Stress and the Hospitalized Child discussion Postings

I have listed four discussion postings about stress and the hospitalized child...Please
Read through the posts; respond to a minimum of two posts where the expressed viewpoint is different from your own. Listed below is my own viewpoint:
Little stress is viewed as something normal, since everyone has stress in life. Though there are some assumptions from different persons, too much stress is not good. Being in the hospital can overwhelm a child as well as the family associated with the child. Besides being sick, children faces strange things happening to their lives hence increasing stress to the changes of environment, being separatd from parent, having no time to play are some of examples of stress that children faces while being sick.
Chronic illnesses of a child can be stressful on the immediate and extended family
Chronic illness impacts almost every phase of an individual's life and leaves a disturbing imprint on the lives of everyone involved. According to a research conducted by Boice (1998), 10% of the children in the United States suffer from a chronic illness. This has continued to show that chronic illness in children as well as adolescents has simply become one of the most serious in pediatric medicine to date (Marcia, 2011).
Different from the past, children living with these illness never lived long to become adolescent. However, this is no longer the case since research has been done and some treatment has erupted. Though this might be the case in the modern days, the specialized and time consuming care needed to cope with chronic illness can be emotionally and physically exhausting for the family of the person who is chronically ill.
Who do you think is most affected when a child is hospitalized?
Hospitalization of a child has direct and indirect effects on family members and their relationship. Though one may wonder who is much affected by such situations, parents as well those associated with the child are much affected (Susan, 1983). In some cases, they feel anger, denial, self blame, fear, shock, confusion and sometimes helplessness. This is brought about by the fact that chronic illnesses are usually not curable making them more stressful on wondering how to handle their loved ones.
Chronic illness has much effect in the family and children suffering from it. For this reason, proper understanding by the parents and relatives is fundamental for them not to reject the hospitalized children. Parents should learn how to support their children. Family members as well should support and while hospitalized, parents should make sure that they convince their children they will be back even if they leave them in the hospital.
While some procedures are being conducted to the child, parents should be with them to hold their hands and show support to them. Letting children understand what is happening to them is vital since this help them cope with the situation (Wolff, 1991).
In conclusion, chronic illness affects most people family; not only those who are suffers from it (children) but also the parents who are more affected. Families should learn to understand that once such misfortune happens to them, they should give support to their children. Considering children as different person from the family affects them and may result in death at an early age. Nurses should also help in showing family members how to take care of the children in their absence to make their life a little bit better.
London, Marcia L.. Maternal & child nursing care. 3rd ed. Upper Saddle River, N.J.: Pearson Education, 2011.
Farkas, Susan C.. Hospitalized children: the family's role in care and treatment. Washington, D.C.: Family Impact Seminar, National Center for Family Studies, the Catholic University of America, 1983
Wolff, Sula. Children under stress. 2nd ed. London [etc.: Penguin Books, 1991.
1)Bridget states that: Parents are stressed over their child's illness, having to miss work to stay with their child, leaving other children at home or with other caregivers and not being able to function in their normal routine. Some may even feel powerless because their child is hospitalized.
"Children are more vulnerable to the stress of hospitalization because they do not have a full range of coping mechanisms such as highly developed problem-solving skills." Quoted from: Ward, S., & Hisley, S. (2009). Maternal –Child Nursing Care: Optimizing Outcomes for Mothers, Children, & Families (Enhanced Revised Reprint). Philadelphia: F.A. Davis
Children's reactions to hospitalization are influenced by their developmental stage, previous experience with illness or separation and acquired coping skills.
A stay in the hospital can be difficult for a child at any age. Illness and hospital stays are both stressful. They disrupt a child's life and can interfere with normal development.
While they are in hospital, children may miss their friends and family. They may be bored, or they may be afraid. Children may not understand why they are in the hospital, or they may have false beliefs about what is happening to them.
How hospital stays affect children at different ages
A hospital stay will affect different children in different ways, depending on age, the reason for their hospitalization, and temperament. Temperament is how your child reacts to new or unfamiliar situations. For example, you might know your child to be easy-going, or more shy or unsure in new situations.
Birth to 12 months (1 year old)
Babies at this age usually develop many new skills. Being at the hospital sometimes does not allow them to practice these skills. These skills may included rolling, sitting, crawling, and walking.
