Patient Teaching Essay

chi washstandeledgeabilityI buzz cancelled chosen blowing as my pedagogics topic for this assignment. The specific lymph glandle leave al mavin be the crude bring forth at in the midst of 2 and 7 mean solar daylights postnatal, in the rawly laid-off from hospital. As a community health shield working with children and young fami stays, I do initial postpartum live with ins at station. white meat nutriment is a truly complex skill, natural, yet roughly snips laborious to do. The knob is a solidifying all overwhelmed with study received in hospital, so posings must be kept piddling, and illuminate easy to go surface. The argona in which I work is multicultural. at that place is oft a language barrier which get along complicates t to for each one oneing and suss turn come out of the closeting. Finding a teach adapted effect is easy (Lon w spikey, p. 95). current takes argon vehement for divine service in providing the take up for t heir babies. Mothers whose babies pooh-pooh to hook onto the teat or who f on the whole upon believe an in gear up latch, whitethorn both(prenominal) condemnations sour rattling tense and stressed. It is weighty to brood calm and supportive during belief.The thickening must be educated, non simply taught revolutionary skills (Rankin, p. 73). The newly acquired info bequeath go out her to exercise her accept decisions and to be the vanguard of her own health cargon team. opinionI bewilder been working with postpartum women for the past 6 yrs, and baffle 3 children of my own. I am able to delectation my own personal experiences with imbi world, my last having halt only 2 long time ago. I work healthful with my co-workers, I screw that I skunk non do it but (Lon move into, p.51). We swear out each other ein truth smell of the way and rescue a sizeable back-up system available in the community. These accept lactation consultants, dope alimenting cli nics, doctors, social workers and community agencies.The student and her family be at the head of the team (London, p.47). They are conventionalityly very propel to learn and ultimately desire what is beat for the indulge. 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 butt end in every(prenominal) case learn a pickle fill up the leaf node by observe the home. I adopt had m any nodes publish me they were skew-whiff- controling exclusively who had half empty bottlefuls of conventionalism on the kitchen counter.The assessment process begins on the cry out front the consult. All new obtains are contacted when they arrive home. All are offered a home visit, many ref manipulation. By military service of a detailed questionn snape, we know the problems to focus on ahead the visit. This is very helpful as we puke be better prepared with the subscribe toed a comparablels. many a(prenominal) unhurrieds are red flag patients (Rankin, p. 160). any(prenominal) speak very little English, hire financial problems, are on welfare, or are single mothers.Culture and covereousness fag influence teaching (London, p.296). It is infeasible to generalize nigh(predicate)(predicate) one culture, so we must be careful to moil deeper when presented with a situation which whitethorn be affected by ones background. The area I work in is multicultural. The women speak many languages and I frequently accept to agree a family genus Ph every(prenominal)us translate the teaching. This is sometimes quite thought-provoking as I am not un supplantingly sure that what is organism translated is rattling what I am sayingI drive not to allow my own beliefs get in the way of my patient care. I may not ever oftentimes agree with the decisions of others but always rub foc wontd on the desired issuing. somewhat clients would p adjoin to so ak up and others would prefer to bottle feed but are being influenced by family members. Support from family members generally improves the outcome (Stalling, p.163). The client strainament withdraw an easier time adjusting to breastfeeding and result breastfeed for a womb-to-tomb period of time with family support. We need to make adjustments in our teaching based on each individuals views. (London, p. 303). We should never make assumptions nigh any social occasion.Self-efficacy is a very authorized reckon in breeding to breastfeed. The learner who gestates she cornerstone do it, exit be to a greater extent successful. My department organizes a group that meets at the community center once a week. recent mothers hold up a medical prognosis to meet each other and learn active breastfeeding. Using these role-models sometimes helps a woman with low self-efficacy learn to breastfeed (London, p.311).When I walk into a home, I muckle often sound out deep down the root 10 minutes whether I will bugger off to make a follow-up visit. At a typical visit I assess the blow and mother, help with breastfeeding if necessary and provide the mother with helpful information she will need in the world-class some months of the ball ups life. A typical visit lasts 1-2 hours. I usually provide printed fabric on the common breastfeeding problems to my clients. On the website WWW.Medela.com, in that location is very helpful information on breastfeeding in several languages. I utilize 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 overflowing to catch by around women. It is grammatically correct. There are no difficult or very technical terms.The exposed in this paper is a mother of two who did not breastfeed her outset child. She speaks English and whole shebang as a clerk in a drugstore. She has a university degree, so t ooshie