Course title: Essay Example

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Child, maternal and paediatrics


Whether for regular check-ups with a paediatrician or overnight surgical stays, going to hospital can become a confusing and frightening experience for children of all age. Daniels (2005, p 111)argues that children are generally bound to the feeling for anxiety and fear, when in unfamiliar atmosphere such as hospital and that depends on the level of parental reassurance as well as the help of keeping their spirits up during the entire duration of treatment (Lawrence 2008, p. 70). For the side of parents and the guardians, this is not an easy time for them due to stress and fear of coping with illness child and the needs of the rest of family members among other notable duties. During this duration, the most important thing for any given parent is to do what ever is possible to help the children feel at home, such as providing the child with best-loved book or their favourite toys. Further, the parent may spend nights in the hospital room or personalize the room with family photos, cheerful posters or the artwork of the particular child (Jameton 2004, p. 241). This paper will critically evaluate holistic care and the concept associated with needs of young hospitalized child

Analyse immediate nursing care for a child

As indicated above, the hospital experience for most children is devastating especially for children under the age of five years such as the case of Sarah. There is a great need of a holistic nursing approach to facilitate smooth and faster rate of healing for children of this age. Coulehan & Block (2005, p.62) argues that holistic nursing is a practise, which focus on the healing of the entire person, through unity of the body minds, spirit, environment and souls. It draws on speciality of the nurses who becomes therapeutic to the patients they take care of (Boswell 2011, p. 189). For young children such as Sarah, holistic nursing approach is vital as it improves on their mental attitudes, thus lifting wellness of the patient through this type of connection. For most of the preschoolers such as Sarah, they may have certain misconceptions resulting from their magical thinking. For instance, they may think that they are the once who caused the illness or believe that hospitalization is a form of punishment for a particular wrong thing that they did (Jameton 2004, p. 201). Upon hospitalization, there are immediate measures, which the nurse and the parent should carry out to achieve the desired holistic care (Bellchambers 2010, p. 102)

Discussing the hospitalization

Smith (2007, p. 397) the aspect of preparing a child for the purpose of hospitalization depends on the child’s age as well as their cognitive levels. Whether one is a nurse or parent, there is a need of taking into account previous hospitalization and whether they were good or bad experiences for the young child. No matter the age of the child, there is a great need of conveying positive attitudes when discussing about the hospitalization process, especially in the first few hours upon admission to the hospital. Informing the on how long they will stay in the hospital should be avoided. For the nurse , it is important to keep in mind that, it is highly frightening to have a child walk in hospital room and have conversations stopped or spelling out certain words which the child cannot hear (Delucia 2009, p. 77).

Beder (2006, p. 435) indicates that there is great need of involving the parents or guardians in the first hours to achieve the desired healing process for the child. Most of the health care professional strongly feels that, parents are invaluable sources of information with regard to the hospitalized child. Parents are usually expert of their children and thus useful in assessing, understanding, observing the well-being and daily needs of the child. Further as a parent it sis vital to initiate conversation regarding the hospitalization process especially in the first few hours of admission. By initiating the conversations, children will be able to express their thoughts and feelings about the hospitalization process (Smith 2007, p. 291). By using hospital resources, such as photos of other children who have previously visited the hospital nurses and other practitioners can help the sick child to over acclimatize to the hospital environment. For the case of Sarah, who have previously suffered from scabies about six weeks ago, which was not treated, lacked the required breastfeeding duration of at least two years, the medical practitioners should take extra care to facilitate her quick recovery(Delucia 2009, p. 79). This is combined with the fact that, her aunt (her next of kin) comes to the hospital after admission of Sarah to the hospital ad lacks knowledge on where Sarah has bee living and her health condition for the last few weeks. Having fainted at the Early Childhood Centre (ECC), where she attends for three hours every morning, its is important for the nurse to inform Sarah’s Aunt on the need of careful monitoring the health of the young child as well as putting up with her during the time of hospitalization (Lawrence 2008, p. 70).

Psychological, social and physical nursing care required by Sarah

Smith (2007, p. 458)
assessment is the first stage of the nursing process that the nurse carries out whole and holistic nursing assessments for all the needs of the patients, regardless of encounters of the patients. Nursing assessment entails gathering of information regarding the physiological, sociological, psychological and the spiritual status of the patient. The main purpose of the assessment stage is to identifying the patient nursing problems, which are either actual or potential. Some of the elements of health taken into account include overall health status, current managements of illness, medical history, and social history as well as how the patient reacts to particular illness (William 1997, p. 299).

