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Neonoral health and life of Neonatal Intensive Care Unit
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Neonatal nurses spend their career working with babies, those that are healthy and those that are not. Working with newborns is guaranteed to have its challenges, especially for those particular nurses who choose to work in the neonatal intensive care unit. The neonatal intensive care unit, or NICU, is where the infants suffering from potentially fatal diseases/disorders are held. NICU nurses struggle with life and death situations each and everyday, which is sure to be accompanied by specific emotions such as moral distress. In the words of researcher Kain (2006), “moral distress is defined as uncomfortable, painful emotions that arise when institutional constraints prevent the nurse from performing nursing tasks that are deemed necessary and appropriate” (p. 388). In simpler words, Kain (2006) is saying that a nurse experiencing moral distress is undergoing painful emotions that are getting in the way of the nurse’s ability to perform essential tasks (p. 388). Heuer, L., Bengiamin, M., Downey, V., and Imler, N. (1996) pointed out that nurses caring for critically ill and dying infants often feel hopeless, incompetent, and disappointed, especially if the overall outcome for the infant is death (p. 1126). These negative feelings that NICU nurses often have are those that are associated with moral distress and can often lead to prevention of proper performance in necessary nursing duties.
Review of the Research
In the past there has not been an incredible amount of research done on the moral distress of neonatal nurses, but as Kain (2006) pointed out, the research that has been done has been conducted in the form of qualitative studies including surveys and interviews (p. 247). It could be assumed that the everyday obligations a N...
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Gallagher, K., Marlow, N., Edgley, A., & Porock, D. (2012). The attitudes of neonatal nurses towards extremely preterm infants. Journal Of Advanced Nursing, 68(8), 1768-1779. doi:10.1111/j.1365-2648.2011.05865.x
Hall, E., Brinchmann, B., & Aagaard, H. (2012). The challenge of integrating justice and care in neonatal nursing. Nursing Ethics, 19(1), 80-90. doi:10.1177/0969733011412101
Heuer, L., Bengiamin, M., Downey, V., & Imler, N. (1996). Focus on children's nursing. Neonatal intensive care nurse stressors: an American study. British Journal Of Nursing, 5(18), 1126-1130.
Kain, V. (2007). Moral distress and providing care to dying babies in neonatal nursing. International Journal Of Palliative Nursing, 13(5), 243-248.
Kain, V. (2006). Palliative care delivery in the NICU: what barriers do neonatal nurses face?. Neonatal Network: NN, 25(6), 387-392.
The history for premature and ill infants is not nothing new. Hospitals bid not start the neonatal nursing program until 1922, however, hospitals started grouping the newborn infants into one area, called the Neonatal Intensive Care Unit (NICU) before this families took care of premature and ill infants at home and either lived or died without medical attention. In the middle of the 1900s, the first infant incubator was invented based on the incubators used for chickens. They used it to keep premature infants warm. So the more they made they need someone to take care of the babies in the incubator that is where then nurse came into the industry.
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).
Moral distress occurs is defined by Jameton as, occurring when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action. Oncology nurses find themselves struggling with moral distress in an oncology unit, which is where cancer patients are cared for and educated by the nurse. An oncology nurse suffers moral distress when they know the right course of action, but feel powerless to act out the choice because of the institution or its policies, lack of resources, lack of support, or legal limits. Oncology nurses provide care over an extended period of time and often administer aggressive treatments. Oncology nurses witness the implications of life-prolonging interventions that
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. It is the duty of nurses to respect the wishes and grieving process of each and every culture; of each and every individual (Verosky, 2006). This paper will address J. William Worden’s four tasks of mourning as well as the nursing implications involved – both when taking care of patients’ families and when coping with the loss of patients themselves.
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.
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.
Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics & issues in contemporary nursing (4th ed.). Stephan Helbra.
Davis J. Anne Diane Marsha and Aroskar A. Mila (2010). Ethical Dilemmas and Nursing Practice. Pearson
Like the general public, I assumed their only job was to aid doctors and perform routine medical procedures that they are trained to do. The purpose of this interview was to gain insight into how much more nurses do, and I was greatly surprised. Marks shared what it is really like to be a pediatric nurse, and all the other roles they must play in their patients’ lives. As someone who has never been admitted into a hospital, or have been in the care of a nurse, her stories were eye-opening for me. Marks gave me a new-found appreciation for all that nurses
Firtko, A.J., & Jackson, D. (2005). Do the ends justify the means? Nursing and the dilemma of
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
Thompson, I. E., Melia, K. M., & Boyd, K. M. (2006). Nursing Ethics: Churchill Livingstone Elsevier.
Integrity, respect for persons, justice, non-maleficence, and responsibility are all identified within the code, however compassion is not directly stated but is implied. To show compassion for others during suffering is an almost automatic response in nursing. When nurses decide to act either beneficently or non-maleficently they are doing a service to those being cared for. When dealing with human lives moral value becomes especially important, and is not situationally dependent. Ethical neutrality does not have a place in professional ethics, and an obligation to respect the moral values is necessary. The code deals with specific issues related to the nursing profession, and ensures standards are upheld. Creation of code of ethics within a profession limits misconduct, create safeguards, promote trust for the profession within society, and preserves the integrity of the profession (Soskolne, 1984) It is important for me to emphasize the difference between the nurse’s code of ethics and the Hippocratic Oath. The nurses ethical code is tailored toward the care provided to the patient, and not the involved science and diagnostic aspect of the
Stability is the key to have healthy patients. Neonatal Nurses are incredible nurses to have in the healthcare facility. All Nurses can provide the same care and dependability in caring for their patient. Nurses are very consistent in the job that they perform. Being consistent, is a very good quality a nurse should have. Nurses gain feelings, and heavier bonds with their patients than doctors. Nurses grow more attached to their patients because of the care provided. Doctor’s have a lot of patients that they have to provide for and prescribe medicine to, so trying to bond with patients is not a huge goal for them as it is for a nurse. Nurses develop their patients to feel welcome and that they can be trusted to provide the patient the proper care, giving the patient various opportunities to ask questions if needed. Doctors spend less time with their patients than nurses. Neonatal nurses are able to build long-lasting relationships, sometimes short-term but that is what a nurse is mainly focused on when doing their job to be successful in the health of the patient.