Adolescent Pregnancy And The Role Of Registered Nurses In Providing Supportive Care

Pregnancy in adolescence has been an international concern for a few years. In such a pregnancy both the mother and child usually suffer from varied causes related to health, living conditions and social stigma. Of the worldwide population of adolescents, a large number of births are from women between the ages of fifteen to nineteen. It is also the pregnancy that witnesses an increased number of deaths as compared to adult pregnancy. This essay will analyse the third scenario in which a teenage mother, Becky, has admitted her eight-month-old son for bronchiolitis. Even though she has been observed to be an attentive and caring mother, a few of her actions require attention and intervention from a registered nurse. A registered nurse’s professional help is centred around the patient where she uses supportive, preventative, palliative and restorative elements. They understand the importance of standards that should be maintained for a healthy professional and therapeutic environment.

The effect of adolescent pregnancies is most visible in the relationship between the parent and the child. Their lack of adequate knowledge of the development of their children forces them to expect unrealistically, which affects their parenting abilities. In such cases, the mother exhibits poor communication skills with her child in ways such as spending less time interacting, talking or looking at them. The role of a mother becomes tiring and burdensome for adolescents as they have to balance the new responsibility and carry out tasks of adolescent life at the same time. The added disadvantage of such mothers not belonging to a good social and economic background makes their journey problematic. (Mangeli et al., 2017, p. 1) Luckily for Ethan, Becky does not exhibit any poor communication with him. Additionally, teenage mothers and their children are prone to social problems where 51% of children enter foster care whereas 44% of them depend on welfare. Challenges Faced By Adolescent Mothers And Their Children Essay  The evidence of adolescent pregnancy forwarding social problems from one generation to the next is presented by the statistics that 36% of children from teenage mothers, experience adolescent pregnancy. (Govender, Naidoo & Taylor, 2019, p. 1) It was reported by Harrison et al. (2017, p. 1) that adolescents who accessed health care expressed negative encounters they had with nurses and health care providers such as fear of being judged when disclosing personal and sensitive details. Due to this stigmatization by a few nurses that do not follow a standard- parents like Becky assume they will be judged every time they visit a facility.

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As reported by Quosdorf et al. (2020, p. 1) adolescent mothers do not prefer to breastfeed as compared to adult mothers who are well-informed of the benefits of this activity as they attend appointments for prenatal care. Upon being asked by the teenage mother to give her child chocolate milk for his afternoon nap, the nurse followed the nursing standards of providing research-based knowledge and tried to explain the detriments of that action. But the mother did not respond well to the guidance- showing that she was unaware of the key points for caring for an infant. This posed a challenge for the nurse as she tried to impart knowledge that would be beneficial for her and her child and was met with an impolite response. Under the International Council of Nurses’ Code of ethics, nurses should maintain the confidentiality of sensitive details and must use their judgement when sharing the information with someone. (The mention of this code was made because Becky would frequently ask about the parents of other infants present with her son and would make remarks about them- the challenge of being responsive but maintaining confidentiality is therefore presented to the nurse as she would also want to be compassionate towards the mother’s situation.

Scenario Analysis: A Teenage Mother With A Sick Child

The main nursing issue present in the scenario is Becky’s reluctance to allow the nurse to help her compassionately and professionally. As pointed by Govender, Naidoo & Taylor (2019) in their paper, adolescent mothers are more likely to develop poor social skills which led to the impolite response to the nurse’s advice on Ethan’s feeding habit in this scenario. In this case, the nurse should try to explain the disadvantages and approach the therapeutic relationship behaviour. According to the second standard for registered nurses, the nurse would provide her support and direct Becky to appropriate resources that will improve her and her child’s health. The nurse would also reflect on their attitude and beliefs in response to the aggressive verbal response and would then plan care accordingly. The ethical issues that are present in the scenario are Becky’s violation of professional boundaries with her nurse when she asks about her shift timing, followed by asking her to buy some groceries stating that she did not want to leave Ethan alone. According to Mangeli et al. (2017), this displayed ineffectiveness on Becky’s part as she did not have the skills to fulfil the role of a mother without help from someone else. The nurse could follow the competency standards set by the Nursing and Midwifery Board of Australia and could assess the sensitivity of Becky’s situation ensuring she clarifies the request with a relevant member of the team if it is not matching with her personal beliefs and values according to sections 2.1, 2.2 and 2.3 of the ethical and professional nursing frameworks. (NMBA, 2018) Lastly, the absence of any visitors for Ethan and Becky shows that they did not receive the support of family or the spouse which, according to Leftwich & Alves (2017) is an issue that adolescent mothers are ‘plagued’ with when compared to adult women, where they have a higher level of partner abandonment. The nurse could provide her compassionate support showing no bias or discrimination to Becky’s situation and communicate with a senior member of the team on the appropriate action that would be beneficial to them both. (Professional boundaries for nurses, NMBA, 2022, p. 4)