Nurses are also encouraged to take the history of the patient prior to any form of treatment. By taking a nursing history to the physical examination, the nurses will be able to establish a rapport with the family members and the patient. For instance, through the Sarah’s Aunt, the nurse will adequately be able to understand history of the preschooler. This includes the fact that she was not fully breast-fed and her immunisations were not complete. Generally, Sarah lacks the vital aspects, which determines the overall health and wellbeing of any human being, a factor that may highly expose to the diseases she is suffering from such as scabies (Smith 2007, p. 243).

Psychological assessment

A psychological or psychiatric assessment is defined s way of gathering of information on a patient with the sole purpose of making diagnosis (Boswell 2011, p. 200). In many medical institutions, this form of treatment is the first step towards a holistic care as assessment on biographic and social information and direct observation along side collection of data from particular psychological tests. For the case of Sarah, psychological assessment is one of the important areas to be undertaken by the nurse in the short term to achieve holistic care .This will establish diagnosis as well as formulation of individual problems accompanied by planning of individual treatments and care. Delucia (2009, p. 77) says that assessment can be carried out in a hospital setting, ambulatory or community setting depending on the medical needs of the patient.

Physical and social nursing care

Braithwaite (2004, p. 41) indicates that performing accurate physical assessments and ability to differentiate normal from the abnormal findings are the most important roles of health care practitioner in the current times. If there is no accurate physical assessments, either for baseline data or during the times when patient conditions changes, then patients are not receiving competent level of care desired. In assessing the physical health, the nurse use observations such as signs easily seen, or any other symptoms. The major techniques used by most nurses include inspection, percussion, Auscultation and palpation. Inspection is a systematic method of observation, which begins with the general observation of patients then progressing to the other body parts. On the other hand, auscultation is the process of listening to sounds over the body cavities in order to determine presence and quality of lung and heart sounds (Brosnahan, & Tracy 2002, p. 120). These tests are in addition to viral signs of blood pressure, temperature, respiratory and pulse rate as well as further examination of body temperature like musculoskeletal and cardiovascular system among other notable forms of assessment (Courtney 2004, p. 39). For instance, through physical assessment, the nurse has established that Sarah is slightly dirty; her hair is drying dull and unkempt. The turgor of her skin is poor and there is evidence of pallor around the fingernails and mouth. Further, the nurse assesses that her pulse is thread and 120 BPM, body temperature at 37. 5 degrees Celsius, low-grade fever, lack of appetite, headache and myalgia (Diamantis 2008, p. 34).

Social and physical assessments are some of the some of the medical processes carried out on Sarah in the short term. Through social assessment, it is easy to ascertain emotional health through enquiring and observing how the client feels and reactions towards the feelings. Rycroft-Malone, J& Bucknall (2010, p. 113) argues that emotional health is all about how confident or balanced a person feels. If a particular thing happens and a person feels emotionally low, then getting back of track becomes hard especially as result of illness (Boswell 2011, p. 189). Further, it is notable that people do not have poor or good emotional health. The emotional health of any person depends on the circumstance one grew in, skills, knowledge, and experiences collected in the entire life and their utilizations. For those people having negative emotional health such as Sarah, they tend to be sad, tearful, withdrawn among other characteristics such as reduced appetite (William 1997, p. 301).

Identifying and treating the possible side effects of a scabies infection

Fitzpatrick (2003, p. 67) indicates that scabies is an extremely contagious disease, which is spread by mites. This type of parasitic infections resulting to itching effects especially when there is exposure to hot environments like a hot shower. It is worth noting that scabies can affect any person regardless of age, as it is not necessarily due to unhygienic conditions. Scabies is most rampant in school going children such as Sarah, as children interact and touch each other mostly in unhygienic manners. On one hand, the unhygienic conditions are favourable for breeding purposes of these parasites as on the other hand they can spread easily due to the small area shared by many preschoolers (Courtney 2004, p. 30). The mites resulting to scabies goes by the scientific name sarcoptes Scabel and they can grow up to half millimetre lengthwise. The side effects of these disease symptoms of this disease include intensive itching that is worse during the night or hot bath, visible barrows especially between the fingers and skin creases such as genitals and armpit (Jameton 2004, p. 231). There is also appearance of Pimple rash or bump rash although is difficult for them to seen clearly. Other symptoms, which can be indentified upon physical assessment includes clear, small , fluid filled lesions or spots among other notable physical appearance such as scalp, face, soles and palms infections. To treat the disease, doctors and physicians are encouraged to use microscopic examinations to examine scraps of skin, thus indentifying the mites, eggs and faeces (William 1997, p. 306). For medication purposes, individuals are encouraged to apply cream to their whole body prior to going to bed as this is the time the parasites are mostly active.

