Ashley Teschendor

Taking care of a newborn B: Making sure the job gets done IV: Three types of levels A: One, two and three B: Describing them V: Education A: Schooling B: Effort it takes Conclusion: Nursery nurses specialize in taking care of premature babies. They are a unique because; only the best of the best qualify for this job. August 9th, 1 963 was the day medical nurses played a different roll. On that day President John F. Kennedy became a father to Patrick Fourier Kennedy. Patrick was born five weeks and a half early, weighing four pounds and ten and half ounces.

Patrick was rushed back to Boston, back then the neonatal intensive care unit was not around. Patrick died 39 hours later after birth. His death sparked interest in the study of prematurely of newborn babies (Alton). Over the past few decades, new inventions were created for the intensive care unit. The first invention of this time period was the incubator which, was created on May 14th, 1891 and later becoming more transmittable. The incubator could now travel around the hospital without touching the baby or more harm for the baby (The History of Neonatal Intensive Care Units).

Also the first techniques to get blood from a newborn baby was discovered at this time period. Although the techniques were becoming more advance the babies were still dying due to diseases and medicine that was not given to them. New technology like the ROI can help out in today’s world. It’s a program where it monitors a baby’s moment outside a mother’s room. Also helps with not mixing the newborn babies up in the intensive care unit. The technology around us has changed overall. Neonatal nurses only get better with time as well. Like all jobs, neonatal nursing also have requirements and duties to newborns.

The duties are working with newborns which is a strong tolerance cause, babies do cry. Neonatal nurses have to do a series of test and register as a nurse. During your nursing program, nurses may want to enroll in classes like pediatrics and entomology. Some employers want you to have work experience with infants or in the intensive care unit, however, employer’s requisites can vary, and you may withal need supplemental, formal inculcation or training. These nurses work with medicos as well as other nurses in a clinic or hospital to avail mothers learn about motherhood.

Some Of the duties involved in neonatal care include giving the mother dedication, running various tests, and of course, recording vitals on her and other information on her body after birth (What Are the Requirements for a Neonatal Nurse). Training is also a big part in this career because; some clinics or jobs won’t hire you unless you have a post-secondary education in neonatal nursing. The most common standard is the BBS which can also be called as the Bachelors of Science in nursing. There are also more educational requirements like knowing the human body and also biology.

Pain management in premature and sick babies has long been recognized as a ITIL component of neonatal care. However, practices pertaining to pain assessment and administration of neonatal nursing remain variable in Neonatal Units. Diseases have been identified as an ineffective way to make a baby healthier. According to CUFF. Com “A neonatal nurse may take care of a baby with multiple problems including drug-addicted babies and premature babies”. They may also care for babies who are weak and fragile or need 24- hour nursing.

Neonatal nurses have to monitor the babies closely and give special care immediately after birth. Neonatal nurses may also attend deliveries. Found on Physical. Com “Some nurses attend all deliveries and assist as well by hooking up laboring patients to monitors, starting Avis, assisting with getting patients ready for C-sections, and assisting with general patient care. Neonatal nurses have more than one job and to become a neonatal. A person must be able to do the same thing multiple times, there’s never time for mistakes. ‘ As neonatal nurse you also have duties during you duration of working at a clinic or hospital.

Duties often are changing feeding tubes, monitoring computers, checking the vitals Of newborn babies or performing incubation’s. Neonatal nurses monitor vital signs such as respiration and temperature, and perform any specialized feeding such as tube feeding. Being a neonatal nurse is not always about the medical field either. Other duties are like rocking a baby, feeding them bottles for daily nutrition and possibly changing a few dirty diapers here and there (Merriments). Not all babies in the intensive care unit get to see their parents often.

Sometimes neonatal nurses keep them company and take on a motherly role. Neonatal nurses can educate a mother and family members about a hazard condition and neonatal nurses interact with them in that way. A neonatal nurse should have excellent speaking skills, with the ability to provide compassion and empathy to parents. They can also draw blood from the neonate and use the sample for testing on a specific task. A neonatal nurse must also understand a newborn baby to prevent harm from risks that specifically affect a newborn baby’s body such as temperature changes or obtain oxygen (Greenwood).

Neonatal nurses work in one of three levels; depending if a nurse gets promoted or has higher education than a nurse can move up levels. Working in the intensive care unit can be stressful. There are three different types of bevels when working in the type Of medical field. The first level is level one. While working in level one a neonatal is a healthy newborn nursery. These nurseries are almost safe during these days because mothers and newborns have a very short hospital stay. The average length of hospital stay after a normal delivery is a minimum of forty-eight hours when the baby is healthy can care-free.

