Stephanie Wong

Nurse 320 Pediatrics 03/18/15

My first pediatric patient was a 9-month-old female admitted for facial eczematic
outbreak with secondary infection. She was very active and interacted with me within her
expected psychosocial and cognitive norms. To build my trust with her I made sure her mother
was in always in sight during my assessment. I also had her mother assist to promote a
comfortable setting. Her bilateral cheeks had lesions that were starting to scab with yellow crust.
Both cheeks were erythematic and slightly weeping. The left cheek was worse than the right; her
neck, shoulder and limbs had some small eczema patches as well.
Before meeting my patient, I noticed in her chart her mother was a teen mother. Instantly,
my highest concern was educational level and how much participation of care was involved.
When I finally met her, she was with her child at all times and always willing to participate. I
asked her about how her experience was when her child was admitted and what she noticed
different. She stated she just noted the weeping skin change within the day, but did not know her
child was febrile. Another concern was her niece that was also admitted with the same diagnosis
was down the hall.
During my assessment I informed her about her daughters diagnosis and the importance
of understanding the care to prevent future infection. I also asked if her niece and daughter
interact a lot and her response was that they live together. That information was vital to let
Professor Ohara know that this was probable cause of the two infants being admitted. I explained
to mother that this could easily be prevented and to keep the girls separated when one is having
an outbreak. I told her to have a thermometer on hand and to watch her daughter for scratching

behavior. If possible infection occurs again, I explained to her the importance of calling her
pediatrician right away. Teaching her good habits at home really made her feel comfortable to
ask questions. I told her its okay to always ask questions and to not feel shame. I reassured her
this the only way she will learn to help her daughter in the long run. It seems she is aware, but
probably scared and overwhelmed to ask too many questions.
Towards the end of the shift, a group of residents stepped into the room to discuss
discharge instructions. The care management that was discussed seemed very robotic and fast
paced to the mother. I sat in and listened to everything and again when it was the mothers turn to
ask questions. She had that stumped face look that made me realize she really needed one-on-one
teaching. I asked her if she understood and she said most of it. So we briefly went over
everything and made it more simply to understand. I asked her if she could relay back at least
two things we covered. She talked about calling the doctor and to keep the cousins separate. She
was very appreciative of the time I spent to help explain her daughters care.
Learning from this clinical day, therapeutic communication with the family builds strong
relationships that can aide better care to the child. With everyone on board, it can really promote
a healthy bond amongst staff and family. My patients is going through the stage of trust vs.
mistrust. Having her mother greatly involved and understanding what to do can really help
relieve stress of the infant. She seemed very comfortable with me towards mid-day of the shift
and started to trust everything I was doing for her. Giving them the attention they truly needed
taught me what true family centered care is about. I understand as nurses we get busy when the
load of patients gets higher. But taking that time to do the little things and ask if they have any
questions can open doors to things that can easily be overlooked.