Women’s Health and Neonatal Care – Page 5

January 01 2017

Judging the Quality of Research Articles

In this study fifteen mothers who had babies born in to the Neonatal Intensive Care Unit (NICU) were evaluated using Spradley’s domain analysis approach. The purpose of the study was qualitative to show how parents develop an ownership as a mother to the baby in the NICU. The study was also quantitative because mothers in the NICU dealt with all emotions that they felt throughout different stages in their stay from stress to grief and feeling like they could not take care of their baby (Heerman, Wilson, & Wilhelm, 2005). The researchers clearly stated their purpose in confirming their suspicion and that is that parents in the NICU do not feel like the baby is theirs until they go home with the baby. This method of study is done interview style and using different stages, meaning parents staying there from at least one week with a 24-34 week gestation baby. The study used middle class mothers that were Caucasian.

The method of study is a valid one to obtain research, however I may have opted to use mothers of different ages, different races and more than one hospital. The factors that I feel interfered with the integrity of the research study is that the people were all of one socioeconomic class and race. This does not give a valid study to the rest of the population, because premature birth does not make exceptions to race, economic status, geographic location, famous or not famous, it can affect anyone. A resource that would help would be other studies that used qualitative research as well with a broader subpopulation.

Although the study only used one socioeconomic class and one race, the study does express the issues that have been mentioned in other studies that talk about what parents feel when they are in the NICU like the study conducted by Dudek-Shriber that showed the stress of parents while in the NICU. The study that Dudek-Shriber utilized was a larger group of mothers and also a diverse population. In comparison to the current study, Dudek-Shriber’s study was more accurate because there was variety in stages of birth, race, mother’s age and the length of stay in the NICU (Raines, 2013).

There are clear links in the subpopulation collected by the researcher to obtain the conclusion obtained, which is that mothers feel like a visitor instead of a mother when they have their baby in the NICU. They do not feel that the baby is theirs until they go home. Now some mothers do feel that they are a part of the baby’s life while they are in the NICU from day one and get involved to the point that they start to act like the staff according to the results. These moms will use the same language to describe their baby but it is not really identifying them as a mother, they are still referring to the baby the same as the nurses. The bonding has not occurred when the mothers are going through the motions that the nurse are going through.

This study cannot be generalized as the researcher only used one race and only fifteen mothers. It was very specific to the one NICU. This study population is of course similar to the population I will be working with, because as noted earlier, prematurity does not make exceptions to race, economic status or age. The researchers concluded that nurses in the NICU need to ask the mothers if they want to be involved at the different stages of the baby’s care so that they can feel connected as a family. Nurses are sometimes very quick about their agenda and will forget to ask the mothers about being involved because they have an agenda to take care of.

References

Heerman, J. A., Wilson, M. E., & Wilhelm, P. A. (2005, May/June). Mothers in the NICU: Outsider to Partner. Pediatric Nursing, 31(3), 176-200.

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October 10 2016

The Affordable Care Act and Nursing

Provisions that Will Afford Immediate Improvement for Health Care

The American Nurses Association for many years has been trying to get congress to pass a law affording health insurance for their nurses and everyone else. When Congress passed the Affordable Care Act, more commonly known as Obamacare, they felt they had won the battle. People in all walks of life were able to maintain health insurance based on what they could afford to pay and there was no longer the stigma of preexisting medical conditions denying coverage for anyone (American Nurses Association, n.d.).

Provisions that Will Fail to Address Deficiencies and Access

On the surface it appears that Obamacare would be a great service for premature babies that will require preventative treatment for a condition known as RSV (Respiratory Syncytial Virus). The problem is that most recently the American Academy of Pediatrics lowered the amount of time that a premature baby can receive treatment for prevention of RSV. Initially it was given to the babies under 2 yrs of age every month for a total of 5 months to get them through the season. Due to the recommendations that the Obamacare made, this was drastically reduced to one every month for 3 months and some babies will only receive 1 dose. This was due to the cost of this preventative treatment (Ertelt, 2013).

