Consider some of the other differences of nursing children in their homes compared to acute care. Then reflect on what benefits there may be in nursing children at home.

Answer: Timescales, infection control, decision making, lone working, communication and working in people’s homes and their environment.

Please take a moment to think about daily activities which can help with constipation problem for children and compare with the guidelines provided on the companion website.

Answers:

• Children are to be encouraged to have six to eight drinks a day – this includes breastfeeding and formula milk feeds.
• A varied diet in particular foods including plenty of fruit and vegetables, are a good source of fibre.
• Encouraging physical exercise.
• Supporting families with establishing a routine of regular toilet visits (sitting on the potty or toilet), after meals or before bed, and praise them whether or not they poo each time. This is particularly important for boys, who may forget about pooing once they are weeing standing up.
• When sitting on the toilet it is advised that children should rest their feet flat on the floor or a step – this will help get them to form a good position for passing stools.
• Some children can develop anxiety using the toilet in certain situations, such as at nursery so it’s important to talk to them about their worries.
• The GP or paediatrician may prescribe laxatives for a while to make sure the stool stays soft enough to push out regularly.

Source: NHS Evidence (2014)

Research one of the many common childhood conditions and using the nursing process, think about your role with consideration to community working practice.

Answer: For example, chickenpox, whooping cough, tonsillitis, impetigo, conjunctivitis, eczema, asthma. There are a number of roles community children’s nurses can contribute to pathways of care for children and young people with acute and short-term conditions. These are divided into two sections:

• avoiding hospital admission; and

• enabling early discharge thereby reducing length of stay.

The CCN service can provide follow-up care and treatment, supported by appropriate protocols, to prevent the hospital admission of moderately ill children (for example, those with respiratory conditions or gastroenteritis). Advanced children’s nurse practitioners who are skilled in assessing ill children, making diagnoses and ordering investigations and treatment, including prescribing medication, are able to provide services in a range of settings more accessible to families. This can be a vital part of the pathway in areas where traditional secondary care services are being consolidated on fewer sites. One group who can benefit from this is single parents and parents isolated from their extended family, who seek advice when their children suffer relatively minor illnesses. Empowering them to manage these illnesses themselves reduces their dependency on the NHS. For example, walk-in centres providing assessment, advice and treatment enable parents to manage the illness at an early stage, thus preventing the need for attendance at accident and emergency departments or admission to hospital. CCN services can not only prevent hospital admission for some children, but reduce the length of stay for those who need to be admitted.

Have a look at the public health priorities for England from Public Health England (2014).  Are these the same or have the priorities changed? Do you agree with them? Or do you feel there should be other topics?

See: www.gov.uk/government/publications/public-health-englands-priorities-for-2013-to-2014

Sophie has requested to see you at your school nurse drop-in. She is requesting the morning after pill as she had unprotected sex with her boyfriend on Saturday night. They did use a condom but it split and they didn’t notice until it was too late.

Using the Royal College of Nursing (RCN) position statement, ‘The role of school nurses in providing emergency contraception services in education settings’ (RCN, 2012), write down in a list the important questions that you need to ask Sophie in order to gather further information and provide the correct treatment and advice.

Answer: see www.rcn.org.uk/professional-development/publications/pub-002772

All young people, regardless of gender, or sexual orientation who are believed to be engaged in, or planning to be engaged in, sexual activity must have their needs for health education, support and/or protection assessed. Within your questions, are these factors taken into consideration?

• Whether the young person is competent to understand and consent to the sexual activity they are involved in;
• The nature of the relationship between those involved, particularly if there are age or power imbalances;
• Whether overt aggression, coercion or bribery was involved including misuse of substances/alcohol
• Whether the young person's own behaviour, for example through misuse of substances, including alcohol, places them in a position where they are unable to make an informed choice about the activity;
• Whether the sexual partner is known or as having other concerning relationships with similar young people;
• Whether methods used to secure compliance and/or secrecy by the sexual partner are consistent with behaviours considered to be 'grooming';
• Whether sex has been used to gain favours (e.g. swap sex for cigarettes, clothes, CDs, trainers, alcohol, drugs, etc.)

Please also access www.londoncp.co.uk/chapters/sg_sex_active_ch.html for further information and resources to help develop your knowledge on this subject.