Lori S. Lauver

Parenting Foster Children with Chronic Illness and Complex Medical Needs

The experience of parenting foster children with chronic illness and complex medical needs was explored in a phenomenological inquiry with 10 foster families. Thirteen participants currently fostering chronically ill children with complex medical needs were interviewed. Recorded interviews were transcribed and analyzed using van Manens method. Data analysis yielded five essential themes: Foster parents described being committed to the child in their care, coming to know the needs of a medically complex foster child, and identifying effective and ineffective interventions encountered through day-to-day living with a medically complex child. Furthermore, they shared what it was like to experience loss of a child through relinquishment and death. Last, for these parents, fostering children with complex health care needs was a life-changing experience. The findings show that parenting a chronically ill foster child with complex medical needs is a multifaceted experience having implications for multiple disciplines.

The lived experience of foster parents of children with special needs living in rural areas.

The experience of 10 foster families living in rural communities in the Northeastern United States was explored through phenomenological inquiry. Through an unstructured interview approach, parents were asked to describe what it was like to parent foster children with specialized health care needs. Recorded interviews were transcribed verbatim and analyzed using van Manens method. Data analysis revealed that parents fostering children in rural communities have concerns related to accessing medical care and decision making. They expressed feelings of being overwhelmed and unprepared, isolated, and stigmatized.

Environmental Health Advocacy: An Overview of Natural Gas Drilling in Northeast Pennsylvania and Implications for Pediatric Nursing

This article presents an overview of the Marcellus Shale gas well drilling project in northeast Pennsylvania and serves as a model for how nurses can evaluate such problems in their own communities. Resources to help nurses become involved in the environmental health advocacy process are made available.

Implementing an MSN Nursing Program at a Distance Through an Urban-Rural Partnership

Recruiting, retaining, and educating advanced practice nurses is essential to meet the growing need for advanced practice nurses in rural and urban communities. Through the support of Health Resources and Services Administration funding, the urban school of nursing expanded its MSN program and implemented the graduate curriculum on its rural campus by utilizing emerging online and distance education technologies. The purpose of this manuscript is to provide an overview of expanding an existing MSN program offered in an urban, traditional classroom setting to rural graduate nursing students via an online synchronous format. In addition, the article will describe the rural growth of the existing neonatal nurse practitioner program as an exemplar and the different methodologies that are being used in each program to engage the rural nurse practitioner students in clinical courses. In addition, strategies to address barriers related to rural nurse practitioner student recruitment and retention will be discussed.

Kids into health careers: a rural initiative.

PURPOSE To describe a project that introduces middle school and high school students living in Pennsylvanias rural geographic regions to nursing careers through outreach extended to students regardless of gender, ethnicity, or socioeconomic status. METHOD The authors employed many strategies to inform students about careers in nursing. The methods included: working with guidance counselors, participating in community health fairs, taking part in school health career fairs, collaborating with Area Health Education Centers, serving on volunteer local education advisory boards, developing a health careers resource guide, and establishing a rural health advisory board. FINDINGS Developing developmentally appropriate programs may have the potential to pique interest in nursing careers in children of all ages, preschool through high school. Publicity is needed to alert the community of kids into health care career programs. Timing is essential when planning visits to discuss health care professions opportunities with middle and high school students. It is important to increase the number of high school student contacts during the fall months. Targeting high school seniors is particularly important as they begin the college applications process and determine which school will best meet their educational goals. CONCLUSIONS Outcome measures to determine the success of health career programs for students in preschool through high school are needed. Evaluation methods will be continued over the coming years to assess effectiveness.

Health Fairs as a Forum to Pique Young Children's Interest in Nursing

Kids into Health Career (KIHC) initiatives largely have focused on the recruitment of high school- and middle school-age students. Little attention has been given to informing young children and their parents about health professions careers. The career development literature supports that career development is a lifelong process beginning in early childhood. The purpose of this article is to offer practical ideas to introduce preschool-age and elementary school-age children to health careers in nursing. The value of health fairs as a forum to pique interest is discussed. Outcome measures to determine the success of KIHC strategies for younger children are needed.