Challenges that affect Implementation of the Affordable Care Act

The most challenging aspect of implementing the Affordable Care Act in the United States is cost. The insurance is based on a sliding scale and some folks may pay something and others do no pay anything. The problem with this is the type of service that the patient receives. If the patient does not have good insurance, they will be discharged sooner than later from the hospital.

Ethical Issues that Arise as a Result of Affordable Care Act

The ethical issues that will come up are always the issues of saving a life. When the Affordable Care Act was signed in to law, it was noted that Americans would not be paying for plans that paid for abortions. Yet it was discovered that it was documented in the plan that this would be covered. Through lobbyists this was changed and if a person would like that part added to their policy, the client will pay 1.00 or so more per month to have that coverage added.

In the state of Florida people can have late term abortions up through 24 weeks. Institutions or private physicians can refuse to do these abortions without any penalty. According to statistics, Planned Parenthood received $528 million dollars in federal funding in 2013 (Ertlet, 2014). It is unclear as to how much is being donated to preterm births. In conclusion, maintaining a baby in the NICU is far more costly than providing what society calls today a simple abortion. The costs of a NICU stay can be anywhere in the $2 million dollar range alone in the hospital, this does not include the cost after the infant is home for medications, homecare, therapy, doctor’s appointments with specialists and any other needs for equipment that the baby may have. The cost of an abortion depending on the stage that the pregnancy is at can range from $300 to obtain the abortion pill, which also in some locations is administered free early on to an estimated cost of $2050 for later term abortions (All Women’s Clinic, n.d.).

References

All Women’s Clinic. (n.d.). http://allwomensclinic.com/fees.html

American Nurses Association. (n.d.). http://www.nursingworld.org/healthcarereform

Ertelt, S. (2013). Death panels for babies in Obamacare: Kids with RSV should beware. Retrieved from http://www.lifenews.com/2013/04/11/death-panels-for-babies-in-obamacare-kids-with-rsv-should-beware/

Ertlet, S. (2014). GAO report confirms Obama lied: 1,036 Obama care plans pay for abortions. Retrieved from http://www.lifenews.com/2014/09/16/gao-report-confirms-obama-lied-1036-obamacare-plans-pay-for-abortions/

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October 10 2016

Stress Levels Among Parents of Premature Babies in the NICU

For parents of premature babies, every moment in the NICU brings a mix of hope, fear, and overwhelming stress. Various studies have been conducted on the stress levels that parents of premature babies experience while their infants are in the Neonatal Intensive Care Unit (NICU). A qualitative study was conducted to explore this subpopulation, using semi-structured interviews with two mothers who experienced preterm labor. The mothers reported feelings of separation anxiety after delivering prematurely. They described a sense of a shattered dream, as their ideal scenario of an uncomplicated birth and taking their newborn home immediately was disrupted (Da Costa Krieger et al., 2014).

Numerous studies confirm that parents of premature babies experience high stress, making this a valuable population for ongoing research to identify supportive interventions. Using Spradley’s domain analysis, the study highlighted that mothers were stressed not only because their baby was in the NICU, but also because nurses sometimes made parents feel like visitors rather than primary caregivers (Heerman, Wilson, & Wilhelm, 2005).

These findings emphasize that, regardless of sample size, the common denominator remains: parents of premature babies endure significant stress. This stress is compounded at home due to family obligations, financial concerns, complex schedules, hospital visits, and caring for other children. The NICU itself adds another layer of anxiety, as parents worry about the survival and well-being of their infant.

Conclusion:
While the NICU journey can be overwhelming, parents are not alone. With compassionate healthcare teams, proper guidance, and ongoing support, families can gain confidence and find strength in caring for their premature babies. Every step, no matter how small, is a milestone worth celebrating, and creating a nurturing environment at home helps both parents and infants thrive.

References
Da Costa Krieger, D., Valeria de Oliveira, J., Bittencourt, V., Garcia Parker, A., Ambrosina de Oliveira Vargas, M., Regina de Luz, K., & Marin, S. (2014, August). Perception of Prematurity: A Case Study Aimed at Approaching Mothers. Journal of Nursing, 2754-2761.

