Introduction

Pediatric nurses play an important role as intermediaries between the family, the child, and the healthcare system. Their job is very multifaceted and is crucial to ensuring the health and safety of the population, as many diseases and illnesses that could develop during the first years of life transfer well into adulthood. A pediatric nurse is expected to have a thorough understanding of the unique anatomical, physiological, developmental, and behavioral differences between children, possess the knowledge of common and uncommon diseases as well as pedagogical knowledge and understanding of the family dynamics. The purpose of this paper is to analyze the role of a pediatric nurse and to develop a plan of care for a child undergoing its development stage, from toddler to preschool age.

Four Roles of a Pediatric Nurse

The nurse plays several roles in a relationship with the child and its family. The first role is that of a direct nursing caregiver. A nurse is expected to provide direct medical attention to a child should it become sick or injured. This role is prevalent during all stages of development, as sickness and injury are common in young children. However, the role of a direct nursing caregiver becomes more prevalent once the child learns to walk and run, as the potential for injury increases exponentially (Guises, 2014).

The second role is that of patient education. The prevention of potential health hazards to a child can be achieved through the proper education of parents. Family education starts before the child is born and continues through different stages of life and development. However, as children progress from toddlers to infants, and from infants to preschoolers, their needs change, and so does the education model for their parents (Guises, 2014).

The third role is parent advocacy. The nurse is expected to take good care of the health needs of parents and provide counseling and advice. Many first-time parents have little psychological experience in taking care of a child, which may cause certain psychological and family issues to arise. Depression, lack of confidence, nervousness, and irritability are some of the most common psychological factors encountered in parents during the first few years of the child’s life (Guises, 2014).

The last role of a pediatric nurse involves scientific research. As a medical worker, every nurse is expected to contribute to the promotion of health and higher quality of life by constantly trying to improve the existing practices and conducting medical research. This role can be performed at all stages of child development and target different age groups (Guises, 2014).

Child Development Care Plan

Several researchers in the medical field have created growth and development charts to illustrate the needs and developmental progression of a child through infancy and into later stages of life. The primary four theories used in the medical field when it comes to the child development care plan are the theories of Erikson, Kohlberg, Piaget, and Freud. Piaget’s theory is also called cognitive theory, which focuses on the cognitive abilities of the child and their development (McLeod, 2015). Freud’s theory focuses on the psychological and sexual development of the child (McLeod, 2013). Erikson’s theory is preoccupied with psychosocial factors of the child’s development (“Erikson’s stages,” n.d.). Kohlberg’s theory addresses the issue from a moral perspective (McLeod, 2011). Together, these four theories form a conclusive picture.

Taking the development stage of the child into consideration is of paramount importance when developing a care plan. According to Kohlberg and Erikson, a newborn child has no self-awareness or understanding of the consequences of its actions. Piaget states that a newborn child’s movements are reflexive in nature, and Freud points out that the main source of gratification for the child is the mouth (McLeod, 2013). The development plan of care should involve great amounts of supervision, protection, and control over the child’s diet. At the same time, the parents are to be instructed not to chide, punish, or raise a voice at the child for any misbehavior, as at this stage the child is not aware of what it is doing.

Within a year, however, the child changes considerably. It learns to identify parents and strangers, becomes aware of the world around itself, and reacts to verbal and visual stimuli. The child becomes more mobile, thus raising potential trauma-associated dangers. The care plan for children up to 1 year is supposed to empathize with the safety of the surrounding environment for the child (McLeod, 2015).

At the age of two, the child becomes more self-aware. It is a time of exploration and personality buildup, according to Piaget and Erikson (“Erikson’s stages,” n.d.). Freud states that at this age the child starts viewing its own genitals as a source of pleasure. As far as morals go, the child starts associating good things with pleasure, and bad things with displeasure and pain. At this stage, the plan of care must concentrate on preventing trauma, oral and genital infection, as well as psychological issues. The parents should appreciate and encourage the child’s exploratory and creative side, but at the same time prevent it from causing harm to itself.

At the age of 3-4 years, the child is learning on how to express oneself and understands the modicum of damage done. Egocentric thinking persists. At this stage, the child is normally capable of walking and running, thus increasing the potential danger of trauma. The plan of care for the family should include teaching the child self-restrained, basic hygiene, as well as removing any potentially dangerous objects from reach. Oral infections, genital infections, and traumas are common.

Stressors and Special Needs

A thorough understanding of a child’s special needs and potential stressors is necessary during the development stage of a healthcare plan. Children may express all sorts of special needs associated with hereditary or acquired health conditions, such as asthma, autism, physical disabilities, hyperactivity, attention deficit and so on. Potential stressors and triggers to the child’s conditions must be recognized and dealt with. For example, in a case with asthma, the child should be kept away from potential triggers of asthma, such as flowers, animals, smoke, etc. In the case of physical disabilities, special medical procedures must be taken to reduce the effects on the child’s development and growth. The environment surrounding the child must be adapted to suit its needs (McLeod, 2015).

Complementary Alternative Medicine

Although modern hospitals are well equipped to deal with most healthcare needs of a child, complementary alternative medicine is often used to treat children, as it is considered to be less invasive and potentially less detrimental to health than the standard medical treatments. CAM usually involves massages and acupuncture to treat birth-associated disabilities and traumas, herbal remedies for illnesses associated with the throat, nose, and lungs, as well as musical and audial treatments for hyperactivity, depression, and anxiety (“Children,” n.d.).

Safety Considerations and Injury Prevention

For children aged between zero and four, safety considerations change from one age group to another and are inclined to go up. This is due to the increasing mobility of the child – a newborn can hardly move on its own and cannot put itself in danger by voluntarily approaching any hazards. However, they are more prone to diseases, as their immune system is still developing and weak. As the child becomes more mobile and its immune system becomes stronger, the emphasis is changed from disease prevention towards trauma prevention. It is a standard procedure to keep all harmful objects away from the child’s reach. In addition, sources of electricity ought to be plugged. At the later stages of child development, parents are also expected to pay greater attention towards the child’s psychological and mental states. As the child becomes more self-aware, its needs for compassion, understanding, knowledge, care, and support increase exponentially. The topic of harm is not restricted to physical injuries only, as mental scars could affect the child for many years after.

Conclusions

A comprehensive healthcare plan for a preschool child includes many facets of its life and requires cooperation between the child’s family and the pediatric nurse, in order to ensure the best possible outcome. Child development theories by Erikson, Piaget, Freud, and Kohlberg describe and explore different facets of child growth and behavior, and serve as the cornerstone for creating a plan of care. In the early stages of life, the child needs protection not only from diseases but also from potential trauma associated with daily activities. Nutrition is important at every stage of development. Psychological issues and a clear need for understanding, trust, love, and appreciation emerge in the later stages, as the child’s actions change from reflexive reactions towards mindful requests. Developing and following the established plan of care would ensure the child’s physical and psychological health and a smoother transition into the later stages of development.

References

Children and the use of complimentary health approaches. (n.d.). Web.

Erikson’s stages of development. (n.d.). Web.

Guises, E. (2014). The role of pediatric nurses in health education. Soins. Pediatrie, puericulture, 277, 39-42.

McLeod, S. (2011). Kohlberg. Web.

McLeod, S. (2013). Sigmund Freud. Web.

McLeod, S. (2015). Jean Piaget. Web.