lead position. The neonatologist will be responsible for advising the parents on what to expect during and after labor. After the infant is born, the neonatologist has to find a method to properly care for the baby. Because most premature babies have a low birth-weight, their lungs need to be supported and they need to be kept warm. During this whole process, the neonatologist interacts with the parents to keep them updated on their baby’s condition (Weaver, 2009).
When the baby is admitted to the NICU, the mother is unable to have the usual bonding moments where she holds and comforts her newborn. Rather, when visiting with her child, she is required to take endless precautions, has limited time to be with her baby, and must see her little child connected to many machines helping to keep the baby stable (Shanmugam & Ramachandra, 2015). In their study, Shanmugam and Ramachandra (2015) questioned 100 mothers of neonates in the NICU, and recorded the correlation between their stress level and coping strategies. They found that 38 of the mothers had severe stress, 28 had moderate stress, and the remaining had mild stress. Of these women, 25% had good coping, 50% had moderate coping, and 25% had poor coping. A large finding from this study was that nurses and health care providers played a very big role in helping to reduce the stress levels of the mothers by talking with them and listening to their concerns, while also providing adequate care for their children. If the mother is using negative coping strategies, such as holding in all of her concerns and filling her mind with the thoughts of death, financial issues, and fear of the unknown, she is going to cause her body great harm (Shanmugam & Ramachandra,