Also, working in level one could be a starter because, you can ease yourself in the different levels of opportunity before going to the level two and three nurseries. When working in the level one nursery your duties re fulfilling the basic needs of a newborn like a changing diaper, feeding and educating mothers about the newborn baby. Working in the level two nurseries is different in many ways. They care of infants with of 32 weeks of age. The level two nursery in the intensive care unit is an intermediate care or a special care nursery where the baby may be born prematurely or may be suffering from an illness.

These babies may need supplemental oxygen, intravenous therapy, specialized feedings, or more time to mature before discharge from the hospital (The Academy of Neonatal Nursing). The final bevel is the level three nurseries inside the intensive care unit. The level three neonatal intensive care unit admits all neonates or premature newborns during the first 28 days of life who cannot be treated in either of the other two nursery levels. These babies may be small for their age, premature or sick term infants who require high technology care, such as ventilators, special equipment or incubators, or surgery.

The level three units may be in a large general hospital or part of a children’s hospital. Neonatal nurses provide a direct patient care to these infants (The Academy of Neonatal Nursing). Like most jobs in today’s world you need education to do a topnotch job. TO become certified in the neonatal nurse staff, a college or university education to prepare a register nurse depending on whether students attend a bachelors or associate degree program takes about two to four years to complete. After graduating, students take the state licensing exam to become an RAN.

There is no special program for neonatal nursing in basic RAN education. Some nursing programs have an elective course in neonatal nursing (The Academy of Neonatal Nursing). To become an RAN you have to cake a series of test like INC_EX which is a statewide test to work in a hospital with newborn babies. The test is based on broad subjects like biology, infection control and therapy. Hands on training are very valuable because that’s what most jobs look at when you apply at a clinic or hospital. Supervision is usually carried on with a registered nurse who teaches you the basics working in a level one, two or three nursery.

After schooling you must become certified with the state board admissions. To be credited, you need service hours, passing the state board admissions test and having at least our years of nursing school. Work ethics and speed are two characteristics in neonatal nurse practitioners because their response can depend on the life of a newborn baby. By finding the right job at a clinic or hospital the neonatal nurse must target these employers directly and highlight an internship experience in this specialty.

Also, check for job opening with professional organizations, such as the American Nursing Association nurse practitioners are required to have exceptional communication skills since they have to inform families about postpartum, intensive and neonatal care. Emotional invitations is another valuable characteristic in a job in which neonatal nurse practitioners may have to address negative effects on the occurrence of death of patients under their care to their mother (Neonatal A neonatal nurse salary depends on the higher the edification.

As read on Puzzle that Neonatal nurses working for sizable voluminous hospitals will naturally, earn more than those working for more minuscule hospitals. Nurses employed in sizable voluminous cities will be earning much more than those employed in hospitals and health care centers in rural areas. For a neonatal nurse who is a Irishman with little to no experience will earn about $50,000 per year. With around four to five years of experience, you can facilely earn anything between $55,000 to $65,000 per year.

Neonatal nurses with more than ten years of experience can earn between $65,000 to 575,000 per year and even more. (Salary. Com) Depending on the area that the neonatal nurse opts to live in is a wide-spread. Neonatal nurses have an arduous time because, sometimes in a rural area not much transpires but if that neonatal nurse peregrinates to a more immensely colossal city, there is always more room to invest and have a safe job there. Nurse Practitioner Job Description). Charities have also been created to help fund the intensive care unit. The first one was the March Of Dimes.

March Of Dimes helps out with bring caution to everyone about newborn babies. According to March of Dimes in the United States, 1 in 9 babies are born prematurely. Worldwide, 15 million babies are born too soon each year. Taking part in March for Babies is more than just support. Consumers are changing the future for babies and making the world a better place and bringing more jobs like neonatal nursing to a whole new bevel. According to the American Association of Colleges of Nursing, a 1 994 study revealed that infants cared for by neonatal nurse practitioners stayed in the hospital an average of 2. Fewer days and incurred $3,400 less in costs than those cared for by medical residents. The babies under the care of the neonatal nurse practitioners were generally younger with lower birth weights charities have funded neonatal studies today. Today the average decreased because, money IS being funded to create programs where neonatal nurses and gaining more knowledge and a better understanding of the newborns hat are born into this world every day. Clearing doubts and fears in the minds of new parents of a newborn is also a task which is performed by almost all neonatal nurses.

