Immunizing Children Who Fear and Resist Needles: Is It a Problem for Nurses?

Chilliwack Health Unit, Chilliwack, British Columbia, Canada.
Nursing Forum 01/2010; 45(1):29-39. DOI: 10.1111/j.1744-6198.2009.00161.x
Source: PubMed


Despite increasing evidence that immunization procedures can be stressful for children, little is known about what the experience of immunizing frightened and needle-resistant children can be like for nurses.
This article presents findings from a qualitative research project designed to explore public health nurses' feelings toward immunizing needle-resistant children. A constructivist theoretical perspective and an action research approach framed the study. Data sources included two survey questions and audio-recorded transcribed data from three focus groups. Participants included 35 public health nurses from five different health units in one Canadian province. The data were analyzed for themes and were confirmed with participants through ongoing member checking.
The following four overarching themes were identified and are used to explain and describe significant features of the immunization experience that were stressful and problematic for nurses: (a) nurses experience stress when immunizing children who fear and resist needle injection; (b) the strength of child resistance and some adult behavior creates an ethical dilemma for nurses; (c) some adult responses make immunizing difficult and unsafe; and (d) resources to help nurses cope with these situations are inconsistent.

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    • "Consequently, the strength of children's resistance can create an ethical dilemma for healthcare providers (Ives & Melrose 2010). Healthcare providers who restrain might feel that they have to choose between causing harm and promoting health (McGrath & Huff 2003, Lloyd et al. 2008, Ives & Melrose 2010). "
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    • "This in turn can lead to physical harm for the nursing staff (Lambrenos & McArthur, 2003) and children respectively, and Llyod, Urquhart, Heard, and Kroese (2008) find that nurses experience negative emotions during this action. In a study by Ives and Melrose (2010), the nurses described a feeling of powerlessness when the children had to endure those trying NRMP. Similarly, the nurses in our study reflected upon the negative consequences of a difficult procedure for the children but also for themselves. "
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