Following are the standards that would apply to the scenario- the National Safety and Quality Health Service (NSQHS) standard of health literacy where effective communication would achieve the target of providing information about health and healthcare to meet the requirement of Ethan and Becky. Due to Becky’s condition, the nurse would be responsible for providing information in an easy-to-understand language that can be applied even outside the healthcare facility. (Safetyandquality.gov.au., 2021, p. 18) The criteria of partnering with patients for their care, under the NSQHS standard, applies to the scenario as well, where actions 2.05, 2.06 and 2.07 allows the nurse to identify the ability of Becky to make appropriate decisions for the welfare of her child, and suggest or identify someone else to make decisions for them. In addition, the organisation will aid in setting goals, communicating and making decisions for the active participation of Becky and Ethan in their future and present welfare outside the health care guidance. (Safetyandquality.gov.au., 2021, p. 17) Finally, the fourth, fifth and sixth standards of the registered nurse under the Nursing and Midwifery Board of Australia where the nurse is responsible for conducting holistic and appropriate assessments to develop a plan that is best suited to the needs of the mother and child and is agreed upon by Becky. The nurse’s responsibility will extend to providing appropriate directions in effective intervals to ensure that the plan is accurate and safe for them which is performed concerning related guidelines, legislation and regulations. (Nursingmidwiferyboard.gov.au., 2022)

Conclusion:

In conclusion, the essay discussed the challenges that a nurse providing care for an adolescent mother and her child, faces while also highlighting the problems faced by such mothers, majorly of the social and economic aspects. The stigmatization of teenage pregnancy by health care providers discourages mothers such as Becky from seeking professional help as they share the fear of being judged and not taken as seriously as an adult mother seeking professional help. The standards that have been placed by the Australian nursing organisations ensure that health care professionals provide the necessary care to people without any bias or judgement while ensuring their best interests are kept at the centre of their professional decisions. These standards also allow their application during situations such as the scenario where a nurse is required to make well-researched decisions that are ethically, culturally and professionally sound. The achievement of a similar nursing response would be possible only if such nursing standards are implemented internationally, ensuring justified nursing care.

References:

Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., … & Fisher, M. (2017). Standards for practice for registered nurses in Australia. Collegian, 24(3), 255-266.

Harrison, M. E., Clarkin, C., Rohde, K., Worth, K., & Fleming, N. (2017). Treat me but don’t judge me: a qualitative examination of health care experiences of pregnant and parenting youth. Journal of pediatric and adolescent gynecology, 30(2), 209-214.

Leftwich, H. K., & Alves, M. V. O. (2017). Adolescent pregnancy. Pediatric Clinics, 64(2), 381-388.

Mangeli, M., Rayyani, M., Cheraghi, M. A., & Tirgari, B. (2017). Exploring the challenges of adolescent mothers from their life experiences in the transition to motherhood: a qualitative study. Journal of family & reproductive health, 11(3), 165.

Naidoo, S., Taylor, M., & Govender, D. (2019). Nurses’ perception of the multidisciplinary team approach of care for adolescent mothers and their children in Ugu, KwaZulu-Natal. African Journal of Primary Health Care and Family Medicine, 11(1), 1-11.

NMBA. (2018). Nursing and Midwifery Board of Australia- Code of ethics for nurses

NMBA. (2022). Nursing and Midwifery Board of Australia – Code of conduct for nurses

NMBA. (2022). Nursing and Midwifery Board of Australia- National competency standards for registered nurse

NMBA. (2022). Nursing and Midwifery Board of Australia- Professional boundary for nurses.

Nursingmidwiferyboard.gov.au. (2022). Nursing and Midwifery Board of Australia – Registered nurse standards for practice.

Quosdorf, A., Peterson, W. E., Rashotte, J., & Davies, B. (2020). Connecting with adolescent mothers: perspectives of hospital-based perinatal nurses. Global qualitative nursing research, 7, 2333393619900891.

Safetyandquality.gov.au. (2021). National Safety and Quality Health Service Standards- Second edition.  Challenges Faced By Adolescent Mothers And Their Children Essay