The Practice of Health Promotion in Pediatric Nursing

Hundreds of thousands of babies are brought into this world daily. With our population growing more rapidly than ever, there is an apparent demand for pediatric nurses to provide care to these children. Pediatric nurses have the ability to promote a healthy lifestyle to children through many stages of their lives with the use of ample resources to maintain well-being and to allow patients to retain the healthy habits they have been taught in order to thrive from birth into adulthood. This paper will explore how pediatric nursing is closely intertwined with health promotion, as nurses play an essential role in educating their patients on how to live an active lifestyle, and preventative actions against unhealthy behaviours.

Pediatric nurses work with children alongside their parents to deliver expert health care from birth to late adolescence. Pediatric nurses provide a variety of services with specialized skills in many work settings in order to effectively care for children at every stage of development. Some well-known fields of pediatric nursing include neonatal pediatric nursing, neonatal intensive care unit nursing, and labor and delivery nursing. Pediatric nurses work in settings such as children’s hospitals, community hospitals and major medical centers. Examples of tasks which pediatric nurses are widely responsible for include: identifying changes in a child’s signs and symptoms, advocating for children, differentiating between normal and abnormal findings, analyzing situations to detect changes in status, determining a child’s needs in relation to pain management and administering medication (Graduate Nursing EDU, n.d.). The Canadian Association of Paediatric Nurses (2017) identifies five national standards of pediatric nursing which serve as a framework for pediatric nursing to ensure consistency and high-quality nursing care is met with the delivery of services to all children. These standards include: supporting and partnering with the child and their family, advocating for equitable access and the rights of children and their family, delivering appropriate care, creating a child and family friendly environment and enabling successful transitions within the plan of care and between health care professionals and institutions (Canadian Association of Paediatric Nurses [CAPN], 2017). Pediatric nursing is recognized by the Canadian Nursing Association (CNA), but the specialty only emerged in the mid 1800s when the first children’s hospital opened, making it a fairly new medical specialty. According to Broadribbs Introductory Pediatric Nursing (Hatfield, 2006), children were cared for by their relatives and often died due to sickness or fatal diseases in the 1800s. In the 1980s, physicians Marshall Klaus and John Kennell conducted studies that revealed separation of babies from their mothers at birth had negative effects on family relationships (Hatfield, 2006 p.4). Hospitals then began modifying regulations and slowly implemented more policies which reflected the needs of children and families (Hatfield, 2006 p.4). There are challenges in pediatric nursing as nurses must be able to cope with the sorrow associated with children who are ill. Pediatric nurses also deal with stressed parents whose children are in a vulnerable state, and they must be capable of reducing the parents’ anxieties. Although there are challenges pediatric nurses face, there are also rewards associated with pediatric nursing. In particular, neonatal nurses’ job satisfaction is correlated with compensation such as improved patient health status and advocacy such as assisting a new nurse with a task they have not done independently (Archibald, 2006). A critical aspect of job satisfaction in pediatric nursing is positive patient outcomes, which is strongly influenced by health promotion.

Health promotion is a means of achieving positive health outcomes in nursing as it has the ability to increase quality of life, increase understanding of the patient’s illness, and it allows patients to self-manage their illness (Kemppainen, Tossavainen, & Turunen, 2012). Health promotion aims to eliminate factors that could cause disease or illness with the use of programs and education to raise public awareness. According to the World Health Organization (WHO), health promotion is defined as the process of enabling people to increase control over, and to improve their health (The WHO Health Promotion Glossary, 1998). Preventative care, which focuses on maintaining health and not only the treatment of disease, can be categorized into three levels of prevention; primary, secondary and tertiary. Primary prevention aims to reduce risk factors of poor health and promote protective health by intervening before the consequences occur. Secondary prevention strives to prevent the advancement of a disease by intervening when diseases are detected in the early stages. Tertiary prevention targets the management of chronic diseases to increase one’s quality of life and improve their ability to function (Tasmanian Government, n.d.). Nursing creates an opportunity for nurses to educate their patients with appropriate information to manage and improve their health status. In nursing, health promotion can be implemented at the level of public health and population health. Public health involves a concern for people around the globe and it works to prevent health problems prior to occurrence. Examples of public health include immunizations, promoting healthy eating and active living, and protection against environmental health hazards. Public health maintains the well-being of our community and keeps it free from illnesses which could have been prevented through the implementation of health policies and programs (Falk, 2014). In contrast, population health focuses on the health of specific groups of individuals and aims to reduce health inequities (Falk, 2014). Using the results of the health of specific populations, policies can be implemented to improve the health of those which are at risk for ill health. Through the promotion of healthy lifestyles and reinforcement of methods that reduce and prevent illness, nurses have the capability to significantly improve the overall health and well-being of the population.