Babies may not get enough sensory stimulation, for example music, sunlight, body positions, touch, and toys.
If the baby's family is not able to stay often or able to hold the baby, the baby's relationship with people may be affected.
12 months to 24 months (1 year to 2 years old)
Children continue to develop new skills. Opportunities to develop these skills may be limited by illness.
Daily routines are different and so sleeping and eating patterns can change while your child is in hospital. Once your child is home again and back to familiar routines and surroundings, those eating and sleeping patterns will return to normal.
Children are developing trust in their caregivers. This can be difficult at the hospital, because there are many people involved with the child's care during what are often stressful circumstances.
Being away from family is very stressful, because children at this age are often fearful of strangers.
Children of this age often do not fully understand why they are in hospital.
2 years to 5 years
Being away from home and familiar routines is stressful.
Children may be afraid they will be hurt by hospital procedures.
Children may believe they did something wrong and that is why they are now in the hospital.
These children may know more about their bodies, but their understanding is still limited.
Language skills are developing fast, but children may misunderstand words they hear.
5 years to 12 years
Being away from home, school, and friends is often stressful.
Fear of needles and pain is common.
Fears about surgery, for example falling asleep and pain after surgery, are common.
12 years and older
Being away from home, school, and friends is often stressful.
Privacy is often important
Teenagers may be more aware of and concerned with long-term effects of illness.
How parents can help a child in hospital
There are many ways you can help your child cope with the stresses of a stay in hospital. The less stress and anxiety your child has, the better his recovery from illness will be. Here are some ideas.
Getting ready for the hospital
If a hospital stay is planned, you can help your child get ready for the experience ahead of time. How you prepare your child will depend on their age. Talk to the doctors, nurses, social workers, or Child Life specialist about how to prepare your child. Many hospital have programs to help with this.
Keep in mind that you are a role model for your child's behavior. If a parent shows fear and sadness at a child's hospitalization, this encourages the child to feel the same way.
Talking with your child
Talk to your child about any fears, anxieties, and other concerns they may have. Do not lie to your child about what will happen. Give them simple explanations they can understand. Answer the questions they ask. It is okay not to have an answer.
Visitors
Familiar faces are reassuring. Visits from caregivers, especially parents, will help your child stay connected to his or her world outside the hospital. If visits are not possible, phone calls and Internet chats are good too.
Familiar objects from home
Bring favorite things from home, such as toys and stuffed animals. This will help comfort your child.
Play
As much as possible, children in hospital should be encouraged to play. Play can take a child's mind away from pain, anxiety, and illness in general. Play also helps a child stay stimulated. This encourages normal child development. Play can involve toys, books, games, puzzles, and arts and crafts.
Play can also be organized at the hospital. Often this is done by social workers and Child Life specialists.
2) Mirita states: When a child is hospitalized it affects the entire family. Siblings, depending on their age, may have feelings of abandonment, rejection, loneliness and confusion. They may become withdrawn or attempt to draw attention to themselves. The parents have altered family roles which causes stress and anxiety. The parents also feel helpless and unable to protect their child. They have concerns about missed days at work. The child that is hospitalized may have anxiety when separated from their parents and this can cause psychological disturbances that may have a lasting effect on their emotional well-being. The child may have behavior regression, sleep disturbances, loss of appetite and aggressive or withdrawn behavior. I think children are hit the hardest when hospitalized. They have limited number of coping mechanisms. The child may have fear related to procedures, treatment, pain and separation from parents and also their friends especially if the child is a teen or pre-teen. The child's developmental age affects how the child reacts to hospitalization. Infants have not developed selective attachment to their parents. As long as the infant has contact with a nurturing caretaker they may have no adverse effects. A toddler whose routine is interrupted may have naughty behavior or regressive behavior. Older children may express anger, sadness, exhibit negative responses and have a tendency to reject authority. The nurse has many roles in this situation to include maintaining the child's routine as much as possible. Minimize parental separation when possible. Minimize fear. Listen to the parents and accept cultural, socioeconomic and ethnic values. Encourage the parents to stay with the child and to bring familiar items from home such as favorite toys or blanket. Allow the child to participate in care and ask questions. Provide developmentally appropriate therapeutic play. Family-centered care will help the child and parents cope with the stress of hospitalization. The nurse will have to earn the trust of the child and the parents. This can be accomplished through prompt attention to the child's needs
3)Jamie states:I am posting on this discussion topic this week as part of the health care team, thankfully not as a parent who has experienced hospitalization with a child. After reading the chapters and doing research on this sad topic, I think that the parents are more affected by their child's hospitalization. I know that the child is the one who is sick and being poked and prodded and at times fighting for his life, but the family goes through torture, hell.
