Neonatal Jaundice

This chapter explains the pathophysiology of bilirubin metabolism and the common causes of jaundice in neonates. It also describes the investigations and management of this condition

No second chance: junior neonatal nurses' experiences of caring for babies at the end-of-life and their families

Death of an infant is acutely stressful for parents and professionals. Little is known about junior nurses' experiences providing end-of-life care in Neonatal units (NNU). This study aimed to better understand junior nurses' experiences providing end-of-life care in NNU. Neonatal nurses (n = 12) with less than 3 years experience participated in a focus group. Nominal Group Technique (NGT) was used to build consensus around the challenges faced, alongside suggested developments in improving future care provision. Primary analysis involved successive rounds of ranking and decision-making whilst secondary analysis involved thematic analysis. All issues, whether environmental, professional or social appeared driven by an awareness on the part of nurses, that there was no ‘second chance’ which created a huge pressure to ‘get if right’ for the infants and families. Regarding future care 2 areas of improvement identified were ‘Education and Training’ and Support. This paper unpacks these findings making recommendations for practice.

The neonatal nurse: advocating for breastfeeding mothers

Accurate information and support from healthcare professionals as well as respect for parental choice are all factors which contribute to effective breastfeeding in the neonatal unit; with this in mind, Colm Darby and Sharon Nurse discuss the potential problems in expressing breast milk and the interventions which might be effective in avoiding them. Advocacy is an inherent part of neonatal nurses' role whilst caring for sick, vulnerable babies. Colm Darby is a male neonatal nurse working in a predominantly female environment and passionately believes in supporting and advocating for mothers who want to provide breast milk for their babies. In this article, CoIm uses Borton's model of reflection to discuss how he acted as an effective advocate for such a mother.

Textbook: Maternal- Neonatal Care made Incredibly Easy!

This textbook is the perfect reference book for students new to midwifery and those studying for exams. The diagrams and explanations are simple and esay to follow

No second chance: the experiences of junior neonatal nurses in providing end-of-life care for babies and families in the NNU

Background

An infant’s death is acutely stressful for parents and professionals. Little is known about junior nurses’ experiences providing end-of-life care in Neonatal Units (NNU).

Objectives

To better understand junior nurses’ experiences providing end-of-life care in NNU, the study explored the challenges and opportunities inherent in their practice relating to providing such care to babies and their families.

Methods

Neonatal nurses (n=12) with less than 3 years’ experience who were undergoing a neonatal education programme participated. Two focus groups were convened each with 6 nurses. The Ethics Committee at the relevant University approved the study. Nominal Group Technique (NGT) was used in the focus groups to build consensus around the challenges faced by junior nurses, alongside suggested developments in improving future care provision. Primary analysis involved successive rounds of ranking and decision making whilst secondary analysis involved thematic analysis.

Results

The study identified the pressures these nurses felt in having only one chance to ‘get it right’ for the infants and their families. They perceived the need for further ‘education and training’ highlighting that improved education provision would include both additional courses and internal training sessions. Greater ‘support’ from mentors themselves more experienced in this aspect of care within the NNU was identified as important in addressing issues around confidence building and skill development.

Conclusions

The results highlight junior nurses’ need for specific education and mentorship around end-of-life care for babies. This presentation will outline the implications for practice, education and further research.

Complex contests and the influence of aggressiveness in pigs

Animal contests vary greatly in behavioural tactics used and intensity reached, with some encounters resolved without physical contact while others escalate to damaging fighting. However, the reasons for such variation remains to be fully explained. Aggressiveness, in terms of a personality trait, offers a potentially important source of variation that has typically been overlooked. Therefore, we studied how aggressiveness as a personality trait influenced escalation between contestants matched for resource holding potential (RHP), using detailed observations of the contest behaviour, contest dynamics, and escalation levels. We predicted that winner and loser behaviour would differ depending on personality. This was tested by examining 52 dyadic contests between pigs (Sus scrofa). Aggressiveness was assayed in resident-intruder tests prior to the contest. Contests were then staged between pigs matched for RHP in terms of body weight but differing in their aggressiveness. In 27% of the contests a winner emerged without escalated physical fighting, demonstrating that a fight is not a prerequisite between RHP-matched contestants. However, the duration of contests with or without fighting was the same. In contests without a fight, opponents spent more time on mutual investigation and non-contact displays such as parallel walking, which suggests that ritualized display may facilitate assessment and decision making. Winners low in aggressiveness invested more time in opponent investigation and display and showed substantially less aggression towards the loser after its retreat compared to aggressive winners. Aggressiveness influenced contest dynamics but did not predict the level of escalation. Prominent behavioural differences were found for the interaction between personality and outcome and we therefore recommend including this interaction in models where personality is considered. Analyses based on contest duration only would miss many of the subtleties which are shown here and we therefore encourage more detailed analyses of animal contests, irrespective of the level of contest escalation.