EMLA Versus Nurse Coaching Child Stress: A Case Study

Staff nurses have great responsibilities in caring for patients. Often, these nurses experience heavy workload. Heavy patient load and stress contributes to burnout. Why is burnout important to discuss in relation to nurses? Burnout affects the performance of the nurse and the quality of care he or she provides to the patient. Therefore, it is imperative that staff nurses decrease the possibility of burnout and increase or maintain excitement and enjoyment in the field of nursing. If nurses do so, they will find joy in their work and quality of patient care will be increased. Contributors to burnout and

pain is the usual cause for persons to look for treatment. Inadequate pain management can cause delay in healing process. It can also leads to prolonged hospital stay. The acute pain management theory describe how nurse can manage pain with minimal effects from the pharmacological interventions and use of alternative methods of pain management (Good &Moore, 1996) The main factors are in the management of pain are Pharmacological, non-pharmacological, patient participation, education and different interventions. Effective pain management involves the application of non-pharmacological interventions and usage of pain medications. (McEwen & Willis, 2014). The pain management theory deals with management of pain in daily basis. It offers the knowledge about alternate methods in pain

In a study conducted by Hatfield and Young (2007), 1,727 procedures such as venipuncture, intravenous (IV) catheter placement, intramuscular (IM) injections, urinary catheterizations, and nasogastric tube placement in 1,210 children have been reviewed. Their findings reveal that almost none of the patients received pain management. Although traumatic for the patient, these procedures are considered to be minor by many nurses, and the culture of pain management has not been seen as the standard of care (Hatfield & Young, 2007). Nursing staff is encouraged to change the culture by embracing their role as patient advocate. Every patient deserves a triage pain assessment with ongoing assessments as necessary. Pain control measures must be implemented prior to beginning potentially painful procedures. Discussion must take place between the parents and healthcare staff in order to deliver the best comfort measures on a case-by-case basis.

Children have multiple or prolonged exposure to trauma, experience various symptoms and reactions, and long for progressive techniques to heal their pain.

Whether it’s administering pain medication or allowing the parent to hold them in between procedures, it is the nurse’s job to determine the actual stressor.

The major stressors of hospitalized children include fear of the unknown and unfamiliar people. Lying to children about upsetting realities, such as their diagnosis or a procedure that is occurring, is ineffective and does not help children deal with stress. Educating children on their treatment better prepares them for stressful situations while hospitalized. While nurses identify crying as a sign of stress, child life specialist recognize crying as an effective coping mechanism for stress (Kaddoura). While both nurses and child life specialists are helpful to treating a child, child life specialists focus on children’s emotions while nurses focus on medical care. The issue here is that not all hospitals have child life specialists, so the emotions of children are disregarded. Although medical care is obviously a priority while a child is hospitalized, a child’s emotion and stress are very important to their recovery and health. Research shows that focusing on children’s emotions with the use of child life specialists makes a difference for children and families. Child life programs have been shown to reduce children’s pain, decrease the emotional distress children feel while in the hospital, and lower parents’ anxiety about their children’s hospital stays

It has been documented that children undergoing surgery and their families experience high levels of distress and perioperative anxiety. Stress and perioperative anxiety have the potential to cause more harm on post-surgical healing, in consideration of both physical and mental health, if not addressed promptly and properly. Child Life Specialists are pediatric healthcare professionals who are able to provide interventions to help reduce anxiety and increase developmental growth within pediatric patients, provide family centered care, and facilitating therapeutic play interventions for pediatric patients, all the while in the hospital environment (Child Life Council, 2014). Child life specialists are able to meet these values and missions to create a standard of practice that the American Pediatric Association recommends in all pediatric healthcare settings (Child Life Council, 2014). Typically, when child life specialists are working with pediatric patients undergoing anesthesia for surgical procedures they are able to participate as a part of the multidisciplinary health team to provide family centered care and increase a patient and their families understanding on the medical procedure at hand. A common intervention for pediatric patients undergoing anesthesia for surgical procedures include medical play and medical preparation sessions.

1. Assume you are in charge of socializing the newly hired nurses at a local hospital. What steps would you take to ensure that they understand the hospital 's organizational culture? How would you help them understand how to manage stress on a daily basis so as to prevent burnout later in their careers? Explain.