I read an article in a pediatric nursing journal that addressed this subject and made it clear that parents of a hospitalized infant/child feel completely useless, anxious, exhausted, powerless, stressed, scared and vulnerable. Even when a person has medical knowledge, they feel ignorant and helpless. The author of the article states that she “wishes there had been a chart describing the different players according to title, role and decision-making capacity.” She states that not knowing who makes what decision and not knowing who reports to whom, made it extremely confusing for her. She stated that there would be conflicting information between the different teams (resp. cardiac, medical) and it was hard to know who was really making the medical decisions for her son. The article goes on to describe how hard it was for her to feel like she was protecting her son and caring for her son, when she couldn't even hold him at times. The one thing she wanted her sick and dying infant to know was that "he was loved" and the only way she felt like she could let him know that was to be there all the time with him, to bathe him, kiss him and brush his hair.
The developmental age of the child affects their hospitalization, in my opinion. Hospitalization and care from a nursing standpoint for an infant is completely different than caring for a sick child or adolescent. A sick infant can't care for themselves, they can't speak, can't feed themselves, can't wipe their own tears away, can't let us know they're in pain, can't refuse to be stuck one more time. Their hospitalization and care is different than an older child who can follow directions, express pain, ask questions, answer questions, refuse to be poked, smile when they see their parent(s), etc…
As the nurse, in order to help reduce some stress on the parents I should remember that the parents are the primary caregiver of the sick child; I am the nurse assisting the parents. Assist the family with resources they need or will need. Always keep lines of communication open and available to the parents- give them all the phone numbers needed to the hospital, nrsg station, etc... Allow parents access to the unit and child as much as possible and access to procedures as appropriate and allowed by the medical team. Write the medical team members names down with their phone numbers for the parents. Inform them and explain any tests or labs that are being done, or will be done so that they feel included in their child's care.
As a nurse caring for a sick child, I have the opportunity to relieve some of the stress from the parents by treating them with respect, dignity and kindness and keeping them informed and included in their child's medical treatment.
4)Dwane states:What to expect from a hospitalization ?
A pediatric patient will be confined to their room, moving from primary room to temporary areas to possibly perform tests such as imaging (CT, MRI, X-rays, etc.). Within their room, should be a T.V, video games, board games and a colorful environment, yet all task such as playing, shower, homework, sleeping, eating, etc, will be performed in this estranged environment. Throughout the day and/or night strangers (nurses, doctors, varying therapist) will perform other task like vital signs, blood test, requesting urine/stool samples, among other things PRN. Altogether the hospitalization would separate a child from their friends, family, school and their normal daily routine. Yet, in this new environment, a child may still be able to be nurtured, play with current friends, make new friends, and enjoy hobbies. Throughout, a parent would live vicariously through their child's disposition, going through a period of grievance, guilt, and helplessness, all the while dealing with work, bills, school, relationship, and other children.
Overall I find it hard to say who between a child or parent would be affected more if a child is hospitalized, but my answer would lean towards both being affected equally. Now it is highly dependent on the age developmental stage and seriousness of the illness and/or injury. A child younger than an adolescent age, may not know the seriousness of their situation and may bounce back to a carefree attitude, yet may still be emotionally scarred if treated indifferently and/or physically debilitated/mutilated. Now when hospitalized, all stages of development would be affected by succumbing to some fear of separation from family and/or friends and develop an anxiety towards the unknown. This is why the moment from admission, nursing interventions should include; approaching calm and compassionate, encourage family and friends to visit as often as they can (making shifts, as to keep a steady and realistic schedule), explaining daily routines and future procedures. All in all, it will take a team effort by the child, parent, and healthcare members to ease the stressors of hospitalization on all involved.