Perspectives On Pediatric Nursing

Family Centered Care- a philosophy of care that recognizes the centrality of the family. That family is the patient Atraumatic Care- a philosophy of providing care that minimizes physical or psychological distress for the child/family

Nursing Roles
Roles of the Pediatric Nurse - caregiver - advocate -educator - researcher -manager/leader

Advanced Practice Roles -PNP -CNS -Case Management All roles more independent. Masters prepared.

 Role of educator: improves tx results. May focus on health promotion, maintenance, self care, and management of health condition. Advocate: acting to safe guard &advance the interests of another; directed at enabling the child &family to adjust to the changes in the child's health in their own way. Nurse must be safe of childs&fam needs, resources, and the services available.

Case Manager: enure the care plan considers the fam wishes & contains services. Coordinates quality of care n cost outcomes. Optimize pt self care abilities, promotors continuity of care, and encourages effective utilization of resources. Discharge planning. Researcher: stay up to date w new research findings that improve healthcare or cost.

 Go in and talk to parents bc the child is surveying you-- if child sees that the parents are cool with you, kids will be more comfortable.

Legal and Ethical Issues

Informed Consent- the duty of a health care provider to discuss the risks and benefits of treatment or procedure with a client prior to giving care. Any invasive procedure or participation in research Must be signed by legal guardian; comprehension of disclosed info

"Touching of any person by another without informed consent is battery" Nurses role in obtaining informed consent: asses child's developmental level and parents view of that, review the minors informed consent rights, develop a therapeutic relationship w fam and child, serve as a witness when they sign or give verbal consent by phone in emergency.

What you need to know about informed consent!

Minor- anyone under the age of 18 does not have rights and responsibilities of an adult. Assent- means the pediatric client has been informed and is willing to permit the prescribed treatment or procedure. Even if guardian signs for child, child must still be in compliance and know that they have the opt to decline.(dissent is choice to not participate).

Emancipation of a Minor

 If child comes in with life threatening emergency, care of child may be given without consent Refusal of medical care by parents may be over ruled by judge. Ex: blood and Jehovah's Witness Declaration of death of child requires more testing-- multiple EEG's to prove no brain activity, and multiple tests declaring no breathing

Who gives informed consent?

Mature Minor Doctrine: 14&15 yr olds who can understand tx risks Divorced Parents Medical Emergencies Refusal of Medical Care by parents Organ Donation of tissues/organs

 Negligence- an occasion when a person owes a duty to another and through failure to fulfill that duty causes harm. Malpractice- is professional negligence. Nurse or Doctor. License may be revoked.

Malpractice in the Pediatric Setting

 Your State Nurse Practice Act! Good Samaritan Act- will cover in "good faith" State Laws Risk Manager in your health care facility Policies and Procedure Manuals Ethics Committees

Legal Resources for Pediatric Nurses

Brain Death
Is an irreversible form of unconsciousness characterized by:
Complete loss of brain function while the heart continues to beat. Child kept alive by ventilator support with no active breathing. Child guidelines differ for brain death vs. adult criteria.

 Nuclear Family; mom dad and sibling Extended Family; grandparents Blended or Step Family; d/t high divorce rate Single Parent Family; stress in finance Gay and Lesbian Family

Definitions of Family

Parenting Styles
Authoritarian or Autocratic Democratic or Authoritative Indulgent or Permissive Indifferent or Uninvolved

Children need consistency/routine, not just a "cool" parent

School Nursing
History Screenings
Vision and hearing testing Height and weight measurements Scoliosis Pediculosis Immunizations Dental (in some states) Tuberculosis (in some states)