Journal

Nursing Care of Children and Families
NURS 4832L Tuesday Clinical
Michele Smith
Akron Children’s Hospital Beeghly Campus
Pediatric Surgery
6505 Market Street
Boardman, OH 44512
Rose Mae Lopez, MSN, RN, CPN
November 28, 2023

1. Recognize the specialized nursing care needs of the infant or child in a surgical
environment including the preoperative, operative and post-anesthesia care units.
One of the most important responsibilities a nurse has during the perioperative
process is maintaining patient safety. During the preoperative phase, the nurse
verifies the patient by name and birthdate as well as confirming that a true
understanding of the upcoming procedure is had. In the cases that I was able to
view, the parents were asked to verify their respective patient’s information and were
also able to describe the procedure for which the child was being prepared. The
nurse also verifies the last time the patient had anything to eat or drink and confirms
any known allergies the patient has. All of these steps are done to ensure patient
safety. Of course, offering emotional support is important for the patient and his/her
family. Establishing a trusting rapport and reducing anxiety regarding the upcoming
surgery is key. Providing reassurance and answering any questions helps to provide
this support.
During the interoperative phase, the nurse continues to advocate for patient safety
by performing a time-out immediately before the procedure begins. This ensures
that all members of the operating team agree what surgery is being performed and
what that procedure entails.
Ensuring safety for the patient continues during the postoperative phase for the
nurse up until the time the patient is discharged from the hospital. Monitoring vital
signs and staying at the bedside until the patient awakes from anesthesia helps to
do this. Once it has been confirmed that no complications will arise (approximately
30 minutes) the parents/family members are encouraged to come be with the
patient so that they can be present when the patient awakes. This is especially
important for infants and toddlers, as they can be quite anxious and disoriented
after awaking from anesthesia. Prior to discharge, the nurse explains any instructions
for the patient along with offering any potential reactions/behaviors that may be
observed after going home. This anticipatory guidance helps to inform the
patient/family of what could be expected or not expected, as well as when
something may warrant a call to the doctor.
2. Identify the interdisciplinary team approach to prepare the child for the
surgery/procedures scheduled.
In addition to the nurse verifying patient information and understanding, the

anesthesiologist and the doctor meet with the patient and his/her parents do the
same. They review what is his/her role and responsibilities are during the procedure
that is being done, oftentimes offering an estimate of the length of time the surgery
will take. They also avail themselves to any questions or concerns regarding the
procedure at this time. This helps to relieve any stress or anxiety regarding the
procedure that the patient or family has.
3. Discuss the role of the RN as the primary care giver to the child and family. Include
discussion of the teaching role.
The RN plays a pivotal role in the pediatric setting, as takes on several
responsibilities as such. Health promotion is key. This includes educating the parents
or family members, as well as the child, appropriately, to help lead them toward
independence for, in addition to playing a primary role in, taking responsibility for
the child’s overall health. Health promotion is difficult to achieve without the
understanding and support of the child’s family.
Although the parents or caregivers for the child play a pivotal part in the child’s care,
advocacy for the child is a role that the nurse must play, legally and ethically. The
child is the nurse’s patient; therefore, the nurse has a responsibility to advocate in all
areas of health promotion for and on behalf of the child.
The nurse must be able to communicate effectively with both the child and his/her
family. The nurse may use play or other developmentally appropriate
communication techniques to accomplish this.
Effective education to the child and the family is one of the major avenues that is
used by the nurse that helps children and families make informed decisions. The
nurse be able to provide that teaching to a preschooler as well as an adolescent;
therefore, being able to do appropriately is crucial to learning.
4. Identify the role of the Child Life specialist in the operative environment.
The Child Life specialist’s goal is to assist children during any medical tests but also
to help those children prepare for a surgical procedure. This is done through
education, rehearsal or role-play, and enhancing coping skills. This is done for the
patient’s as well as the parent’s benefit. When the patient is an infant, an important
task is to attempt to earn the child’s trust to decrease any anxiety the child may have
when separated from his/her parents and taken to surgery. This can be done by
playing with the child or by simply being present so that the child is able to become
familiar with the specialist’s face. When the patient is a school-age child or
adolescent, role play and/or distraction can help to ease the patient’s anxiety. One
procedure I was able to observe involved a 16-year-old whose stuffed animal
accompanied her to surgery donning its own surgical cap and “IV.”
5. Impression
I enjoyed my time observing the various procedures while in surgery. I was able to
see how the child patient is ALWAYS the priority, and how so many people came
together to achieve a common goal for the best outcome of the patient. Needless
to say, this did not surprise me at all. It has always been my observation that the
nurses and medical personnel work together so cohesively, that only the best kind
of care can be provided to the patient and his/her family.

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Nursing Care of Children and Families

NURS 4832L Tuesday Clinical

Akron Children’s Hospital Beeghly Campus

6505 Market Street

Rose Mae Lopez, MSN, RN, CPN

November 28, 2023

In addition to the nurse verifying patient information and understanding, the

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