Patient Teaching Essay

IntroductionI require chosen lactateing as my dogma topic for this assignment. The specific inviteele impart be the un employ give at amongst 2 and 7 twenty-four hourss postpartum, fresh discharged from hospital. As a community health nurse work with children and young families, I do initial postpartum visualizes at stem. Breast nourishment is a genuinely complex skill, natural, yet approximately cartridge holders difficult to do. The leaf node is a roofy overwhelmed with training line upd in hospital, so sittings must be kept short, and made escaped to run into. The argona in which I work is multicultural. on that point is practically a language barrier which further complicates statement and learning. purpose a teachable moment is easy (Lon founding father, p. 95). unexampled m differents argon ardent for dish up in providing the best for their babies. M go to piecess whose babies ref aff beam to catch onto the detractor or who have an in improve la tch, may somewhattimes be dumbfound real tighten and stressed. It is Coperni usher let on to remain calm and supportive during teaching.The knob must be educated, non simply taught new skills (Rankin, p. 73). The newly acquired nurture testament engage her to cultivate her calculate decisions and to be the head of her own health safekeeping police squad.AssessmentI have been working with postpartum women for the past 6 years, and have 3 children of my own. I am able to riding habit my own mortalal experiences with suckleing, my last having stopped l ane(prenominal) 2 years ago. I work well with my co-workers, I complete that I can non do it however (Lon take for granted, p.51). We answer each other e genuinely step of the bearing and have a advanced mainstay-up system getable in the community. These include nurseling consultants, suck ining clinics, doctors, social workers and community agencies.The savant and her family be at the head of the team ( London, p.47). They atomic number 18 usu on the wholey rattling motivated to learn and ultimately loss what is best for the heaple. It is easier to phase angle relationships with the thickening at home (London, p. 63). The environment is non-threatening to the learner and teacher. I can as well as learn a lot close to the invitee by observing the home. I have had m any(prenominal) customers testify me they were breastfeeding exclusively who had half empty bottles of code on the kitchen counter.The assessment passage begins on the telephone originally the visit. All new mothers argon contacted when they get to home. All are offered a home visit, some refuse. By help of a detailed questionnaire, we agnize the problems to focus on before the visit. This is very laborsaving as we can be better prepared with the required tools. Many patients are red flag patients (Rankin, p. 160). rough articulate very little English, have financial problems, are on wel off the beate n lead-in(predicate)e, or are single mothers.Culture and religion can influence teaching (London, p.296). It is by of the question to generalize just around one culture, so we must be painstaking to dig deeper when presented with a situation which may be affected by ones background. The area I work in is multicultural. The women speak many languages and I often need to have a family extremity translate the teaching. This is sometimes quite challenging as I am not unendingly sure that what is being translated is actually what I am sayingI tense not to let my own beliefs get in the way of my patient care. I may not always agree with the decisions of others besides always stay focused on the coveted outcome. Some guests would prefer to breastfeed and others would prefer to bottle feed tho are being influenced by family members. Support from family members generally improves the outcome (Stalling, p.163). The client will have an easier time adjusting to breastfeeding and wil l breastfeed for a lasting period of time with family support. We need to act upon adjustments in our teaching base on each individuals views. (London, p. 303). We should never extend to assumptions about anything.Self-efficacy is a very meaning(a) factor in learning to breastfeed. The learner who thinks she can do it, will be to a big(p)er extent successful. My department organizes a group that meets at the community center once a week. New mothers have a chance to meet each other and learn about breastfeeding. mount these role-models sometimes helps a woman with low self-efficacy learn to breastfeed (London, p.311).When I walk into a home, I can often tell inwardly the archetypal 10 minutes whether I will have to make a go through visit. At a typical visit I assess the botch and mother, help with breastfeeding if necessary and cater the mother with accommodative development she will need in the counterbalance few months of the bumbles life. A typical visit lasts 1 -2 hours. I usually set up printed material on the joint breastfeeding problems to my clients. On the web internet site WWW.Medela.com, there is very helpful schooling on breastfeeding in several languages. I use this site often to print out information on latching, sore nipples and engorgement. The information on the site is generally well written and edited. The vocabulary is easy ample to understand by or so women. It is grammatically correct. at that place are no difficult or very technical terms.The subject in this paper is a mother of two who did not breastfeed her starting child. She speaks English and works as a clerk in a drugstore. She has a university degree, so can easily understand information at the 12th grade level.PlanningThe general goal of this teaching is for the client to be able to breastfeed in the correct manner and to understand the benefits of breastfeeding in order to pro capacious breastfeeding for as long as possible. The sideline are the specifi c objectives for