The Journal of perinatal & neonatal nursing
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Prominent American and British obstetricians have been advocating for performing more Cesareans. They argue that Cesarean section is as safe or nearly as safe as vaginal birth, eliminates pelvic floor damage and the consequent symptoms caused by vaginal birth, is safer for the infant, and is desired by many women; however, abundant evidence in the medical literature refutes the validity of those claims.
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J Perinat Neonatal Nurs · Jun 2001
Managing women's and children's services: contemporary models as a template for the future.
Historically hospitals have struggled with organizational design and management of services within a single institution. The traditional design has been a bureaucracy with a hierarchical management structure. ⋯ The SBU has application for selected portions of a health care organization. The SBU will be discussed as it specifically relates to women's and children's health care services.
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The birth of a baby can be a joyous event. When an infant requires neonatal intensive care, concern may overshadow joy. This work reports a descriptive, qualitative study that explored parents' perception of their experiences in the neonatal intensive care unit (NICU) when faced with the dilemma of withholding and/or withdrawing treatment from their infants. ⋯ When health care providers demonstrated to parents that they cared, it helped promote trust between providers and parents. Trust promoted parents' confidence in information received and ultimately in the decision reached. Thus, parents were focused on relationships with health care providers, not on ethics.
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J Perinat Neonatal Nurs · Sep 2000
Ethical issues in the delivery room: resuscitation of extremely low birth weight infants.
The neonatal team attending high-risk deliveries is often faced with difficult ethical decisions concerning aggressive cardiopulmonary resuscitation for infants of 22-24 weeks gestational age (GA). These decisions are often based on the ethical principles of beneficence, nonmaleficence, justice, futility, autonomy, quality of life, and best interests and legal rights of the infant. ⋯ The perinatal and neonatal intensive care nurse must understand the moral, ethical, legal, and professional responsibilities and their effect on her/his own judgment decisions. These, in turn, will affect the infants, their parents, and other colleagues.
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The manner in which the contextual dynamics of the neonatal intensive care unit (NICU) culture influence decisions around withholding and withdrawing treatment for very low birth weight infants is examined based on sociological studies of the NICU culture. The influence of these dynamics on nurse and parent participation in treatment decisions is discussed. Steps toward increasing nurses' role in decision making and ability to empower the participation of parents include (a) using an understanding of the dynamics of the individual NICU to establish a collaborative team culture, and (b) demonstrating that data obtained through relationship with the infant make an important and valid contribution to ethical decision making.