Braithwaite (2004, p. 45) the side effects of this infection includes skin reactions, as witnessed in the case of Sarah where her skin turgor is poor and evidence of pallor around fingernails and mouth. There are also evidences of tingling, numbness and dizziness, gastrointestinal infection, allergic reactions among other notable side effects. To treat these side effects, it is important for Sarah to visit the physician for check ups as well as treating the home environment and all the furniture used in the home through vacuuming, laundering the bed linens among other notable measures (Courtney 2004, p. 33).

Planning for Sarah discharge

Inadequate discharge planning is often results to poor outcomes as well as raised likelihoods of readmission to children, especially those having special acre needs (Gale Group 2002, p. 108). Faced with limited methods of discharge, most of health acre professional feels they have no choice except sending the children home to their communities and families. This is because they feel they are not able to provide the required environment to keep the children safe in the hospital (Smith 2007, p. 407). Too often, discharge dates set by guidelines of family insurances or clinical status of child. It is worth noting that outcomes of the discharge processes would be further improved if discharge dates are includes an assessment of readiness of family home acre plans, in additional to prevailing health care status of the child. Bernadette (2008, p. 9) To manage the discharge process of a child, discharge meetings should take place, thus enabling both the physician and family members to access the needs of child. The meetings should generally centre on the child and the family members. Depending on the type of discharge employed, the effects are enormous to the child as well as family members as indicated by the table below. argues that, discharge of children from hospital is not necessarily an indication of full recovery. It is simply an indication that, physician has determined a stable condition of the child, thus hospital-level care is not required at that time.

Beder (2006, p. 439) argues that the best interest for a child are served in a short for achievement of effective and safe form of treatment. However, it is worth noting that move from the hospital to home environment increase the level of stress of a child as well as the entire family. College and Association of Registered Nurses of Alberta (2004, p. 50) discharge planning is a process of indentifying ongoing social and health care needs of family and the child. It also deals with making plans, which are necessary for ensuring safety and continuity of required care, preparing and coordinating the contributions made by various agencies and professionals (Braithwaite 2004, p. 42). In Australia, a child discharge procedures to follows the model of CCNUK (Care coordination) with an identified lead professional coupled with action point with time scales (William 1997, p. 301).

Family support

Effective discharge planning should enable the family of the affected child to live a normal life as much as possible and they should be able to support their child carry out activities done by children of their age (Beder 2006, p. 409). These include going to school, enjoy their leisure among other activities such as accessing local community facilities. Burkhardt & Nathaniel (1998, p. 56) indicates that parents should be supported to be parents, thus care staffs should avoid disregarding the roles of parents to their children. There is also the need to recognize the needs of the parents such as going to work, paying for child care, working tax credits, thus the need of being supported morally due to child’s condition that may forms part of their support baggage. Smith (2007, p. 457)of a smooth transitions from hospital to home based care for the sick child, thus avoiding frustrations to the affected family. indicates that at least 80% of set check lists are satisfied prior to releasing of a child from the hospital .This way, there is enhancement

Working with indigenous families as compared to non-indigenous families

Braithwaite (2004, p. 40) nurses and other medical practitioners must be aware of differences existing between indigenous families and non-indigenous families as far as nursing activities are concerned. In most of the instances, indigenous Australian do not take place in physical activities as compared to indigenous population .As a result of this, the indigenous group is prone to increased health complications such as diabetes, obesity, heart disease among others. The main driving factor for this is increased poverty levels, leading to low education level and access to medical care and cultural barriers on some issues such as physical exercises (Smith 2007, p. 400). On the other hand, the non-indigenous groups are wealthier; more informed and take part in physical exercise among other important aspects regarding personal health.

Due to the poor state of most indigenous families in Australia, infant morality for this group is higher than national average approximated at 15.1 deaths per 1000 births taking place in the country (Courtney 2004, p. 31). According to Victorian Aboriginal Health Service, Koori population from Victoria is one of the groups where children are born having small weight due to the effects of smoking, the highest as compared to other states or territories. Low birth weights are associated with raised risk of neonatal deaths as well as different diseases in later stages of life. This includes diabetes, cardiovascular disease among others (Lawrence 2008, p. 72).


From the above information, it is clear that adequate immediate and efficient nursing care is important to sick children (Beder 2006, p. 303). This way, they can be able to recover quickly, thus avoiding enhance frustrations to the family members. There is also the need of early preparation with regard to discharge process, to facilitate smooth environmental transitions. For the case of Sarah, who is suffering from scabies along side other illness, the recommended nursing practises should be followed to quickly allow her to resume school and in good health (Mitchell 2001, p. 30).


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