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.S. health care system for the first time during a pregnancy or with a sick child. This requires a greater sensitivity on the part of health care providers to the sociocultural aspects of care. As the level of violence in the world increases, more and more families are exposed to living in violent communities. The incidence of abused children and pregnant women is also increasing. All of these concerns require increased nursing attention. Empowerment of Health Care Consumers In part because of the influence of market-driven care and a strengthened focus on health promotion and disease prevention, individuals and families have recently begun to take increased responsibility for their own health. This begins with learning preventive measures to stay well. For some families, it means following a more nutritious diet and planning regular exercise; for others, it can mean an entire change in lifestyle. When a family member is ill, empowerment means learning more about the illness, participating in the treatment plan, and preventing the illness from returning. Families are very interested in participating in decision making regarding their childbearing options. Parents want to accompany their ill children into the hospital for overnight stays. They are eager for information about their child’s health and want to contribute to the decision-making process. They may question treatments or care plans that they believe are not in their child’s best interest. If health care providers do not provide answers to a client’s questions or are insensitive to needs, many health care consumers are willing to take their business to another health care setting. Nurses can promote empowerment of parents and children by respecting their views and concerns, addressing clients by name, and regarding parents as important participants in their own or their child’s health, keeping them informed and helping them to make decisions about care. Although a nurse may have seen 25 clients already in a particular day, he or she can make each client feel as important as the first by showing a warm manner and keen interest. Family Teaching displays are presented throughout this text to provide insight into ways in which nurses can help empower families. What if... In the past, children with pneumonia were always hospitalized. What if Melissa Chung demands that her 6-year-old, diagnosed with pneumonia, be hospitalized, even though it is your clinic’s policy to have such children cared for at home by their parents? Would you advocate for hospitalization or not? ADVANCED-PRACTICE ROLES FOR NURSES IN MATERNAL AND CHILD HEALTH As trends in maternal and child health care change, so do the roles of maternal and child health nurses. All maternal and child health nurses function in a variety of settings as caregivers, client advocates, researchers, case managers, and educators. Many nurses with a specified number of years of direct patient care, clinical expertise, and validated completion of pertinent continuing education programs are certified in their specialty. In addition, maternal and child health nurses function in a variety of advanced-practice roles. Clinical Nurse Specialists Clinical nurse specialists are nurses prepared at the master’s-degree level who are capable of acting as consultants in their area of expertise, as well as serving as role models, researchers, and teachers of quality nursing care. Examples of areas of specialization are neonatal, maternal, child, and adolescent health care; childbirth education; and lactation consultation. Consider, for example, how a child health clinical specialist might intervene to help in the care of a 4-year-old child with diabetes mellitus who has been admitted to the hospital. The child is difficult to care for because he is so fearful of hospitalization and perplexed because his parents are having difficulty accepting his diagnosis. A clinical nurse specialist could be instrumental in helping a primary nurse organize care and in meeting with the parents to help them accept what is happening. Neonatal nurse specialists manage the care of infants at birth and in intensive care settings; they provide home follow-up care to ensure the newborn remains well. Childbirth educators teach families about normal birth and how to prepare for labor and birth. Lactation consultants educate women about breast-feeding and support them while they learn how to do this well themselves. Case Manager A case manager is a graduate-level nurse who supervises a group of patients from the time they enter a health care setting until they are discharged from the setting, or, in a seamless care system, into their homes as well, monitoring the effectiveness, cost, and satisfaction of their health care. Case management can be a vastly satisfying nursing role, because if the health care setting is “seamless,” or one that follows people both during an illness and on their return to the community, it involves long-term contacts and lasting relationships (Peterson, 2004). Women’s Health Nurse Practitioner A women’s health nurse practitioner is a nurse with advanced study in the promotion of health and prevention of illness in women. Such a nurse plays a vital role in educating women about their bodies and sharing with them methods to prevent illness; in addition, they care for women with illnesses such as sexually transmitted infections,
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