easily pick up information at the 12th fool level.PlanningThe general goal of this teaching is for the client to be able to breastfeed in the halal manner and to at a lower placestand the benefits of breastfeeding in locate to prolong breastfeeding for as long as possible. The following are the specific objectives for this clientle. At the end of the sessionThe client will enunciate at least 5 benefits of breastfeeding vs bottle feeding. The client will demonstrate 3 diverse breastfeeding positions one time each. The client will describe the treatments for engorgement and sore nipples. The client will list 3 resources for further information aft(prenominal)wards the visit. The client will recognize and state 3 factors which pade the blow is receiving sufficient milk from breastfeeding. article of faith tools make white plague ofd will be demonstration, banter, and hand-outs. It is substantial to prioritize learning needs. There are some facts which are very fire 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 chthonicstand the relationship amidst frequent feedings and increase milk production.Content outline banter of the benefits of breastfeeding.Discussion of the factors indicating that the mishandle is receiving sufficient milk. thoughtfulness of the client breastfeeding using 3 different positions. Demonstration of proper breastfeeding technique for each position as needed. Discussion of breast engorgement and sore nipples and their management. Discussion of resources for further information about breastfeeding and the assess the need for a follow-up visit. *The teaching is closelyly through with(p) by discussion and demonstration. This is a steady-going way to get continuous feedback from the client. It is as well as a legal way to find out that all the important material is not forgotten. Practi ce makes perfective tense. Adult learners need to be involved in the teaching (Rankin, p. 196) and inadequacy to impose what they learn right away. This is in particular important with breastfeeding, as the new mother must be able to outgo it within a very short time.It is not always necessary to cover all the information with each client. whatsoever are too overwhelmed with information already others may already have the knowledge base and simply need help with latching.ImplementationI generally borrow teaching about breastfeeding straight off after having evaluated the client. I begin by discussion of the benefits of breastfeeding and the factors which indicate that the frustrate is receiving enough 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 milksupply may be reduced. Then, I assist the client at putting the youngster to the b reast using different positions as needed. I sometimes use a clam up breast to show the client the correct angle to use opus feeding to envision a proper latch. opthalmic aids sometimes help to make it supposem more than real. When that has been mastered, I hide with a discussion of the two most common problems found in the starting 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 hardly a(prenominal) old age or weeks, it is helpful for the client to have this information in writing.I also provide an information stable gear on the resources the client loafer use if she should need further help after the visit. I generally make a follow-up call one to deuce-ace 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 provide s helpful information on breastfeeding and the common associated problems. The computer is only a tool, however. It provides information, not study (London, p. 246). I abide available to my clients by telephone or by email at all times.Recording transcribed (T=teacher, L=client)T Did you breastfeed with your outgrowth child?L no. I essay for about 3 days but gave up callable to the disquiet.T Did you receive any help?L No. still it was less important to me then. 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 interchangeable to breastfeed him as long as possible. some of my jocks have had babies in the past years and all are breastfeeding. They make it go through so easy. I decided to establish harder 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 turn out but he was too asleep(predicate), and so was I. The front day he had a few bottl es. Yesterday, I tried for the first time. I speak up it went ok but my nipples are very sore. I would like to learn how to breastfeed properly.T Well, we sack discuss a few things now and I endure show you the proper technique for a few different positions when he wakes up.L OKT First of all, wherefore 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 Joshua.T Breast milk is definitely the best for babies. whiz 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 aurora 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 col ostrum is?L Yes. I have been reading up on breastfeeding since I found out I was pregnant again. It is the yellow liquidness that comes out before the milk comes in. I know that it helps to hold out back jaundice.T Yes that is true. It acts as a mild laxative to push the baby to pass his first stools of meconium. It can also help to prevent ear infections and allergies. It is very rich in nutrients and allergies. Did Julia have jaundice?L No, she didnt.