Pre-Pregnancy Obesity and Weight Gain During Pregnancy: Relationship To The Development Of Gestational Diabetes Mellitus and The Birth Of a Large For Gestational Age Neonate

Poster Presentation Objective To compare the prevalence of gestational diabetes mellitus (GDM) and large for gestational age (LGA) neonates in pregnant obese women who gain less than, within, and greater than the 2009 recommended weight gain guidelines of the Institute of Medicine (IOM). Design A retrospective cohort study. Setting Data from the University of North Carolina (UNC) Perinatal Database. Sample Women with singleton pregnancies and body mass indices (BMI kg/m 2 ) ≥ 30 delivering between January 2012 and December 2012 who underwent routine screening for GDM at UNC Womens Hospital. Methods We measured the association between early weight gain (EWG) and diagnosis of GDM and the association between total gestational weight gain (TWG) and LGA neonate. To determine EWG and TWG, respectively, we subtracted prepregnancy weight from weight at GDM screening or weight at last prenatal visit >37 weeks. We calculated and classified EWG as less than, greater than, and within based on IOM guidelines for first trimester (1.1 pounds) and second trimester weekly weight gain (0.4‐0.6 pounds; 0.6 = above). Women were separately classified as gaining less than ( 20 pounds) IOM guidelines for TWG. We compared maternal demographics and medical history data using Pearson chi‐square and t test. We reported unadjusted and adjusted risk ratios (RR, aRR) with 95% confidence intervals (95%CI) for GDM and LGA with women gaining less than IOM guidelines as reference. Final adjusted models included prepregnancy BMI, EWG within guidelines, and gestational age at 1‐hour screening. Results Among 778 obese women, 67% (524/778) had full data for EWG analysis; 33% (171/524) gained less than, 17% (90/524) within, and 50% (263/524) greater than IOM recommendations. EWG adherence was not associated with a GDM diagnosis ( p = .9). Seventy‐one percent (549/778) had full data for TWG analysis; 24% (130/549) gained less than, 20% (108/549) within, 55% (304/549) greater than IOM guidelines. Compared with women gaining less than, those gaining within IOM guidelines were more likely to have an LGA neonate (RR = 2.88, 95% CI 1.05‐7.95; aRR=3.36, 95% CI 1.10‐10.31). Compared with women gaining less than, those gaining greater than IOM recommendations were more likely to have an LGA neonate (RR = 3.25, 95% CI 1.30‐8.08; aRR=3.54, 95% CI 1.10‐11.79). Conclusion/Implications for Nursing Practice Among obese women, EGW adherence to IOM guidelines did not affect GDM diagnosis in our data. Total gestational weight gain within and greater than the IOM recommendations was associated with birth of LGA neonate. Using arenas of practice, health policy, and education nurses can assist in decreasing the incidence of LGA and GDM.

SPN NewsThe Society of Pediatric Nurses: Position Statement on Child Welfare

The Society of Pediatric Nurses (SPN) is dedicated to supporting its members in their practice. Since its inception in the mid 1980s, SPN has been instrumental in advocating for high quality, culturally sensitive, and comprehensive care for children and families. Advocacy for children and families takes on many forms. The development of position statements by the organization serves as one mechanism to begin to address some of the issues encountered by pediatric nurses in their practice settings. In 2008, the SPN Public Policy Committee developed its first position statement on child welfare. At that time, statistics showed that 906,000 children were victims of child abuse and neglect, and 3 children died every day from maltreatment (National Court Appointed Special Advocate Association, 2006). Foster care statistics also were alarming with more than 500,000 children living in foster care, and adolescents representing approximately one-third of this total (Love, McIntosh, Rosst & Tertzakian, 2005). Approximately half of all children in the United States (US) child welfare system had significant emotional or behavioral issues (Burns et al., 2004). Given these statistics and other child welfare issues, including the many children in kinship care and grandparent homes, and child homelessness, the position of SPN was to encourage careful assessment and identification of health and welfare needs, interdisciplinary collaboration including social services, referral to appropriate resources with careful follow-up, and political awareness advocacy. The impact of a declining global economy continues to affect millions of children and their families. Child welfare statistics remain relatively unchanged with the exception of

The Society of Pediatric Nurses Position Statement on Child Welfare

The Society of Pediatric Nurses (SPN) is dedicated to supporting its members in their practice. Since its inception in the mid 1980s, SPN has been instrumental in advocating for high quality, culturally sensitive, and comprehensive care for children and families. Advocacy for children and families takes on many forms. The development of position statements by the organization serves as one mechanism to begin to address some of the issues encountered by pediatric nurses in their practice settings. In 2008, the SPN Public Policy Committee developed its first position statement on child welfare. At that time, statistics showed that 906,000 children were victims of child abuse and neglect, and 3 children died every day from maltreatment (National Court Appointed Special Advocate Association, 2006). Foster care statistics also were alarming with more than 500,000 children living in foster care, and adolescents representing approximately one-third of this total (Love, McIntosh, Rosst & Tertzakian, 2005). Approximately half of all children in the United States (US) child welfare system had significant emotional or behavioral issues (Burns et al., 2004). Given these statistics and other child welfare issues, including the many children in kinship care and grandparent homes, and child homelessness, the position of SPN was to encourage careful assessment and identification of health and welfare needs, interdisciplinary collaboration including social services, referral to appropriate resources with careful follow-up, and political awareness advocacy. The impact of a declining global economy continues to affect millions of children and their families. Child welfare statistics remain relatively unchanged with the exception of