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Premature Baby

A new medical practice for premature babies -Touching or No Touching- In the world, more than 300 thousand people are born in a day, but 10 percent of them are born as premature babies. The premature birth rate has increased by about 36 percent since the early 1980s, and many of them have died. Fortunately the good news is that the survival rate of the preterm has increased remarkably due to improvements in neonatology, such as using incubator transport. However, compared with in utero transport, incubator transport, based on separation between with mother and infants, is not natural thing, and it still has risks.

Incubator transport for preterm still has some known disadvantages including infant instability by lack of adequate systems for securing the infant, and separation of mother and infant. Even though it has some risk, it has been known as an optimal practice for care of extensible number of premature infants. According to Statehealthfacts. org, in the United States in 2009, there were 502,306 preterm births born. This is 12. 2% of births in the United States, 2009. Table. 1 Number of births, number of preterm births, and preterm births as a percent of all births in the United States 2009 Normal full term babies are born at 38 weeks.

Babies born before 37 weeks are defined as premature babies, and those born between 24 and 29 weeks are ‘extremely premature’. They usually have less weight than 1. 5kg (3. 3lb). And all babies born with less than standard birth weight, 2. 1kg (4lb) are at risk. Therefore, babies born early need special care and monitoring to help them to gain weight. To reduce disadvantages of incubators and improve care preterm babies, ‘Kangaroo care,’ a new medical practice for preterm babies, was introduced and being conducted in some united states medical facilities.

Kangaroo care is also known as kangaroo mother care, kangaroo baby care, and skin to skin care. Although the name varies, the concept is that holding an infant, naked except for a diaper and hat, against the bare chest of an adult for the purpose of providing the infant with a natural thermal environmental, nurturing touch, and enhanced opportunity to breast-feed. “Although numerous studies have explored the value of kangaroo care for premature or stressed newborns, the literature informing the effects of kangaroo care to people is scarce” the study by Janice Collisons said.

Mostly, the incubator as a present medical system is being used. The current predominant model of neonatal stabilization like incubators involves placing the infant in an open warmer immediately after delivery. This practice immediately separates the mother and infant during a crucial period of extra uterine adaptation, and may be a venue for delayed neonatal physiological adaptation, reduced breast-feeding, and impaired maternal infant bonding. The goal of my research is to know the benefits of kangaroo care as a stabilization method for preterm infants, and to figure out how it contributes the health of infants.

In March of 2010, a mother gave birth to a premature infant son, named Jamie. She was told that the baby had died despite the best efforts of the medical staff. She was given a chance to hold and cuddle him on her chest in order to say goodbye. When placed on her chest, his breath began coming in short bursts, and his parents and the medical staffs were astonished when Jamie opened his eyes with stable breathing. Jamie is now a normal active 2 year old boy. What this mother and child experienced is kangaroo care because it is similar to the same care a baby kangaroo receives in its mother’s pouch.

Doctor, Susan Ludington says “many people don’t understand this situation, but there are eight reports of other babies revived by kangaroo care. The mother can stimulate the baby to live. I think the Kangaroo care helped” In fact, this method had been used in Colombia. Due to increasing mortality rates in Bogota, Colombia, in 1978, Dr. Edgar Rey introduced kangaroo care to alleviate the shortage of caregivers and lack of incubators. This care was found to be an inexpensive and very beneficial experience to babies in Bogota, Colombia.

The mortality rate finally fell to 30 percent from 70 percent. Most studies have proven that Kangaroo care has positive impacts on babies and their parents; some studies have proven there is no change; but no study has proven that kangaroo care has hurt either parent or baby. By offering it to newborns, they have a stable heart rate, more regular breathing, improved oxygen saturation levels, no stress, longer periods of sleep, more rapid weight gain, and earlier hospital discharge. The first benefit of the kangaroo care is that preterm babies can have longer periods of sleep.

Researchers have come a long way in determining the major cause of colic. The common conclusion in 1999 is that colic is caused by a baby’s inability to transition from one sleep state to another – like from an alert state into a sleep state and back again. Kangaroo care performed in a quiet, low light environment with any baby has been proven to reduce crying and help the baby learn to transition from one sleep state to another. A study done by Patricia Messmer in 1997 found a significant increase in sleep time for the neonates during Kangaroo care.

The kangaroo care can relieve the pain of preterm babies during treatment such as blood test, injection of medication, and several physical tests which give significant pain to the babies. Because the premature babies are really vulnerable to surroundings, doctors need to take blood samples to check their health every day. They usually take 3cc amount of blood from the babies. The volume of blood drawn (3cc) from babies is proportionate to that drawn (400cc) from adults. How painful it is for the babies to stand.