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 a great deal quicker.T Thats true. It can also save you money. The average follow of formula for 1year is about $1800, and that doesnt complicate the bottles and other supplies. Breastfeeding requires you to eat about an trim 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 release as early as 6 weeks postpartum even when breastfeeding.L serious 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 think 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 sixth 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 everyd ay. They should gradually change from the black meconium stools, to browned 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 almost every time he feeds.T Thats great. He should also be cheery mingled with 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 get 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 with(p) anything for the injure?L I am taking isobutylphenyl propionic acid and I was given some lanolin ointment at the hospital. Do I need to wash it off before I feed the baby?T No, it is harmless for the baby. The best way to reverse 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 hand a depleted tot 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 atomic number 42 of lanolin. 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 abet your milk production and also to prevent engorgement. Do you know what engorgement is?L Yes. I was very gormandise about a week after Julia was bor n.T Engorgement can be very painful and can make it impossible 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 promote more milk than others. If you get engorged, it is important to continue feeding often. You can apply warm compresses and massage your breasts. If it is more severe, you may need to express a pungency of milk for relief, which you can do manually or you may need to use a heart. A well-fitted supportive bandeau may help.L I have bought a good bra, but havent worn it yet. I will send my husband out to demoralize a inwardness today. What kind do you recommend?T It depends on how often you would like to use it. If you are preparation to breastfeed all the time, then a manual pump may be enough. There are however, some two-a-penny electrical pumps which you can buy for under $40. These may be easier and quicker to use. You can use them to relieve eng orgement 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 access to the internet?L YesT If you check out the site www.medela.com, you can find 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 elevate more milk production.L give thanks you, Ill check the site. Would you like to see how I feed him now?T Sure.(L puts baby to the breast using flub 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 light between his gums, like this. In order to get him to latch on well, you first need to make sure that you are comfortable since you will be breastfeeding so often. Use pillows to get yourself comfortable. Take your time and r elax before you start. When you are ready, make sure the babys hoist is facing the nipple. His head should be adjust with his body. Gently stroke his upper rima oris 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 space 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 hear him recede?L Yes.T Excellent. Then you are doing it very well. Notice how his body is reorient with his head, he is most comfortable that way. ask at his chin and his nose. See how they are positioned. You can see that he has undecided his mouth very wide and is tak ing 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 aline 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. ar you comfortable?L Yes, very. And no painT Breastfeeding is not always as easy as some hatful 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 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 yo uve 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 birth weight)T He lost a bit more weight. But thats normal. nearly breastfed babies lose 10% or more of their birth weight in the first few days. They usually regain their birth weight within 10 days. Do you remember how to tell if he is boozing enough?L Yes. He should have at least 6 wet diapers every day after the sixth day and a couple of stools. He should also wake up alone to feed and sleep well between feedings. And of course, he should gain weight.T Exactly.T I will be reverting 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 ear lier, there is a breastfeeding clinic every thorium 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. paygrade 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 information (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 anxious to learn proper techniques. She had self-efficacy, skills and knowledge all important factors if changing behaviors (Rankin, p 292). She was wondrous 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 learner 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 insistent 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 raise her and give her positive feedback. Sometimes I forget the goals of the session and get off get through, or provide the client with needless information. I find that using a ch ecklist 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 allows them to refer to the information as a audience when they need it most.ConclusionThe teaching session went very well. The client was intelligent, educated and caliber to learn. Overall this teaching technique use for teaching breastfeeding works well with most of the clientle I see at home. Every person is queer and adjustments always need to be do accordingly.BibliographyForrest, S. (2004). Learning and teaching The reciprocal link. The journal of Continuing Education in N ursing, 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 illness (5th ed.). New York Lippincott.