this clientle. At the end of the sessionThe client will evoke at to the lowest degree 5 benefits of breastfeeding vs bottle feeding. The client will demonstrate 3 diametric breastfeeding postal services one time each. The client will describe the treatments for engorgement and sore nipples. The client will list 3 resources for further information after(prenominal) the visit. The client will recognize and state 3 factors which indicate the scotch is receiving sufficient back out out from breastfeeding.Teaching tools used will be demonstration, discussion, and hand-outs. It is historic to prioritize learning of necessity. There are some facts which are very interesting but which are not necessary for the client to know. (Rankin, p. 191 and 197). The breastfeeding mother does not need to know the physiology of the breast, but she does need to understand the relationship between frequent feedings and increased draw production.Content outline password of the be nefits of breastfeeding.Discussion of the factors indicating that the baby is receiving sufficient milk. reflection of the client breastfeeding using 3 different positions. Demonstration of proper breastfeeding proficiency for each position as needed. Discussion of breast engorgement and sore nipples and their way. Discussion of resources for further information about breastfeeding and the assess the need for a follow-up visit. *The teaching is mostly do by discussion and demonstration. This is a good way to get continuous feedback from the client. It is too a good way to ensure that all the Copernican material is not forgotten. Practice makes holy. big(p) learners need to be involved in the teaching (Rankin, p. 196) and extremity to curb what they learn chastise away. This is oddly important with breastfeeding, as the new mother must be able to master it within a very short time.It is not always necessary to cover all the information with each client. Some are too overwhe lmed with information already others may already have the knowledge base and simply need help with latching.ImplementationI generally start teaching about breastfeeding presently after having evaluated the client. I begin by discussion of the benefits of breastfeeding and the factors which indicate that the baby is receiving liberal milk. Many women do not believe that they have enough milk and worry about the need to offer a supplement. It is important to explain this to them. If they do offer a supplement, their own milk return may be reduced. Then, I assist the client at put the baby to the breast using different positions as needed. I sometimes use a dummy breast to cross-file the client the correct angle to use while feeding to ensure a proper latch. Visual aids sometimes help to make it charmm more than real. When that has been mastered, I continue with a discussion of the two most common problems found in the first weeks of breastfeeding, sore nipples and engorgement. I provide the client with written material on proper latching technique, sore nipple management and engorgement. Since these problems sometimes occur after a few days or weeks, it is helpful for the client to have this information in writing.I also provide an information sheet on the resources the client can use if she should need further help after the visit. I generally make a follow-up call one to three days after the visit and a follow-up visit as necessary. I sometimes refer the clients to the company Medelas website, www.medela.com. This site provides helpful information on breastfeeding and the common associated problems. The computer is only a tool, however. It provides information, not education (London, p. 246). I remain available to my clients by telephone or by netmail at all times.Recording transcribed (T=teacher, L=client)T Did you breastfeed with your first child?L none I assay for about 3 days but gave up due to the pain.T Did you receive any help?L No. only if it was less important to me thence. I was ok with bottle feeding.T Do you want to breastfeed Joshua?L Yes. I will be taking a year off of work and would corresponding to breastfeed him as long as possible. Many of my friends have had babies in the past years and all are breastfeeding. They make it look so easy. I decided to try ticklisher this time.T Joshua is 3 days old. How have you been feeding him?L I tried to put him at the breast right after give up but he was too sleepy, and so was I. The first day he had a few bottles. Yesterday, I tried for the first time. I think it went ok but my nipples are very sore. I would resembling to learn how to breastfeed properly.T Well, we can discuss a few things now and I can show you the proper technique for a few different positions when he wakes up.L OKT start-off of all, why do you want to breastfeed?L Everyone is telling me that it is the best thing for my baby.T They are right, but what do you think?L I want to do whats best for Josh ua.T Breast milk is definitely the best for babies. One of the best things about breastfeeding is that the milk is always ready. You dont have any bottles to warm up or prepare, especially at 200 in the morning when youre exhausted. Because it is available right away, you dont have to make the baby wait. This will make it easier to calm him before he gets too agitated. It is also a great time to bond with the baby and will make Joshua feel more secure. Breast milk is the best thing for your baby. Do you know what colostrum is?L Yes. I have been reading up on breastfeeding since I found out I was pregnant once a put one over. It is the yellow liquid that comes out before the milk comes in. I know that it helps to pr scourt jaundice.T Yes that is true. It acts as a mild laxative to encourage the baby to pass his first smokes of meconium. It can also help to prevent ear infections and allergies. It is very productive in nutrients and allergies. Did Julia have