Réflexions sur le nursing en périodes obstétricale et néonatale

Nursing in perinatal and neonatal periods

The meanings of « nursing »

 In agronomy, in mechanics, in cooking,

 _{In medicine : nurture, cure, protect, concerning adults and mainly}

Reasons for difficulties:

 Technical evolution and advances

 _{Psychological evolution and advances}  _{Short of time to get « pauses »}

 _{Ethical and medico-legal pressure in decisions}  Short of time to obtain retro-information

Advances in understanding: research

and observation have a tremendous

importance

Advances in understanding the anatomical

development of CNS: formation of pathways in

cerebrum and cerebellum.

Things arriving in utero: sleeping and awaking periods, movements and suction…

Basic concepts about neurobiology

 _{Roles of pulsatile}

secretion of hormones by the placenta

 The situation of the preterm neonate

 The effect of neonatal experience

 The effect of human inter-relation process

Advances in understanding the physiology of the

fetus and infant:

To be improved: the preparation during pregnancy,

during labour and delivery, and in obstetrical

Advances in understanding about

clinical examination and other usual

situations

When everything is processing normally and as

imagined, the « task » seems easy

…

However, when a difficulty is coming at once, we are not enough prepared in imagining and living a « difficult » task

One should consider not only the present, but also the past of individuals…

Advances in understanding the hospital periods: High Risk Pregnancy, labour and delivery, Neonatal Intensive Care, Pediatrics

Several aspects should be re-adjusted:

- in people working with or living a pregnancy: - in people working with or living an infant:

Re-defining the concept of nursing:

 What does « nursing » mean ?

 _{Who is in fact performing « nursing » ?}  _{Who is actually being « nursed » ?}

 _{What are the periods concerned by the perinatal and neonatal}

The importance of adverse experiences and or depression in the

mother during the first 3 years of life: reasons to change in us several references…

 _{Imprinting bad memories}

in the infant

 _{Effects on limbic and}

frontal structures

 _{Effects on eating and}

sleeping habitudes

 _{Super-added effects on}

Redefine periods and field of works



_{Periods: fetal, perinatal, neonatal, infantile, etc…}

_{Field of work: in the « unit » and outside the}

Conclusions

( 1 ): nursing is an envelope

around the «infant + family» , which is including

several type of persons with their knowledge and

ignorance…

Conclusions ( 2 ): that envelope should be devoted

mainly to parents and the infant

 _{Before birth}

 _{After birth in « acute and}

long-term » phases.

 _{Clinical research should}

include non separately doctors and allied persons

There isn’t although a universal « key » for all cases, we can remind basic things.

Have a nice day today and nice days in your work. This fetus tell us a timid «bye, bye»