Childrens Nursing free essay sample

Identify opportunities for child health promotion Moules and Ramsay (1998) identify many areas for child health promotion. This includes smoking, exercise, diet and nutrition, sexual health, dental health, skin care and the sun, accidents, alcohol and drug abuse. As with the other branches of nursing, health promotion can take forms of primary, secondary or tertiary intervention. Interventions may depend on the age of the child. Younger children, for example pre school aged children will benefit form health promotion aimed at the parents. Health promotion activities may include: †¢Assessing needs Social support: providing support by creating groups, counselling sessions and creating opportunities for listening and building friendships †¢Providing education through different medians †¢Detection of disorders and health problems via screening programmes †¢Providing practical help :providing access to information and knowledge, for example legal and economic advice †¢Community projects and community development As children’s health is determined by a wide range of factors, addressing the wider determinants of health is viewed as been effective health promotion. Whichever method used the child’s health needs to be viewed holistically, Hall and Elliman (2003). Explore issues of consent: Fraser Guidelines/ Gillick competencies Caulfield (1996) p287, Individuals over eighteen years who have the mental capacity can make their own decisions regarding health care. The Family Law Reform Act also allows young people of the age sixteen to eighteen to also make their own decisions. Consent issues become more complex when dealing with individuals under the age of sixteen. National Society for the Prevention of Cruelty to Children NSPCC (2009) state Gillick competency and Fraser guidelines are used to assess whether a child under the age of sixteen is competent and mature enough to make their own decisions and understand the consequences of their decision regarding health care. The guidelines originated after a legal case between Victoria Gillick and her local health authority. Gillick took the authority to court in order to prevent her daughter under the age of 16 being able to receive contraceptive treatment and advice without parental consent. Gillick lost the case. In 1985 Lord Fraser produced guidelines specifically for contraceptive advice and treatment which stated treatment could be given to children under the age of 16 providing the advice was understood. Advice and treatment could be provided if the professional was unable to persuade the child to discuss contraception with their guardians, sexual intercourse would continue without contraception, mental and physical health may become at risk and it was in the young person’s best interest to receive contraceptive advice. Caulfield (1996) p287, If the child is assessed as being competent they have the right to consent. If the child is viewed as incapable of giving consent, the child’s parental guardians can do this on the child’s behalf. Conflicts can arise if the opinion of the child and guardian differ. For example, if the child is refusing treatment, parental guardians can override their child’s decision and consent to treatment. However if the difference of opinion is extreme and the health professional does not know how far the child’s wishes should be taken into account (For example refusal of life threatening surgery) a court can make the final decision. . Explore the concept of family centred care Mcewing, Kelsey, Richardson and Glasper (2003) p 88 identify children’s nursing to be based on a philosophy of family centred care. This approach of care focuses on the family as a whole instead of solely on the child. The nursing environment should encourage and enable the family to help care for the child. This is believed to benefit both the child and the family emotionally and physically. The family unit is maintained and it allows the parents to help care and learn the correct skills and knowledge to help care for their sick child. They also will therefore not feel they are loosing their role as a parent. However it can be quite difficult for parents in this situation and very upsetting for family members to care for their ill child in this setting. Difficulties sometimes arise when family members have differences in opinions also. Therefore it is ultimately up to the family how involved they want to be in their child’s care. The nurse and other members of the multi disciplinary team have a role in supporting the family members throughout the care of the child. Demonstrate an awareness of child protection issues Citizens Advice Bureau (2009) state child abuse can take different forms. This may be physical abuse, sexual abuse, emotional abuse or neglect. Abuse affects a child’s health and development. If reports have been made to social services they will investigate further to find out if the child is at risk and take appropriate action to protect the child. Investigations may involve family visits, medical examinations and interviews. The parents are usually informed about the enquiries being made. In more serious cases and all sexual abuse cases the police will be informed before the parents. Children can be removed from the home and placed under police protection. Further action may be required which may involve a police investigation, applying for court orders to place the child in care or under supervision from the local authority in order to provide support for the family. The child may also be placed on the child protection register. Huband (1996) p449 identifies the Children’s Act (1989). This act: †¢Highlights the rights of children and identifies parental rights are dependant on parental responsibility †¢Recognises the fact that there will be instances whereby children’s rights over power parental rights. Compare and contrast communication between children and that of adults Moules and Ramsay (1998), Similar to communicating with adults its important to use non verbal communication to show the nurse is interested and sensitive to the child and to ensure the nurse does not display signs of authority or superiority to the patient. Again as with communicating with adults it is advised to look relaxed, ask open ended questions and avoid medical jargon. Different types of communication need to be adopted when communicating with different age groups. INFANTS: Emphasis on Non verbal communication as this is what the child relies on to express needs and understand surroundings. Allowing the parents to be in sight of the child will help relax the infant especially if the guardians can remain calm. The nurse should talk to the child at their level, similarly to adult nursing. The child should be focussed upon and communicated with using simple sentences and concrete terminology. Encouraging the child to play and express their feelings through play may help decrease the child’s anxieties. This is a large part of communication in child nursing. Having the parents present is also important to help reduce any fears and encourage comfort in an unfamiliar setting. Are often interested in what is happening around their environment. Allowing the child to question the hospital, treatments and health care improves communication. Questions should be encouraged in both adult and child nursing.   It is important to give the adolescent opportunity to discuss their care alone to provide privacy. The adolescent should be treated autonomous, this will also encourage communication. It is important to be non judgemental as this again will encourage the adolescent to discuss thoughts and feelings more openly. There are both similarities and differences in communication between adults and children. These skills need to be developed in order to communicate effectively with patients of different age groups. Consider the role of other agencies and professional groups e. g. social services, sure start â€Å"Sure Start is the Government’s programme to deliver the best start in life for every child by bringing together early education, childcare, health and family support† Sure Start (2010) Sure Start implements initiatives via outreach programmes and community development to help improve child care, early education, health and family support. The aim is to help reduce poverty. Sure Start deals with children up to the age of fourteen or sixteen if the child has a disability, Sure Start (2010). Social Services have a role to help provide family support services for children if requested alongside protecting children from harm when concerns are raised. Social services are involved in protecting children in care or when placed up for adoption. In order to be successful effective inter agency communication and team work is needed. This may involve health services, education services, social services and police.