The experiment that measured the pain level to premature babies from the blood test was conducted while kangaroo care procedure. The result of the experiment showed that the babies felt less pain when they were on mother’s chest. According to the article ‘Kangaroo care is effective in diminishing pain response in preterm neonates’, it concludes ‘Kangaroo care was effective in significantly decreasing pain response on the behavioral components of a validated composite measure of pain in preterm babies.

Given the many invasive procedures that are part of clinical care in preterm babies, KC may be a safe analgesic alternative in neonates in whom it is feasible and with mothers who are comfortable providing KC for painful events’ The newest studies that are being done in Sweden and other countries concentrate on full term babies in respiratory distress. They take these babies, who would normally be put on respirators, and place them on the mom’s chest immediately after birth in the Kangaroo Care position. Babies stayed on mom until the respiratory distress was gone – within 48 hours for most babies.

Oxygen hoods and cannulas (small tubes) were used if needed. In preterm babies, the effects of Kangaroo Care on these functions are just as dramatic. In 1998, Dr. Susan found a four-fold decrease in apnea during Kangaroo Care and ventilated babies were able to tolerate transfer and position changes without increased oxygen requirements. In 1997, GM Cleary, et al concluded there was no increase in bradycardia(slow heart rate –below 60 beats per min) episodes during Kangaroo Care. In 1998, Gay Gale and Kathleen Vandenburg concluded that the heart rate was more regular for Kangarooed infants.

All-in-all, the baby fared much better when placed in Kangaroo Care. “With my own ventilated preemie (1 pound 12 ounces at birth) I noticed a 50% reduction in oxygen requirements, no apneas, more stable heart rate, and more spontaneous respiration when I held her skin-to-skin. ” Holly Richardson concluded that more rapid weight gain was observed in Kangarooed infants. Kangaroo care allows the baby to fall into a deep sleep by conserving their energy for far more important things. This increased weight gain also leads to shorter hospital stays.

Kangarooed infants can have as much as a 50% shorter hospital stay than babies who are not kangarooed. This means less expense for the parents and children. In 1990, Dr. Susan Ludington demonstrated that mothers showed thermal synchrony with their babies. A recent study placed babies in Kangaroo Care position on the mother’s chest and temperatures were taken periodically of both the mother’s chest and the baby. The study revealed that when the baby got cold, the mother’s body temperature would increase to ‘warm’ the baby up. The reverse was also true.

Given a suggestion of “Your baby looks warm to me” by a nurse, the mother’s chest temperature would decrease within minutes to compensate. Extra blankets and monitoring of baby’s temperature might be needed when Dad or others practice Kangaroo Care, but in 1997, Karl Bauer wrote that one hour of skin-to-skin contact (Kangaroo Care) was no cold to preterm infants. In 1998, Papi A Gomez found infants in Kangaroo Care for more than 50 minutes were 8 times more likely to breast feed spontaneously. Kangaroo Care allows for easy access to the breast, and the skin-to-skin contact increases milk let-down.

A receiving blanket, strategically placed to catch extra milk is extremely helpful – especially if the baby is unable to breast feed. Otherwise, some doctors argue that there is risk of a bacterial infection if vulnerable infants come out from incubators. However, by using kangaroo care the immunity of premature babies is built up so they are not easily affected by any bacterial infection. Why? It’s because of the breast milk, containing lymphocytes and macrophages that produce antibodies. The kangaroo care facilitates an easy access breast feeding for both moms and babies than incubators.

As long as mothers are in good health and can produce healthy breast milk, the premature babies’ immune system will develop. Richardson proposed that brain development is more rapid in the baby who benefits from Kangaroo care. Her research reveals that ‘alpha waves double in a baby being “kangarooed” versus a baby in an incubator. Alpha waves are the brain wave patterns associated with contentment and bliss. Delta brushes are a pattern formed when tracking brain activity that represents the creation of new neural synapses.

Delta brushes are higher during Kangaroo care than during incubator care. ’ Through some cases and studies, kangaroo care can contribute to give an efficient treatment, as well as a miracle revival, to premature infants as long as it comes into wide use in a medical institution rather than using of artificial facilities which give stress to vulnerable infants. These benefits of kangaroo care are basically from mother’s love and communication. The incubator transport may give the stable care to the babies but it’s not perfect and not natural to them. It cannot be compared with mother’s bosom.