jaundice?L No, she d idnt.T Do you know of other benefits of breastfeeding?L I know that breast milk is the perfect formula for babies with the exact right nutrients that they need. It keeps babies from becoming overweight. I also know that it can help me lose the baby fat that much quicker.T Thats true. It can also save you money. The average cost of formula for 1year is about $1800, and that doesnt include the bottles and other supplies. Breastfeeding requires you to eat about an unornamented 500 calories per day. This should cost, by comparison about $300 for the year.L With all the expenses of a new baby, we can use that money for many other things.T Thats for sure.L Can breastfeeding keep me from acquiring pregnant again?T No. It is not a sure form of contraception. Although it is relatively effective in the first 6 months if you breastfeed exclusively. Some women ovulate as early as 6 weeks postpartum even when breastfeeding.L Good to know.T Do you know how to tell if the baby is receiving enough milk?L He will gain weight.T Yes. Thats a very good sign in the long run. There are other things as well. He should have at least 3 urines today since he is 3 days old. Then, you should see one more each day until the sixth day. That means that on the 4th day, he should have at least 4, on the fifth day at least 5 and from the 6th day onwards, at least 6 per day. How many has he had today.L So far he had 1 at 200 and another at 700. I dont think thats a problem.T Good. We would also expect to see a few stools all(prenominal)(prenominal)day. They should gradually win over from the black meconium stools, to brown and then to yellow. Many breastfed babies have a stool with every feed, but some have only 1 or 2 per day. Both are normal.L He has one intimately every time he feeds.T Thats great. He should also be satisfied between feeds. That means he would feed every 1 to 3 hours in the first few weeks and have some period in between when he sleeps or remains calm. You told me that he feeds about every 2.5 hours and usually sleeps in between, so it sounds like he is right on target. A baby who is too sleepy and needs to be woken up for feedings may also not be getting enough. Do you have any questions so far?L No. Im glad hes getting enough milk and cant wait to see if hes gained weight.T You mentioned that your nipples are very sore. Have you through anything for the pain?L I am taking Advil and I was given some Lanolin ointment at the hospital. Do I need to swoosh it off before I feed the baby?T No, it is innocuous for the baby. The best way to avoid sore nipples is correct positioning at the breast. If you have sore nipples already, I will show you how to have Joshua latch on properly. Meanwhile, for the soreness, you should apply a small amount of your own breast milk on the nipples after each feeding. Then let it air dry as much as possible. After that, you can apply a bit of wool fat. Sometimes it helps to use different feeding positions during the day .L The nurse at the hospital told me to let my breasts air dry, but that is not easy in the hospital. How often can I use the lanolin?T You can use it 2-3 times per day.L Ok. I will try that.T Your milk has not come it yet, but should come in in the next few days. It usually comes in by the 3rd to 5th day. It is important to feed regularly to encourage your milk production and also to prevent engorgement. Do you know what engorgement is?L Yes. I was very engorged about a week after Julia was born.T Engorgement can be very painful and can make it unacceptable for the baby to latch on properly.(baby wakes up. L gets the baby)L What should I do if I get engorged?T Engorgement usually lasts only a few days. Some women just produce more milk than others. If you get engorged, it is important to continue feeding often. You can apply warm compresses and abrade your breasts. If it is more severe, you may need to express a bit of milk for relief, which you can do manually or you may need to use a pump. A well-fitted supportive bra may help.L I have bought a good bra, but havent exhausted it yet. I will send my husband out to buy a pump today. What kind do you recommend?T It depends on how often you would like to use it. If you are planning to breastfeed all the time, then a manual pump may be enough. There are however, some inexpensive electrical pumps which you can buy for under $40. These may be easier and quicker to use. You can use them to relieve engorgement and to pump if you go out from time to time.L My friend uses a Safety First pump which is electric. She bought it at Walmart for about $35 and says it works well.T Thats probably a good choice for you too. Do you have admission price to the internet?L YesT If you check out the site www.medela.com, you can witness information about choosing a pump. If you pump to relieve engorgement, you should only pump for a few minutes. If you pump too much milk, you will only encourage more milk production.L Thank you, I ll check the site. Would you like to see how I feed him now?T Sure.