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Category Archives: Women’s Health and Neonatal Care

January 01 2019

The Pain of a Child and Jean Watson’s Theory

Author Rosie's Nurse corner Posted on Categories Women’s Health and Neonatal Care

What a difficult job it is for nurses that take care of kids that are in pain; these nurses make a difference in each child’s life that they touch.   Jean Watson’s theory of human caring is a good example of our human caring for others.  Jean Watson’s theory of human caring focuses on giving as an extension of self.  It is about instilling faith and hope in a person (Alligood, 2013).   When a person is sensitive to another person’s feelings, it helps to build a trusting relationship.  It is important to acknowledge the positive and negative feelings that a person puts out to another person.

Jean Watson believes in her theory that we experience personal growth through teaching and learning as well as spiritual and socio-cultural well-being.  Jean Watson’s theory emphasizes spiritual and nursing practice, which in turn will promote caring and love to the patient.  This will then develop into a caring relationship.    The theory allows the nurse to understand the other person’s perspectives on things and form a mutual bond.  It also promotes growth when a caring environment is formed allowing the patient to be who they are and be accepted for it.  In the case of caring for a child, it creates a  natural caring environment that will help the child and the parent cope during a difficult time.

References

Alligood, M. (2013). Nursing Theorists and their Work (8th ed.). Retrieved from http://online.vitalsource.com/books/9780323091947

Dr. Rosie Moore https://rosiemoore27.com/

January 01 2019

Theoretical Models and Research

Author Rosie's Nurse corner Posted on Categories Women’s Health and Neonatal Care

There are several theorists that can fit the neonatal population, but the one that I am selecting today is Florence Nightingale.  Although she is one of the oldest theorists, her model can still be applied to everyday nursing.  All patients are prone to getting an infection; however, the Neonatal Intensive Care Unit (NICU) is particularly at risk.  Florence Nightingale gave us some principles that would help many of our patients.  She believed in keeping the environment clean, therefore observing good infection control.  She also believed in keeping the patient in the best condition and letting nature take its course or “God.” So Florence did have a spiritual connection which made her sensitive to cultural awareness of others (DeNisco & Barker, 2013).

I believe Florence Nightingale’s research model is quantitative.  She believed that if an environment was kept clean, that the patient would not develop infections.  She believed that nurses needed to wash their hands frequently.  Back in that era, this was not a highly common practice.  Bringing it to this generation, looking at the NICU, it makes sense.  The NICU believes in keeping a sterile environment allowing only certain visitors to see the babies and frequent hand washing and scrubbing for the staff and the parents.  When parents are sick, they are asked not to come to the NICU, if a baby is sick, the parents are asked to wear a mask, gown, and even wear gloves, depending on the baby’s condition. This is an example of keeping the environment free of infections so as not to spread it to the babies (Alligood, 2010).

References

Alligood, M. (2010). Madeleine M. Leininger: Modern Nursing. In Alligood Introduction to the Nursing Theory (7th ed. (p64). Retrieved from Vital Source Bookshelf

DeNisco, S. M., & Barker, A. M. (Eds.). (2013). The slow march to professional practice. Advanced Practice Nursing (2nd ed., pp. 6-17). [Vital Source Bookshelf].

Dr. Rosie Moore https://rosiemoore27.com/

 

October 10 2018

What is a Father’s Role When the Doula is There?

Author Rosie's Nurse corner Posted on Categories Women’s Health and Neonatal Care

The doula never takes the father’s role in the birthing process.  The doula enhances and compliments the father’s role during the entire birth.  In this generation, more fathers are becoming involved in the process of birth.  However many fathers still want to be there for their partner, but maybe not in the coaching aspect for fear that they may do something wrong.  Have no fear dads, you cannot do anything wrong.  When the doula is there, she will guide you through the process of being your partner’s support system.  With the doula there it gives the father flexibility to rest, has a bathroom break, eat, and most importantly learn the techniques that will be needed during the difficult time of labor.

www.windermerebabyandfamily.com

 

September 09 2018

Case Study on Continuous Support During Birth

Author Rosie's Nurse corner Posted on Categories Women’s Health and Neonatal Care

Most recently I was contacted by a mother to be who was interested in having a doula at her birth.  She was very excited to have a natural childbirth because she had heard about horror stories when women went into labor and their doctor rushed them through the delivery.  Much to her disatisfaction, she was told that she could not have a doula and her family in the room at the time of delivery, she had to make a choice because the doctor did not want that many people watching.  I let her know that the choice was ultimately hers as we are not friends or family but we are part of the medical team helping the moms to be through labor and delivery.  She decided that she would go with her family in the room and hope for the best.