Some hospitals, combining both this touching system and the incubator, experience the positive results from the kangaroo care. However, there is still a huge lack of the knowledge of the kangaroo care. How to encourage people to know about the kangaroo care? Telling is the best way to spread it out to people. When people become parents with knowledge of the kangaroo care, they may use this touching in their home. It’s easy for every parent to use. Parents should know that their love and touching are what vulnerable babies need, not a cold and impersonal facility.

Bibliography Articles Barb Morrison. “Kangaroo Care: ‘Natures Best for our Little Ones’” (2006) Web Feb 22. 2012 <http://www. preciousimagecreations. com/presentations/kangaroocare. pdf> Maria Blois. “Hold Me Close: ‘Encouraging essential mother/baby physical contact’” (2007) Web Feb 22. 2012 < http://www. babywearinginternational. org/Blois_research_summary. pdf> Dieter Sontheimer. “Kangaroo Transport Instead of Incubator Transport”(2004) Web Mar 11. 2004 < http://pediatrics. aappublications. org/content/113/4/920. full > Celeste Johnson. Kangaroo care is effective in diminishing pain response in preterm neonates” (2003) Web Mar 11. 2012 < http://archpedi. ama-assn. org/cgi/reprint/157/11/1084 > Leornard A. Herzenberg. “Soluable CD14 enriched in colostrum and milk induces B cell growth and differentiation” (2000) Web Mar 20. 2012 <http://www. pnas. org/content/98/2/603. full> Books Ludington-Hoe. “Kangaroo Care: The Best You Can Do for Your Premature Infant. ” New York: Bantam Books(1993). Web Feb 22. 2012 Bergman. “Kangaroo Mother Care”. Geddes Productions (2003). Web Feb 22. 2012 Web Mhaire Fraser. Mom Uses Kangaroo Care to Revive Child Pronounced Dead. ” Care2 Make a Difference. Web. 22 Feb, 2012 Holly Richardson. “Kangaroo Care: Why Does It Work? ” Midwifery Today. Web. 22 Feb, 2012 Krisanne Larimer. “Kangaroo Care Benfits” Premature Baby. Web. 22 Feb, 2012 Kaiser Family. “United States: Number of Birth, 2009” “United States: Number of Preterm Births, 2009” “United States: Preterm Births as a Percent of All Births, 2009” Statehealthfacts. org. Web Mar 14, 2012 Jane Sheppard. “Breastfeeding for a strong immune system”. Web. 20 Mar, 2012 Rebecca M. Pugh. “Supporting the birth that is right for you”. Web. 20 Mar, 2012

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A Life Worth Fighting for

A Life worth Fighting For There are many babies that are born early; many mothers do everything they can to stay pregnant until at least 27 weeks. There are just some things that can’t be stopped. There are many families that rely on insurance companies to help out with that cost, but more and more insurance companies are trying to or are turning down premature babies that are born before 27 weeks. Should insurance companies be able to turn down a premature baby because of the risk of being sued? Many hospitals even have doctors that will not help the baby if the insurance will not help out.

Many mothers cannot control when they have a baby. There are many hospitals that even tell the mothers that she is fine and that she is just having Braxton Hicks, but in all honestly she is having actual contractions. There are Terbutaline shots that doctors could use to help stop the contractions if they would actually listen to women. There are also different procedures that can be done to stop from someone’s water breaking. There are more and more insurance companies, especially private companies that are trying to turn down babies that are born before 27 weeks.

Private insurance companies sometimes have lower deductibles, but there are a lot of things that they are trying to leave out so they do not have to cover. Companies think that preemies before 27 weeks are a liability and if they helped cover the charges and the baby did not make it that the family would go after them and put them out of business. Sadly many companies are finding that either way they can get sued. There are insurance companies that are turning down preemies; making it so the child does not have a fighting chance at life. With insurance companies turning down preemies, the companies should help pay for abortions.

The companies are pretty much stating they rather a fetus not have a chance than to try and help pay for a preemie or a child with a down syndrome. There are some states like Oregon and Arizona (Abortion Facts) that have abortion laws that are banning abortion, if a state is going to ban abortion than they should make all the insurance companies that are used in that state cover an infant no matter what. Many insurance companies especially private ones are at a higher liability with covering a child born before 27 weeks. There are some many risks that insurance companies could be faced with.