(L puts baby to the breast using cross cradle positioning. The baby does not take enough of the areolaso L has pain.)T He is not on properly. To release the suction, place your finger gently between his gums, like this. In order to get him to latch on well, you first need to make sure that you are wanton since you will be breastfeeding so often. Use pillows to get yourself comfortable. Take your time and relax before you start. When you are ready, make sure the babys nose is liner the nipple. His head should be aligned with his be. Gently stroke his upper brim with your nipple. When he opens his mouth, pull him quickly towards you, so that he can take as much of the areola as possible.L How do I know if he is taking enough?T The most important cue is that you will have no pain. Generally the babys chin is touching the bottom of the breast, and there is a small quad between his nose and your breast. Hold your baby close to you and support his head. There is no normal or standard way to breastfeed. If the baby is feeding well and you have no pain, it is working well.L I dont feel any pain now.T Can you adjudicate him swallow?L Yes.T Excellent. Then you are doing it very well. ceremonial how his body is aligned with his head, he is most comfortable that way. Look at his chin and his nose. See how they are positioned. You can see that he has undecided his mouth very wide and is taking enough of the breast. Would you like me to show you how to hold him in some other positions?L Yes. I would like to learn how to lie down to feed. It would be so much easier at night.T Thats true. When youre very tired, its a lot easier. The basics are the same. You want to ensure that the baby is facing you and that his body is aligned with his head. Make yourself comfortable. Use a pillow behind your back or between your knees if you need one.(L Demonstrates the technique.)T That is very good. Are you comforta ble?L Yes, very. And no painT Breastfeeding is not always as easy as some people make it seem. It takes practice. The beginning is a learning process for you and for the baby. Let me show you one more position that you may like to use. This is the football game hold. It is easier to use when the baby is small like Joshua but is sometimes more difficult later on. Hold him so that his legs and body are under your arm, like this. Then place your hand under his head and neck. If youve ever played football, thats how a football is held.L I dont like that one. It is much easier the other way.T Not everybody likes that position. You have to do whats best for you and for your baby so use the position thats most comfortable.(Baby weighed lost 8.5% of present weight)T He lost a bit more weight. But thats normal. Most breastfed babies lose 10% or more of their stimulate weight in the first few days. They usually regain their birth weight within 10 days. Do you remember how to tell if he is drinking enough?L Yes. He should have at least 6 wet diapers every day after the 6th day and a couple of stools. He should also wake up only if to feed and sleep well between feedings. And of course, he should gain weight.T Exactly.T I will be returning to weigh Joshua again Wednesday (in 48 hrs). I will continue to follow him until he starts to gain some weight. If you need help before then, you can call the CLSC (community clinic) at the number I gave you earlier. As I told you earlier, there is a breastfeeding clinic every Thursday morning as well. At the clinics, there are nurses available to weight the baby and to help you more with breastfeeding. Here is some information on breastfeeding that we discussed today (pamphlets on latching, sore nipples and engorgement given). If you have any questions about them, let me know.Evaluation of learnerI always do a telephone follow-up within 1-3 days. This is very effective as the client will have had some time to process all the infor mation (London, p.62). If necessary, a repeat visit will also be planned. unluckily I cannot always have the client do three separate demonstrations (London, p. 386) due to budget and time constraints.Discussion worked best with the subject in this paper. She was educated and was eager to learn proper techniques. She had self-efficacy, skills and knowledge all important factors if changing behaviors (Rankin, p 292). She was alert and very interested in learning. She participated in the discussion. She was able to apply the information immediately during my visit.At the follow-up visit 2 days later, the client was doing very well. She was able to breastfeed without any pain or difficulty. We discussed engorgement again, a problem which had developed since my first visit. She explained what she had done to relieve the engorgement, which was how I had explained it to her. The what if scenario had worked .(London p.386)Evaluation of teacherI could have done more assessment of the lear ner while I was teaching. I find myself being drawn into a routine with my teaching that is sometimes hard to get out of. Most of the teaching is very repetitive from one client to the next, however, each client learns in her own fashion. I try to keep the client interested in what I have to say. I encourage her and give her positive feedback. Sometimes I forget the goals of the session and get off track, or provide the client with unnecessary information. I find that using a checklist helps me to stay on the right track and to not omit anything important.Evaluation of resourcesThe handouts I usually give out to my clients on latching, engorgement and sore nipples, all score over 70% by the SAM test (Rankin, p.238), thus making them good resources. I provide this information to my clients to use as the situations arise. Although I explain the handouts to all my clients, not all women get engorged for those that do, it usually happens after my visit. Having the handouts at home allow s them to refer to the information as a reference when they need it most. cultureThe teaching session went very well. The client was intelligent, educated and eager to learn. boilersuit this teaching technique used for teaching breastfeeding works well with most of the clientle I see at home. Every person is unique and adjustments always need to be made accordingly.BibliographyForrest, S. (2004). Learning and teaching The reciprocal link. The Journal of Continuing Education in Nursing, 35(2), 74-79.London, F. (1999). No time to teach? A nurses guide to patient and family education. New York Lippincott.Medela (2007) Your Resource for breastfeeding products and information. on-line. Available http//www.medela.com.Rankin, S.H., Stallings, K.D., & London, F. (2005). Patient education in health and sickness (5th ed.). New York Lippincott.