Theory Application Paper: Gerontological Nursing

Introduction

Newborn children are usually exposed to an increased number of painful procedures including heel lancet, suctioning, and venepuncture as part of their custom care within a neonatal intensive care unit (NICU). This condition is painful considering the kind of pain these young beings are exposed to at such a tender age. However, the procedures are beneficial and cannot be avoided, but professionals can improvise to reduce the adverse effects. It is believed that about 10% of neonates are subjected to over 300 painful procedures within the first few weeks of their lives (Matar et al., 2016). Therefore, it is crucial to ensure prevention of pain because it is expected ethically, and if the pain in the newborn is not treated, it could lead to increased morbidity, extended hospitalization, as well as adverse health outcomes. The purpose of the paper is to show the need to improve the treatment procedures of neonates using the Kolcaba's comfort theory which involves administering sucrose before performing the painful procedures.

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Nursing Situation

Throughout the career of a nurse, the effect, as well as timeframe of a disease, is known due to several encounters with different patients and the results of their diagnosis. Nurses are expected to learn as well as build up on every case they handle to ensure continuous improvement in the care they provide. I helped a woman deliver a premature baby due to complications. The child had to be taken to the NICU where many tests had to be done for the doctors to know the kind of difficulty to treat (Born et al., 2004).

Several tests conducted include a blood test, breathing and heart rate monitor, fluid input and output, eye exam, echocardiogram, and ultrasound. It was painful to imagine conducting all these tests on a young baby. If the infant develops other complications, there are specialized tests that are done as well. The baby was treated and later placed in an incubator to promote its growth and development. I advised the mother on an effective way of carrying her child immediately he is removed from the incubator. This technique is known as the Kangaroo care where she was to hold the infant very close to the skin.

Besides, we monitored the child's vital signs by taping sensors to his body. This procedure was primarily to check the blood pressure, temperature, breathing, and the heart rate. We used a ventilator to assist the infant in breathing. It was a lengthy procedure which seemed painful to the neonate. However, after several weeks the child was discharged and taken home by the family. It was a happy moment as I saw the smile on the mother holding her baby.

Middle Range Theory

Comfort is a fundamental requirement of everyone for ease, relief, or transcendence as a result of healthcare conditions that are stressful. Comfort can improve the behavior of people in seeking health, as well as their family members and nurses. Therefore, Kolcaba's theory of comfort is the best suited for this phenomena (Kolcaba, 2001). It aims to ensure comfort in the process of treating infants since sucrose is introduced to the patient's system before the painful procedures.

The theory supports my nursing situation because I have empathy for the infants undergoing many diagnostic processes that are painful and stressful to the patients at a tender age. The theory helps develop a way to make the process more comfortable or less stressful to both the infant, family members, and nurses. The approach would have been helpful in the previous encounter with the premature baby.

Theory Application and Literature Review

The application of the midrange nursing theory by Kolcaba is a natural nursing practice because nurses instinctively evaluate their patient's physical as well as mental comfort. This taxonomic method offers a structure in which to put the informal and formal assessment. Once a want is identified, nurses can intercede in unique ways since the structure relies on the needs of patients. Additionally, nurses can evaluate the usefulness of their interventions by measuring the degree of comfort obtained when comfort needs are targeted purposely (Kolcaba, 1992).

Besides, many nursing approaches to care to rely fundamentally on Kolcaba's comfort theory and are often discussed about patients suffering from symptoms related to discomfort or pains caused by various treatment procedures (Born et al., 2004). Specifically, "quiet time" is the intervention described for its likely use within this type of population as a measure of comfort which addresses the four contexts of Kolcaba's theory of comfort: physical, psychospiritual, sociocultural, and environmental. Many nurses practice within the theoretical framework of this hypothesis without realizing it, and they do so in the efforts to promote patient comfort (Kolcaba, 2001). According to several studies, explicit applications of Kolcaba's theory of comfort are crucial to nursing practice. Using the hypothesis in research can offer evidence for quiet time intervention with patients seeking comfort.

From the literature, I learned the importance of ensuring comfort among infants in the process of their treatment (Kolcaba, 1992). Besides, the comfort is not only for the neonates but also the nurses, as well as the family members of the patient. This knowledge can be applied in many treatment aspects. It can be used for patients of different age groups and those suffering from distinct illnesses as well. If nurses attain comfort, they will attend to their patients with care making the treatment process effective.

Nursing Interventions and Applications

Superior practice nurses should be creative when developing nursing interventions related to providing comfort for infants in their period of treatment. There is a need to perform a comprehensive evaluation of the patient or child. For example, you need to assess the characteristics, frequency, severity, location, onset, and quality of pain before administering treatment (Born et al., 2004). This step will help to ensure that the infant gets effective pain relief.

Besides, providing a quiet environment is a crucial intervention for nurses because excess stressors can intensify the perception as well as the tolerance of pain of the patient. Moreover, the use of nonpharmacological pain relief techniques such as music therapy, relaxation, as well as breathing therapy helps control the situation.

Conclusion

Nurses are the ultimate factors when it comes to ensuring comfort among patients and their families. It is disturbing to see the kind of pain endured by neonates during their treatment procedures. Nurses need to consider the Kolcaba's comfort theory to help solve the issue. Special nurses interventions like a quiet environment, use of nonpharmacological means, and conducting comprehensive research are helpful in achieving the goal or comfort among patients, nurses, and family members. The paper describes the connection between the interventions, theory, and nursing situation.

References

Born, W., Greiner, K. A., Sylvia, E., Butler, J., & Ahluwalia, J. S. (2004). Knowledge, attitudes, and beliefs about end-of-life care among inner-city African Americans and Latinos. Journal of palliative medicine, 7(2), 247-256.

Kolcaba, K. Y. (1992). Gerontological nursing: The concept of comfort in an environmental framework. Journal of Gerontological Nursing, 18(6), 33-38.

Matar, E. M., Arabiat, D. H., & Foster, M. J. (2016). Oral glucose efficacy on neonate's pain responses at the NICU: A quasi experimental trial of two clinical procedures. Applied Nursing Research, 32, 36-40.

Kolcaba, K. (2001). Evolution of the mid range theory of comfort for outcomes research. Nursing outlook, 49(2), 86-92.