Nurses Care for Children With Disabilities, Essay Example

Children with disabilities are in need of a primary care team that is comprised of doctors, specialists and nurses whom act in prevention and later care. There needs to be a new way nurses approach the care of these children that focuses on “improving chronic care outcomes” (Parrin, 2012, p. 149). Over the past twenty years, this care has become more focused but is still lacking in certain areas, especially in regard to children with disabilities. With the aid of certain organizations (World Health Organization) there are innovative practices by the primary care team that may be beneficial to these children, as Parrin (2012) states, “there are opportunities to improve that care and diminish hospital use…imaginative use of team care, meeting all the characteristics of the chronic care  model, may decrease hospital use and costs while improving outcomes, especially participation in normal childhood activities” (p. 153). In evaluating quality of care, the disease functions as an indicator as to how the primary care team (e.g. nurses) should handle biological questions and the need of the child patient.

In the case of children with Down Syndrome abnormal growth “results in the cognitive and physical impairments” (Hughes & Cardwell, 2011, p. 14). This results in severe intellectual disability that results in the dependency on primary care team members or family members in order to properly function in the world. The developmental delay in certain motor functions such as sitting up independently, holding objects, and other physical activities takes months longer for a Down Syndrome child to overcome. When parents fail at providing a more stimulating environment for such children (an environment that fosters adequate learning and use of motor skills) the primary care team comes into play.

The nurse’s job during this time is to be an advocate of the child as well as of certain medical practices. Usually this function comes in to play as being a liaise for the play therapist during the child’s motor functioning skill development. The nurse advised the therapist on how certain play functioned to aid in cognitive abilities. During this time the nurse assesses where the child is developmentally so that milestone markers can be compared to the “normal” developmental markers. The nurse will pay attention to the child’s “gross and fine motor abilities, posture, co-ordination and capacity to learn new skills” (Hughes & Cardwell, 2011, p. 16).

It is also important to note that a child with Down Syndrome may best communicate through a series of nonverbal cues that may both tax and aggravate all parties involved. As language development is stunted in Down Syndrome individuals, and the ability to learn to speak for any infant is it’s own milestone, the double weight of factors playing against a child with Down Syndrome because a significant, if challenging, milestone. A nurse must function as a patient person and pay attention to the child’s nonverbal cues, or perhaps use the guess and check method (i.e. picking up various toys or food and seeing which one the child responds to positively). The child may also use nonverbal gestures to relay emotion, instead of using words, as at certain developmental stages the child with Down Syndrome is significantly behind in language development, they may rely on these gestures for a longer period of time. Thus, the child won’t vocalize needs, wants, desires such as hunger, urination, defecation, or tiredness, but rather, the nurse must keep a time schedule and keep apprised as to how much water the child has drank, how much sleep they’ve gotten (as well as when they’ve gotten it) etc. in order to properly function in their role as care taker. As Hughes and Cardwell (2011) state, “when assessing his pain level, nurses observed his physiological status and behaviour by using the paediatric [sic] pain profile scale … which is suitable for managing pain in children with severe learning disabilities when used in conjunction with parental input” (p. 17). The purpose of such work isn’t just to allow the child to begin proper human functioning but to eventually allow the child to improve their transitional states all the way until their adulthood; in other words, nurses foster independent self-care for children with disabilities.

Nurses are involved in health promotion and skill development for children with disabilities in order to enhance or improve this transition into independent adulthood. The function of a nurse in this capacity is to help children use preventative care knowledge (children with diabetes using early warning detection devices) that aid with the “decrease in the number of emergency room visits and hospitalizations” (Blomquist, 2006, p. 183).

Nurses also function as counselors to the child, family and the primary care physicians; nurses may also “help young people with disabilities by focusing on health promotion and healthcare regimen education and skill development, independent living, work and social skills…help the families and youth develop positive attitudes and high expectations about their abilities to manage their conditions, obtain education, work, and be productive members of their communities” (Blomquist, 2006, p. 183).

The nurse may also fulfill the role of a social worker as they can point the child and family in the direction of potential jobs that the child may be capable of handling with their disability, or even to schools that offer special learning disability programs (such as tutoring) to children with special needs.

References

Blomquist, K. B., (2006). Health, education, work and independence of young adults with disabilities. Orthopedic Nursing 25(3), pp. 168-187.

Hughes, L., & Cardwell, P. (2011). Care of a child with Down’s Syndrome. Learning Disability Practice 14(10), pp. 14-17.

Perrin, J. M. (2012). How can quality improvement enhance the lives of children with disabilities? Future of Children 22(1), pp. 149-168.