Guest Post: Restriction of Visits to Hospitalized Child? An Emerging Need for Theory-Informed Nursing Intervention during Pandemic

Contributor: Ana Filipa Paramos

In Portugal during the pandemic crisis, we have made it impossible for the family to be present during the child’s hospitalization, resulting in increased levels of separation anxiety and stress, with potential negative consequences for the child’s recovery process. Let’s talk about a specific case of a child with a prolonged hospital stay in the middle of a pandemic and unable to have his father visit during the hospitalization. The little boy was accompanied by his mother, but the family nucleus of this child includes his mother and father. Did they speak by cell phone? Yes, they did, but the physical presence and eye contact are not replaceable by a phone call. One afternoon of that long hospitalization, I found the child angry, crying and looking away from our approach, as if he almost blames us for the impossibility of the father being present during the hospitalization. I wondered how we could make this situation less stressful and anxious for the child.

The adoption of a humanistic approach through the use of the Humanistic Theory of Nursing proposed by Josephine Paterson and Loretta Zderad was needed. According to Paterson and Zderad (2007), nursing is seen as an experience lived among human beings that responds to a human need. This theory requires the recognition of the human being as a unique being, endowed with his singularity and, simultaneously, that there is an understanding of the individual characteristics, experiences and needs of each patient (Paterson & Zderad, 2007). Through the dialogue established between me and the child, I understood that his father’s visit was extremely important for the child, since he had a very strong connection with the father.

During our dialogue, there were tears, uncontrollable tears in the child’s eyes. Unable to allow the father’s entry, I asked myself, “How will I be able to respond to this child’s needs?” It was at that precise moment that we decided to place the child’s bed next to the window, allowing the child to establish eye contact with his father, that long awaited and desired eye contact. Immediately after the father’s visualization, a smile and happiness emerged in the child. This contact allowed the immediate decrease in the levels of separation anxiety experienced by the child.

© 2021 Ana Filipa Paramos
Child’s bed next to the window, allowing the child to establish eye contact with his father

in Humanistic Nursing Theory, the concept of nursing does not only address patients’ wellbeing but also patients’ better being, helping them to make the health/disease situation experience as human as possible (Paterson & Zderad, 2007). We must remember that each patient is a person with needs, anxieties, fears and desires that have to be met, regardless of whether we are in the middle of a pandemic or not. We have to try to make the hospitalization experience as less stressful and as comfortable as possible for the patient and, in this case, the father’s visit was an emerging need of this child. Not being a normal visit, the establishment of eye contact through the window was the closest it could be, and it brought immediate happiness to the child. I heard the word “thank you” associated with a look of tenderness and tranquility. Unable to show my smile behind the mask, my eyes shone, and a tear appeared in the corner of my eye, such was the happiness I also experienced at the moment. My experience with the child was an enriching moment for both of us and allowed us both to develop, becoming more and better, of that I have no doubt. We cannot forget that times are difficult and challenging for everyone, but the experiences lived with the patients cannot be put aside in our daily nursing practice.

References

Kleiman, S. (2010). Josephine Paterson and Loretta Zderad’s Humanistic Nursing Theory. In M.E. Parker & M. C. Smith (Eds.), Nursing Theories and Nursing Practice (3rd ed, pp. 337–350). Philadelphia: F.A. Davis Company.

Paterson, J., & Zderad, L. (2007). Humanistic Nursing. http://www.gutenberg.org/ebooks/25020

Wolf, Z. R., & Bailey, D. N. (2013). Paterson and Zderad’s Humanistic Nursing Theory: Concepts and Applications. International Journal of Human Caring, 17(4), 60–73. https://doi.org/10.20467/1091-5710.17.4.60

About Ana Filipa Paramos

I have finished my Nursing Degree in 2016, at Escola Superior de Enfermagem de Lisboa (ESEL). In 2016, I started working as a general nurse at Centro Hospitalar Lisboa Central, more specifically at Hospital Dona Estefânia. From 2016 to 2019 I worked at the pediatric surgery/ pediatric burn unit and in the beginning of the pandemic, I have integrated the pediatric respiratory unit/ COVID, where I currently am.

In 2020 I entered the Master Nursing Course of the Health Sciences Institute of Universidade Católica Portuguesa (Lisbon). This post was made in the nursing theories curricular unit, with the pedagogical supervision of Professor Zaida Charepe (PhD, Associate Professor).

3 thoughts on “Guest Post: Restriction of Visits to Hospitalized Child? An Emerging Need for Theory-Informed Nursing Intervention during Pandemic

  1. thank you for this post. It could be extrapolated to many nursing circumstances duirng Covid. Since when did nursing provide care to patients without their cooperation and informed consent?? Persons should be fully informed and make decisions with their full understanding

    Like

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