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Pediatric nurses are actively involved in health promotion on a daily basis when interacting with their patients. Firstly, pediatric nurses practice primary prevention by educating children and their parents on healthy diet habits to prevent obesity. “Treatment of Child and Adolescent Obesity: Reports from Pediatricians, Pediatric Nurse Practitioners, and Registered Dietitians” states: Like adult obesity, childhood obesity prevalence is rising. As these children age, the obesity epidemic will lead to epidemics of diabetes, hypertension and cardiovascular disease… studies in obese children suggest that interventions focused on improved eating and activity behaviour may lead to marked, sustained weight loss, with long-term outcomes superior to adult studies. (Barlow, Trowbridge, Klish, & Dietz, 2002, para. 5)

Pediatric nurses are responsible for ensuring their patients’ diets are well balanced and their food intake is appropriate for factors such as the child’s age, height and weight. Through the prevention of childhood obesity, there are many risk factors that are eliminated which could have resulted in negative health outcomes that are extremely difficult to eradicate as an adult. Parents should also be involved in the child’s education on nutrition as they play an important role in implementing good dietary habits and making lifestyle changes for their child. Pediatric nurses may also give instructions for weight loss through diet and physical activity changes to patients who are already overweight which is secondary prevention. Furthermore, the collection of family health history is a useful tool for health promotion in pediatric nursing. Family health history is a risk factor for chronic disease, as one’s risk of developing a disease increases drastically when a relative has previously had it (Kanetzke, Lynch, Prows, Siegel, & Myers, 2011). Collecting family health history is a particularly important part of health care visits during childhood as it allows pediatric nurses to address the condition at an early stage before it progresses if children show risk factors to a disease (Kanetzke et al., 2011). Catching a disease or illness at an early stage and preventing its progression is an example of secondary prevention. Compiling family health history also benefits the parents as they can apply directives given by the nurse to themselves, which can raise awareness to healthy habits they should participate in. Lastly, pediatric nurses incorporate health promotion into their profession through aiding children with type 1 diabetes mellitus with the development of independent behaviours to effectively care for themselves and manage their glycemic control. Type 1 diabetes mellitus is one of the most common chronic diseases in children and it requires treatment that encompasses many specialized skills such as insulin injections, nutrition management and physical activity (Pelicand, Fournier, Le Rhun, & Aujoulat, 2013). Self-management support is a crucial component of managing the chronic illness as it is imperative for children to learn to autonomously control their glycemic levels without the need to rely on their parents. The education and support from pediatric nurses helps to avoid the very serious consequences which could arise from insufficient management of the disease and treatment (Pelicand et al., 2013). The management of a disease such as diabetes mellitus is an example of tertiary level prevention which indicates the promotion of health through the management of a chronic disease to increase quality of life.

Pediatric nurses work closely with their patients and their patients’ families to provide adept health care in a variety of different environments. Not only do pediatric nurses engage in direct illness treatment but as well as health promotion at primary, secondary and tertiary levels to improve the health of their patients and the public. Through emphasis on health promotion in pediatric nursing, the prevention of disease and management of disease progression in children is improving each generation to create a healthier population. Children are the future of creating abundant wellness in our society and this all begins with the health of our youths.