Heerman, J. A., Wilson, M. E., & Wilhelm, P. A. (2005, May/June). Mothers in the NICU: Outsider to Partner. Pediatric Nursing, 31(3), 176-200.

October 10 2016

From NICU to Home: Supporting Parents of Premature Babies Through the Transition

Going home from the NICU can be one of the most stressful moments for parents of premature babies, especially without proper guidance. Families often face the challenge of caring for a baby who requires more attention than a full-term infant, and without a structured transition program, the stress can quickly become overwhelming.

The implications of current discharge practices are significant. Parents of premature babies may experience depression and anxiety due to the high level of responsibility and uncertainty. While in the NICU, families endure the emotional roller coaster of whether their baby will survive. Once the infant reaches a stable point, planning for home care begins. If the baby requires tube feedings, oxygen, a tracheostomy, or monitoring devices, major family adjustments are necessary. One parent may leave work to provide care, and missed home health visits can create unsafe situations, placing the primary caregiver under intense stress and extended hours of vigilance.

A multidisciplinary team—including nurses, doctors, occupational therapists, child life specialists, and nurse educators or consultants—should support families during this transition. The bedside nurse is particularly critical, as they develop the closest relationship with the family and understand the baby’s daily needs.

Parents benefit from clear, step-by-step instructions, demonstrations, and written reference materials that they can consult at home (Ronan et al., 2015). Current educational resources often use full-term infants, which does not realistically reflect the challenges of premature babies with medical complexities. Future research should include infants of varying gestational ages and medical conditions to better guide transition programs.

By implementing structured transition programs, NICUs can help reduce parental stress, promote family safety, and improve long-term outcomes for premature infants.

Reference:
Ronan, S., Liberatos, P., Weingarten, S., Wells, P., Garry, J., O’Brien, K., & Nevid, T. (2015, March/April). Neonatal Network, 34(2), 102. http://dx.doi.org/10.1891/0730-0832.34.2.102

February 02 2015

Feeding Readiness for Preemies

One of the most exciting moments for a parent of a NICU baby is when you can start feeding the baby from the bottle. Most are not able to do the breast feeding due to the difficulty latching on, but what a joy to feed your baby even if by bottle whether it is your breast milk or specialized formula. There are different opinions in the medical community around feeding readiness. My passion for the neonatal intensive care unit arose from having a premature infant myself. My son was given breast milk initially via NG Tube until he was ready to try a bottle. Initially the bottle feeding was started once per day and increased and they would leave the bottle feeding for when the parents were there to feed the baby to create that bonding experience. One day I arrived at the NICU on a weekend ready to spend the entire day with my son. I was excited to feed him several times per day, but I was greeted by the shift nurse telling me that I was doing it wrong. She took over the feeding entirely and when the rest of the feedings occurred that day, she took over stating that I was making the baby aspirate due to my inexperience. I was only allowed to hold him. When change of shift occurred she said okay time to go, I stated that we were in a private room and the nurses close the door so that we do not have to leave during change of shift. We were in a private room because at one point the baby had developed a hospital borne infection called serratia and would remain in a private room until discharge. Staying in the room was an arrangement that I made with upper management due to the fact that I worked full-time as did my husband and we did not have much visit time with him during the week. She proceeded about her business and ripped the baby right out of my arms.

I cried for days until Monday came and I made a complaint to my head nurse who assured me that this was documented in my chart right on the front that I was allowed to stay whenever I needed to. She showed me the chart and stated that she would speak to the nurse about her abruptness. The weekend nurse apologized to us a few days later, but by then my feelings were already crushed. It was later discovered that the baby was aspirating even when he was fed via g-tube it had nothing to do with how I was holding or feeding him. It was inevitable. In the end, it was decided that the baby would have a Mickey G-tube inserted surgically for feedings to expedite his discharge to home.

As nursing professionals we need to be sensitive to the needs of our patients and their families. We should always read the chart prior to walking in the baby’s room and talking with the family to see if there are any new changes since last you saw the baby. How could the nurse that was in charge of my baby rip him right out of my hands and ask us to leave.? When you look at how he was being fed here vs those those nurses that truly cared about bonding .