For a premature baby to stay in the Neonatal Intensive Care Unit (NICU) for even two days the hospital bill would range from $25,000 to a $100,000. Many insurance companies don’t see any type of outcome from that. They think that a family with a low deductable should have to pay more each month for insurance if the family expects them to pay that much for their child. There are also many “big named” companies that think spending that much on a baby is ridiculous. Yes, to someone that child may be their only child or only chance at having a baby. Insurance companies look at the long run.

Either the deductable is going to go up or the monthly payment is going to go up. Why should we have insurance companies if they are going to have the option of what they cover when the situation arrives? There have been insurance companies that have been sued for babies that do not make it because they were limited the help and the medication the baby was receiving. On the other hand, there are also insurance companies that are getting sued due to turning down a baby and the baby surviving. Many insurance companies if they cover having a baby that early will only support or help pay for certain things.

There are a lot of tests like Neonatal respiratory distress syndrome (Premature Infant) that the child needs done and insurance companies refuse to pay for but if the child doesn’t have the tests done than the doctors don’t know what exactly they need to do to help the baby live. Therefore, there are many babies that do not make it due to an insurance company turning down certain things. There have also been many insurance companies that have been sued for turning down helping a family and the child makes it. It is neglect on the insurances part for not giving the chance they deserve.

There are quite a few doctors (Smith) (Graham) that refuse to help babies that early because of insurance companies, but there are also doctors that believe a child that early does not have a chance. In 2008 Sara Capewell gave birth to a little boy that the doctors had refused to help or send to the NICU because she was at high risk of having a premature baby and they had told her not to have any more children. (Smith) So the insurance companies are part of the reason infants do not receive proper care, and there are insurance companies get “lucky” because the doctor refuses to help the family out.

There are doctors out there that are only in the profession for the money. They don’t care if they are saving a life or not they just want the “big” paychecks every two weeks. They think that if an insurance company isn’t going to help pay for the care of a baby that early than the hospital won’t get the money making so they don’t get paid. So they turn down families that have no control over the situation. Many mothers are sent home to have the baby so they can have their time with the baby when the infant doesn’t make it.

How unfair is that to not even give a child a chance because they are worried about not getting paid. Well insurance companies think that they are “lucky” for there being doctors like that. It makes the hospital look bad not the insurance companies. Every child should have a chance to live. If insurance companies are not going to help a family or mother give that child a chance at life then the insurance company should really look into assisting with birth control and abortion fees. Every child has the right to fight for their life and an insurance company should be there to help no matter what the case is.

Works Cited Allen, Vanessa. “‘Doctors Told Me It Was against the Rules to save My Premature Baby'” Mail Online. 10 Sept. 2009. Web. 22 Mar. 2012. . “Facts About Abortion: State Abortion Laws (U. S. ). ” Abort73. com / Abortion Unfiltered. 10 June 2010. Web. 22 Mar. 2012. . “Premature Infant: MedlinePlus Medical Encyclopedia. ” U. S National Library of Medicine. U. S. National Library of Medicine, 28 Feb. 2012. Web. 22 Mar. 2012. . Smith, Graham. “England’s Healthcare System Allows Premature Babies to Die. ” Godlike Productions. 08 Sept. 2009. Web. 22 Mar. 2012. .

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Discuss the Use of an Assessment Tool When Caring for a Child

In the following commentary I am going to reflect upon what I have learned about conducting the new born baby assessment regularly carried out on the neonatal unit. To write about the new born baby assessment it is important to understand what assessments are, why assessments are important and how this particular assessment is an essential part of nursing. “Assessment forms the first part of any nursing activity and is the first step in the nursing process.

Without a comprehensive assessment of the child and family’s needs, care cannot be planned, delivered or evaluated effectively. ” (Great Ormond Street Hospital 2012). Examination of a new born infant allows nurses to assess and monitor a new born baby’s condition and promptly identify any abnormalities in order to treat and give appropriate care as early as possible. It is an important part of overall care contributing to the baby’s wellbeing and survival (NNF Teaching Aids: Newborn Care 2010).

Over the time I have spent so far on the neonatal unit I have learned about the physical assessment of new born babies and observed the trained staff carrying out these assessments day to day. The assessment of a new born infant involves the checking of several aspects of the baby’s anatomy; the Brain (the control centre for all organs), the Heart (pumps the 80mls of blood around the baby’s body), the Lungs (provides o2 for the body’s organs and muscles), and the Kidneys and Liver (filters toxins out the body to be excreted). These vital organs are the key to the baby’s survival in life.

