Pediatric Nursing

For the purpose of confidentiality the name of the case study, has been changed
(UKCC 1996) The aim of this essay was to select a client, the client in this
case being a ten-year-old boy with cystic fibrosis, in a hospital setting. To
assess the holistic needs of that client, using Beck, Williams and Rawlings
The five dimensions of self, (Beck 1993) Josh has lived with cystic
fibrosis for 7 years People with CF suffer from chronic lung problems and
digestive disorders. The lungs of people with Cystic Fibrosis become covered
with sticky mucus, which is hard to remove and promotes infection by bacteria.

Many people with CF require frequent hospitalisations and continuous use of
antibiotics, enzyme supplements, and other medications. Born and living in hull
59 miles away, Josh has to be admitted to this ward every two months for
treatment, when admitted he generally remains in hospital for three weeks. Josh
has no father, but has a mother who is very protective and takes a keen interest
in his care. His mother who works as a sales assistant in a small shop in hull,
travels with Josh every two months and stays with him for the duration.

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Intellectual Dimension Education has been provided in hospital for many years,
the 1944 education act stated that all children should be educated according
to age, ability and aptitude (Hull 1989). One of the problems with having to
attend the ward every few months is the lack of schooling Josh received, and
increased chance that he will get behind in his schoolwork. This is why it is
extremely important that education and homework should continue in hospital. The
teacher on the ward that I worked came to see the children at 9am until 12pm
Monday to Friday, spending around 15mins with each child. Having spoken to the
teacher she said that she has to find each childs level, and work from that.

This has its benefits, giving the child the one to one tuition, however in
Joshs situation, he wasnt very well, and didnt feel particularly
motivated. The last thing he felt like doing was schoolwork. The teacher did
nothing to motivate Josh, she would explain what he had to do, and then leave
him until the following day. As soon as the teacher had gone, he would put the
work down and do something else. It was left to the nurses on duty to motivate
him to do his work, which during busy periods was quite difficult, so regardless
of the teacher being employed by the hospital, I dont believe in Joshs
case it was very useful. Making it a little more interesting would have helped,
and spending more than fifteen minutes to actually sit and go through the work,
would not only ensure that he did the work but gave some contact with another
person Emotional The emotional state of the child is also a crucial element in
development and health. According The Department of Health, We now have a far
greater knowledge of how children develop both emotionally and physically. With
that understanding has come an awareness of the emotion vulnerability of the
child and the effect which early experience can have on later development, (DOH
1991) Joshs mother was very anxious about Josh and about her job, she was
finding it incredibly difficult to hold onto jobs that allow her the time she
needs to spend with Josh every few months. To help with the accommodation aspect
of her living temporarily in Leeds, there is a building for families called
Ecclesley house, which is situated in the grounds of St James hospital. It
enabled parents to be close to there children and to have all the comforts of
home. This is not only hugely beneficial for the parent but also for the child.

It was especially advantageous for Josh and his mum, who came all the way from
Hull. It was important to allow mum to be able to ask any questions she wanted
and to have those questions answered in a clear legible way. It was important to
allow mum to have as much hands on care for Josh as possible, giving her some of
the responsibility of care for Josh. This is known as family centred care,
Family centred care can be described as a multi-faceted concept incorporating
interaction between child, family and nurse, to provide holistic care,
(Brunner and Studdarth 1991). Providing an opportunity for the family to care
for their hospitalised child under nursing supervision, (Brunner and
Studdarth 1991).


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