Pain In Neonates

There are more than 70% of premature babies that are born between 34 and 36 weeks gestation a year. When a baby is born early, or born with birth defects, the Neonatal Intensive Care unit is its first home. The nurse’s in the NICU have the difficult job of preparing baby’s and parents for a health life together. A baby who has been put into the NICU will stay there until it is healthy enough to go home.

Special care and attention must be given to infants in the Neonatal Intensive Care Unit (NICU) because of their small size and the health complications they face. One particular challenge faced by health care professionals in the NICU is the management of pain for preterm babies. Preterm infants must undergo a wide range of tests, procedures, and, often, life-saving measures during their hospitalizations, which not only subjects them to pain, but pain-related stress and anxiety. This has an impact on the infants themselves, as well as on the family members and friends who are involved in their care (Smith, Steelfisher, Salhi, & Shen, 2012). The purpose of this paper is to examine the problem of pain management among preterm NICU patients and propose the implementation of kangaroo care as a pain management technique.

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.

First pain is an everyday experiences that is expressed through the use of language and is then legitimized (Waddie, 1996). If a patient as a history of depression or chronic pain they have pain every day and the concept is used to help explain their pain. As nurse we use the concept of pain to find a base line of the pain and to assess new pain. In surgical patients they may have multiple types of pain from the incision, emotional, and history. The concept educates the nurse of the different form that pain can present itself. Pain can also guide how we treat the patient. Emotional pain would not be treated with the “so know pain pills”, but with talking or listening to patient. Concept of pain also address the different form of patient and how the nurse and patient response to it. If a patient is having somatic pain from an incision the nurse could react by applying heat or ice. Pain is what the patient says it is.

Group members are struggling with the many facets of having a NICU baby. This session will deal with some of the very common issues. Parents of NICU babies are often worried about how slowly their child may be progressing in comparison to other babies. This session the group will work through some of those progressions and regressions and help the parents to cope with this. Parents are sitting in the NICU for hours, watching other babies do things that their baby is not doing. However, this session will help show the parents that they are all doing this. Every parent in the group has likely been the parent on either end of that frustration/joy. Regression can be hard for parents and does happen often during a NICU stay. Group members may show some reluctant to talk about their child’s set-backs. They may be discouraged by them. Parents have a strong desire to know when their child will be discharged from the hospital. This can cause them to become upset when that does not happen (Pepler et. Al, 2012).

In this study the researchers tested the pain responses in newborns who are experiencing heel sticks. They split forty-eight newborns into four categories, each with a different type if milk odor origination. The four groups were: own mother’s breast milk odor, another mother’s breast milk odor, formula milk odor, and a control group (Nishitani, 2009). Different reactions were recorded in the duration of the heel sticks such as crying out, grimacing, and motor activities. Another

Neonates were once thought to be too developmentally immature to experience pain, it has been now understood that neonates even if very premature are able to process pain sensations and respond to that pain (Boyle, 2011). Although it is now understood that neonates can sense pain, it has been found that procedures have not changed to adequately address pain in the neonate. It has been found that pain in neonates that is over a long period or multiple acute pain experiences has long term effects on how pain is perceived into childhood (Boyle, 2011). One intervention that has been found to decrease pain experienced by a neonate is sucrose. It has been found that sucrose takes about two minutes to take effect and provides an analgesic

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

This is a study that focused on eighty-three women and examined the effects of cultural and educational influences on the pain in childbirth. The eighty-three women are divided into Middle-Eastern women and Western women. The women ranged in ages from nineteen to thirty-eight. There were thirty people from the Western group and that consisted of women whose mothers were born in Europe, the US or another English speaking country. There were fifty-three women from the Middle Eastern Group and that consisted of women whose mothers were born in Asia, North African or another Middle Eastern countries. The women were classified by the cultures but were also classified by their level education. Those who had twelve years or less of schooling were in the low education group. Those women who had more than twelve years of schooling were in the high education group. In the Western group sixty-six percent were in the high education group. While the Middle Eastern group only had thirty-three point nine percent in the high education group.

The nurse must be mindful of each intervention initiated and the possible benefits of the intervention against its potential harmful effects for both mother and fetus. Not providing basic comfort measures for the mother can cause serious physical and emotional problems and could lead to possible fatigue and feelings of failure from the mother. The priority of this nursing intervention is to provide the mother and fetus with the least discomfort as possible and

Patient’s in the NICU are considered to be very tiny and fragile and immunocompromised due to their immature organ systems which can lead to many dangerous medical problems. Patricia W. Stone states “maintaining a safe environment reflects a level of compassion and vigilance for patient welfare that is as important as any other aspect of competent health care” (Stone, 2008). The patient’s safety should always be a top concerned for a nurse because in a health care facility the purpose is to heal the patient and get them on the road to recovery. Nurses must learn from the errors of the past and use their knowledge to improve the quality of nursing to the patients to ensure if errors do happen again that the use of evidence-based practices are put into place to improve their outcomes. According to Higher Quality of Care and Patient Safety, “Registered Nurses (RNs) are instrumental in achieving multiple care goals, including promoting infant health and clinical stability, maintaining the integrity and cleanliness of central catheters, and preparing families for their role in infant care and successful transition it home” (Lake, 2016). Nurses are reasonable for the education of the families of the patients to ensure that the best quality of care for the patient is maintained outside the hospital to ensure the best medical outcome for the infants.

Childbirth is a beautiful thing. After the hours of labor, there is nothing more special than having the newly mother able to hold her child the minute after it’s born. It makes the pain that you had just experienced go away because all that matters in the world is that newborn child in your arms. During labor, every woman has her own experience but one common experience is the pain. According to Kitzinger (1978) “Labor pain can have negative or positive meaning, depending on whether the child is wanted, the interaction of the laboring woman with those attending her, her sense of ease or dis-ease in the environment provided for birth, her relationship with the father of her child and her attitude to her body throughout the reproductive

Specific Purpose: To inform my audience about the different forms of pain management used during childbirth.

Childbirth can be described as one of the most rewarding and also painful experiences in a woman’s life. Most women choose some type of method to ease pain, however, there has been a lot of controversy over with pain management method is the most effective. According to the CDC (Center for Disease Control), In 2013, there were 3,932,181 births recorded in the United States, 32.7% of those births were surgical procedures. In 2012, 1.36% of recorded births occurred out-of-hospital, meaning these births took place mostly in homes or birthing centers. Without the option of medicine that a hospital provides, how were these women able to manage their pain during labor and delivery. There are many different methods for easing pain during childbirth, some methods involve the use of medicine and surgery, and others include natural techniques, such as hypnosis, Lamaze, and many others. It is a personal preference of the parents over which method is right for the needs of the mother and child. This can be an overwhelming decision for new parents to make because they have to take into consideration the safety of the mother and child, pain management for the mother and desire for medical involvement.

Nurses working within the neonatal unit require a particular set of skills to adequately fulfil their roles and responsibilities within this fragile setting. The role of a neonatal nurse is to provide intensive nursing care to an infant who has inherited complications at birth due to varied reasons (Tubs-Colley, Pickler, Younger, & Mark, 2015). These complications often manifest as undeveloped internal organs that make simple bodily functions such as breathing and regulating body temperature incredibly difficult. The neonatal nurse provides close monitoring and extremely individualized care per patient to stabilise and further develop these body systems artificially post-uterine (Drozdowicz & Dillard, 2014).