To begin to asses these organs is by examining the skin as this is the easiest organ to view and the examination is non-invasive so therefore should not distress the baby. The skin can be a key indicator of if something is wrong. The nurses and I looked at the colouring, the texture, the nails, and looked closely for any presence of rashes. The skin regulates body temperature (Ross and Wilson 2010) therefore monitoring a baby’s temperature is an important part of caring for a baby. The skin is also the baby’s first stage of protection from infection forming a barrier between its self the outside environment.

The head is another important indicator of what is going on within the baby. We examined the fontanel as this can swell or sink to show signs of dehydration or Hydrocephalus. A dry mouth can also be an indication of Dehydration. During birth the baby’s head can change shape due to the sutures in the skull (as seen in the diagram, Nucleusinc 2010) therefore it was important for us as nurses to check the sutures and the overall shape of the head and look for any bruising or swelling caused by trauma to the skull during birth.

It was important to observe and record the baby’s activity eg Agitated, Alert, Active as this will forms the baseline for further assessments of the baby and could help identify any neurological abnormalities. The next stage of the physical examination was the eyes. A discolouration of the whites of the eyes could be an early indication of Jaundice and be a warning to start treatment. Staring or bloodshot eyes could indicate a raised intracranial pressure or raised a blood pressure.

Pre-term babies are often on o2 therefore checking the lung function, the patency of the airway and the o2 delivery method is important in order to maintain o2 saturations above 95%. Having conducted the physical assessment of the baby the digestive system needed to be assessed. This was done by a physical examination of the abdomen and by looking at the method of feeding (Breast, Bottle, NG Tube, OG Tube, JJ Tube, or PEG) and the amount of milk to be administered (amount per day: ml/kg/day times baby’s weight divided by the number of feeds to give in 24 hours).

The Neonatal Unit’s policy is for the preterm baby is to start them on 60ml/kg/day +30ml per day up to 150ml and for the term baby to give 40ml/kg/day + 20ml per day up to 150ml. After this the doctors take over calculating feed volumes. These feeds are then recorded on a feeding chart and totaled at the end of every 24 hour period to monitor fluid intake. The initial assessment of a new born infant is a complicated process but is vital in providing the best possible care for the baby.

The initial assessment acts as a baseline for further care to be compared with. Without an assessment important information and signs may be missed with awful consequences. Although I have observed and assisted with the assessment process I do not yet feel comfortable performing this assessment on my own as I feel I have a lot more to learn so as I don’t miss something or disregard any of my findings as insignificant.

References:

  1. Boston Children’s Hospital (n. d. Assessments for newborn babies. [online] Available at: http://www. childrenshospital. org/az/Site600/mainpageS600P1. html [Accessed: 22/07/2012].
  2. Healthy Babies (1997) Guide for Newborn Physical Assessment, Anticipatory Guidance and Health Teaching. Vermont: Maternal and Child Health Home Visiting Nursing Standards and Competencies.
  3. Macqueen, S. et al. (2012) The Great Ormond Street Hospital Manual of Children’s Nursing Practices. Chichester: Blackwell Publishing Ltd, p. 2.
  4. NNF Teaching Aids: Newborn Care (2010) Examination of a newborn baby. [online] Available at: http://www. newbornwhocc. org/pdf/teaching-aids/2010/Examinationofanewbornbaby-ENC6. pdf [Accessed: 22/07/2012].
  5. Nucleusinc (2010) Skull sutures in infants and fetuses. [online] Available at: http://www. nucleusinc. com [Accessed: 22/07/2012].
  6. Waugh, A. and Grant, A. (2010) Ross and Wilson Anatomy and Physiology in Health and Illness. 11th ed. Churchill Livingstone, p. 354-358.

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Neonatal Nurse

Job Outlook of a Neonatal Nurse Modern-day fertility treatments have made the dream of parenthood come true for thousands of people. Each year, more advancements are made in this field, and as fertility treatments become safer and more available they are also becoming more common. However, with the advent of fertility medicine has come a sharp rise in multiple and premature births, sending more newborns to the NICU. All nurses count patient care among their most important responsibilities, but an ill or premature newborn needs round-the-clock monitoring and care.

In addition to the high-pressure environment of the NICU, neonatal nurses also are tasked with helping the families of the babies in their care understand what is happening. Taking responsibility for these tiniest of lives requires an immense amount of diligence and strength. Before setting out on such a daunting career path, many potential neonatal nurses want to know: What is the job outlook of a neonatal nurse? And what is a typical neonatal nurse salary like?