They also tie in closely with the psychological effects which develop as the treatment progresses. In one study conducted by Enskar and von Essen, it was found that in most 8 to 12 year olds, pain came from the diagnostic procedures and treatments. There were comparisons between children who were receiving treatment at the moment and those who had completed it. Of the children who were receiving treatment, they had more problems with hair loss and nausea compared to those who had completed the treatment (Enskar & von Essen, 2008, pp. 37, 39). During the duration of the treatment, the patients typically felt the physical effects even more compared to when it was completed. There is also a distinct comparison between which effects are emphasized between school aged children and adolescents. Children felt weak and tired physically while adolescents felt fatigue mentally and emotionally (Hooke, Garwick, & Gross, 2011, p.

Pediatric pain management is measured subjectively because it is based off of what the patient says or how the nurse interprets the pain scale. Pain is rated using different scales, unfortunately these different scales could yield different results. Nurses are trained to use pediatric pain scales to analyze and treat pain but parents are not supplied with the tools to manage pain when the patient goes home. With 84% of all pediatric surgical procedures performed on an outpatient basis, the importance of teaching parents how to assess for and manage pain has become more important than ever (Rony, Fortier, Chorney, Perret, & Kain, 2010). According to Rony’s et al. (2010) study, it is apparent that pediatric pain is not being treated effectively. The study showed that 58.8% of children were receiving less than the daily recommended does prescribed by the pediatrician (p.1). Results of the study also showed that parents had false assessments on if their child was actually in pain. 36% of parents believed that if their child was in pain, they would cry out for the parent , 30% agreed that their child would always tell them if they are in pain, while 22% said that the child would report their pain immediately (Rony, Fortier, Chorney, Perret, & Kain, 2010, ). Children do not always verbalize when they are in pain. Sometimes the pain can be so intense that a child is unable to talk. If the child catches on to the parents negative perception of pain medications, the child may not

Uncontrolled pain can have a major impact on a patient’s quality of life and the ability to obtain successful operative outcome. (Crisp et. al 2012) The importance of pain management in postoperative care is emphasised in this essay, to provide the understanding that effective postoperative care includes providing the patients with maximum comfort, satisfaction and encourage the healing process for early discharge from hospital. Inadequate pain control in postoperative care can also enable the patient to feel hopelessness, develop depression and other effects that can lead to detrimental consequences. (Human Rights Watch 2009) Therefore, the effects of uncontrolled pain is also discussed in this essay, to highlight the significance of appropriate

Although there is increased awareness of pain management in adult patients [20, 21], pain management in pediatric patients should be given a high priority by all health care professionals through advocating for optimal use of comforting strategies that reduce pain distress during painful procedures[3, 21]. However, our study demonstrated the use of few evidence based comforting strategies for pediatric pain management during IV line insertion by the participating health care providers at the Mulago national referral and teaching hospital. This may be attributable to the fact that the hospital receives many visiting professors annually who may be the source of information for practice change as they participate in the care of patients.

Pediatric Care Nurses have a demanding job that is often overlooked by most. People do not take into account how much a nurse will give to his or her patient, especially considering that patient is most likely a child between the ages of infancy to eighteen (“How Nurses”). The patients, being very young, can attribute to the amount of stress the nurse feels to do his or her best which can in some form bring an emotional factor into the mix, especially if the nurse has children himself/herself (Izumi 203). While being a pediatric care nurse, emotions play a large role in the way these professionals do their job. A step back is needed to see the emotional and physical stress these pediatric care nurses face when doing their job.

We spend much of daily lives working. In fact, Americans spend about eight-times as many hours working as they do eating and drinking (U.S. Bureau of Labor Statistics, 2013). Approximately seven in ten Americans report that they experience symptoms of stress (Anderson, Belar, Breckler, Nordal, Ballard, Bufka, Bossolo & Bethune, 2013). Stress is elicited by a variety of psychological stimulus associated with our jobs, our residences, our social interactions, and the activities we engage in (p. 249, Franken, 2007). Many Americans live with the burden of an unsatisfying job as well as a stressful workplace. An online survey of 1,848 people in the United States, conducted by the American Psychological Association, found that 74 percent of

The study sought to improve patient care in three areas. The first area was improving pain assessment documentation by introducing a standardized pediatric assessment. The second area was decreasing the time the patient received pain medication. The last area was evaluating the effect of the nursing intervention in reducing the pediatric patient’s pain at discharge via a pain scale. This study was conducted at a 35 bed level 2 emergency department in the United States. A total of 1200 EMRs were collected from pediatric patients ranging from 3 months to 6 years in age (Ramira et al., 2016, p. 43). Half of the cases were review before the