Delivery day came and she was very excited to give birth, what she did not anticipate was being in labor for almost 2 days with a failure to progress.  She received her epidural the minute that she arrived there and she thought surely she would deliver within a few short hours.  Well, she notes that was not the case after she failed to progress.  The Epidural slowed the labor down and because she was bed bound, she was not able to put all the labor tips into action to help herself along.  She ended up with a C-section for failure to progress.  The good part is that both mom and baby are doing great, the sad part as she put it was that she was never given an opportunity to try to birth her baby naturally before she was offered an epidural the minute she walked in the door.

The benefits of having a doula documented by the 2017 Cochrane Review indicated that having continuous support for women during childbirth, showed positive outcomes when a doula was part of the birth team.  When a doula is present, it decreases the chances of having pain medications, c sections, and it helps the mother have a positive birth experience that she will remember for life.

Here is the study that was done by the Cochrane Review https://www.cochrane.org/CD003766/PREG_continuous-support-women-during-childbirth

  • Review: 26 studies on the effectiveness of continuous support during labor, which can include doula assistance. The studies included more than 15,000 women from a variety of backgrounds and circumstances.
  • Results: “Continuous support during labor may improve outcomes for women and infants, including increased spontaneous vaginal birth, shorter duration of labor, and decreased cesarean birth, instrumental vaginal birth, use of any analgesia, use of regional analgesia, low five-minute Apgar score, and negative feelings about childbirth experiences. We found no evidence of harms of continuous labor support.”
  • Quick birth terminology lesson: “Analgesia” refers to pain medication and “Apgar score” is how babies’ health is assessed at birth and shortly afterward — the higher the score, the better.The researchers also looked to see if the type of support made a difference. They wanted to know—does it matter who birthing persons choose for continuous support? Does it matter if they choose a midwife, doula, or partner for continuous support? The researchers were able to look at this question for six outcomes: use of any pain medication, use of Pitocin during labor, spontaneous vaginal birth, Cesarean, admission to special care nursery after birth, and negative birth experiences.For two of these outcomes (designated with asterisks*), the best results occurred when a birthing person had continuous labor support from a doula– someone who was NOT a staff member at the hospital and who was NOT part of their social network. The researchers found that overall, people who have continuous support during childbirth experience a:
    • 25% decrease in the risk of Cesarean; the largest effect was seen with a doula (39% decrease)*
    • 8% increase in the likelihood of a spontaneous vaginal birth; the largest effect was seen with a doula (15% increase)*
    • 10% decrease in the use of any medications for pain relief; the type of person providing continuous support did not make a difference
    • Shorter labors by 41 minutes on average; there is no data on if the type of person providing continuous support makes a difference
    • 38% decrease in the baby’s risk of a low five minute Apgar score; there is no data on if the type of person providing continuous support makes a difference
    • 31% decrease in the risk of being dissatisfied with the birth experience; mothers’ risk of being dissatisfied with the birth experience was reduced with continuous support provided by a doula or someone in their social network (family or friend), but not hospital staff

    The rate of special care nursery admissions was no different between people who received continuous support and those who received usual care. The rate of Pitocin was also no different but there was a trend towards more Pitocin with continuous support from hospital staff and less Pitocin with continuous support from a doula.

If you have questions about your birthing plan, contact us for a complimentary 20 minute call to discuss your concerns 407-760-1662 or email us at info@windermerebabyandfamily.com

  • www.windermerebabyandfamily.com
September 09 2018

The Benefits of Hiring A Doula

Author Rosie's Nurse corner Posted on Categories Women’s Health and Neonatal Care
Doulas provide emotional, physical, and educational support to expectant mothers during the labor process and postpartum.  The doula is professionally trained in childbirth with the purpose of helping women have safe, memorable experiences and empowering a birth the way the mother desires. The doula services begin typically a few months before the birth in order to establish a relationship with the expectant mother.  Having the relationship early allows the doula to answer any questions that the mother and father have prior to delivery, ease any anxiety, and assist in developing a birth plan. During labor, the doula will provide the mother with comfort measures, position changes, breathing techniques, and partner involvement in the birthing process.  A doula leads to a better birth outcome and helps to reduce complications for both mother and baby.    Doulas use touch and massage as a means to decrease stress and anxiety during labor.  They use the sound of their voice to have the mother focus during the difficult stages of labor allowing this moment to engage the birth partner on the focal point.

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