The rise in newborns needing extra neonatal care has resulted in a corresponding upswing in the job outlook of a neonatal nurse. In the last 20 years the number of hospitals with NICUs has grown along with the demand for their services. As with most nursing positions, demand is expected to continue to increase in the years to come. The job outlook for a neonatal nurse is bright – there is a very good chance that neonatal nurses will continue to be in demand. Neonatal Nurse Salary A neonatal nurse salary is affected first and foremost by the kind of nurse involved.

The median Neonatal Nurse Salary by Job Title chart shows that nurse managers and nurse practitioners earn a much higher neonatal nurse salary than many other positions. Indeed, a large percentage of a NICU’s staff will be neonatal nurse practitioners. For a neonatal nurse, yearly salary is also tied to years of experience. Researching a Neonatal Nurse Salary by Years of Experience, we can see that for a neonatal nurse, salary increases by over $20,000 over 20 years of experience. Many smaller or more rural hospitals may not have a NICU, which may be why comparing Neonatal

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Nurse Salary by Number of Hospital Beds tends to show higher salaries for larger hospitals. Looking for a city with high neonatal nurse salaries? Check the median Neonatal Nurse Salary by City report to see which cities offer the highest salaries. Average Neonatal Nurse Yearly Salary Dr. Salary doesn’t make house calls, but he can give your salary some intensive care! Learn the difference between asking, “what is the median neonatal nurse salary” and, “what is the average neonatal nurse yearly salary” in the Ask Dr. Salary article, “Why is Median Better than Mean for a Typical Salary? “

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Seasons of Life: Infancy and Early Childhood

The following reviews the value of understanding human development over a lifetime and highlights key theories from within the first five years of life as recognized in the Seasons of Life video series. Included is a reflection on a theory of attachment, three clocks that influence life, temperament and early memories. How these theories pertain to the individual‘s early development and effects in later years will be discussed along with the author’s personal opinion.

Seasons of Life: Early Perspective What appears to be universally interesting about life is people. This is evidenced by the large amount of information, resources and theories that surround people and their development. The video series Seasons of Life: Infancy and Early Childhood (1990) highlight key elements in early development and their effects that contribute toward the individual throughout their life.

One theory mentioned in Seasons of Life, is that of attachment. John Bowlby expressed that innately humans are equipped at birth to cause attachment to their caregivers. If the attachment is successful the cycle should continue, acting as the foundation for healthy, successful relationships throughout the lifep (Bowlby, 1982). Each of the child subjects in the Seasons of Life appeared to have successful attachment to their caregiver. This was regardless of whether the child stayed primarily in the home for care and was surrounded with extended family, had few local relatives, spent time in day care or had a grandparent as a main caregiver.

Also reviewed in the film were three clocks that caused influence in people’s lives. The first was a biological clock. This clock was said to have the strongest influence early on, and as early as in the womb. The second was a social clock. This clock was described as society’s age related expectations of the individual at any given time (Berk, 2010). For example that people should marry in their twenties then follow with having children, et cetera. The social clock was also described as evolving with societal changes in expectations. The psychological clock was listed third and described as the passage of time in people’s lives. This timekeeper could drive people to become themselves. Examples stated were of feeling an age rather than the actual years lived and where evidence of deep long-lasting emotional attachment could be revealed in later years.

Another aspect of development highlighted was temperament. A wide range of child temperaments were represented in the film. It was discussed that these dispositions would remain with the children throughout their years. Some were seen as relaxed and easy-going and others were challenging and determined. The narrator discussed that the temperaments seen in early months and years might serve the children later on toward reaching their goals.

Additionally mentioned in the video, and perhaps the most impactful for me, was that the individuals search for the meaning of self could and would be directed back to their earliest memories. Concrete memories were mentioned to be available beginning around 3 to 4 years of age.

Of all the information available in Seasons of Life, that of correlating my feelings of self and my earliest memories was overwhelming. As the narrator spoke, my mind wandered over many memories that, now I understand, forged much of what I have become today. Some were bitter, others sweet, and they all held an interesting explanation of why and how I have become me.

I greatly enjoyed watching Seasons of Life. With a smile, I was really happy to see Mr. Rogers one more time. I have since forwarded along the website to many in the hopes it will shed light on a current struggle or awaken an understanding, just as it has for me. I plan on employing these new resources in my interactions with family and those around me while anticipating what the next episode has to offer.

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Essay about Infant Observation

On the day 6th of the month 9th of the year 2012, I observed the infant Alonso Herrera Rivera. Alonso is three months and a week old, his weight is 17Ibs with 7oz his height is 26in. The infant has a round head, dark brown hair with dark brown Chinese eyes, and rosy cheeks with […]

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