I am wondering what people think of the new HPV (human papilloma virus) vaccine that is now available in some parts of Canada? I don't know about the U.S.A. What are people's feelings? I have mixed feelings, I feel that it has the opportunity to be a wonderful prevention tool, but that if not presented with enough education could make this generation of girls coming up, a little more free with their sexual practices. I wonder how many might feel that they are now immune to many STD's. I don't have a daughter yet, but feel that if I did, I would be wanting all the research available, one to assess the side effects, and two to see if the promiscuity rate in countries who have already initiated the practice have risen. It will be interesting to see.

Great Experience

Wow!! What a difference a little research and understanding makes. We went for the immunizations today and I used some of the distraction techniques I had read about, taking a toy from home, having Dad there, and singing songs. Although he still screamed, it didn't seem to have the same level of distress as the previous immunizations. I was refreshed to see that the nurse went through all the immunizations with me today, and when she was about to give the Intramuscular injections in his arm, I stopped her and asked for her to give them in the leg, no fuss she did. All in all it was a way better experience today. I am happy I started this course.

Next Immunization appointment

Tomorrow my son has his 18 month immunization administration. I am having mixed feelings about the whole experience, but after reviewing the literature surrounding pain management in infants/toddlers during immunizations, I feel more confident as a parent that I can help to decrease the distress felt by my little guy. As for change in the whole system, I am still pondering my next motivated step in this. My thoughts are to continue to review the literature and then possibly approach the clinician at the Public Health Unit here and discuss the literature out there surrounding this topic. It would be nice to discuss with this person as well, the possibility of implementing some of these techniques into practice at this Public Health Unit on a trial basis, part of Kurt Lewin's theory of change, moving. The process may be a slow one, but I think if the subject is approached properly and well supported with literature that is well read, and established the change from no techniques to teaching parents distraction techniques will be an easy transition.

Where are we in change?

Kurt Lewin's stages of change included unfreezing or unlearning, moving, and refreezing or relearning. It is this change theory I feel best applies to the topic of pain management in infants and toddlers during routine immunizations. I know many colleagues who state that infants and toddlers need to feel that pain and learn to cope with it, or that the pain involved is minor and short lived, or my favorite that the pain they feel is a normal part of life. Is pain a normal part of life. All throughout our nursing training we are taught to manage individuals pain and to understand the differences between acute and chronic pain. We spend time learning the different methods for pain reduction. As a society we look for ways to manage pain. I wonder then what is the difference between the pain associated with an immnization injection and the pain associated with some childhood illnesses. Do they not still develop the same response? Lewin's stage of unfreezing is applicable to the stage nursing is at right now with pain management in infants, toddlers and children. We are having to relearn, rethink our methods of pain control. It is a heated topic being studied worldwide with many researchers discovering that simple measures such as distraction make a long lasting difference in pain management for children. So back to Lewin's theory, we are unfreezing, relearning our approach to pain management, looking for the move to correcting the lack of understanding for our shorter ones.

Little pain as precursor

Thank you anonymous for posting your thoughts to this page. I tend to disagree with your opinion, but it is your opinion. Many reseearchers have completed studies on pain managment and it's effects of pain tolerance in later years. Taddio, Katz, Ilerich and Koren published a study conducted on the Effects of Neonatal Circumcision on Pain Response during Subsequent Routine Vaccination. Their preliminary studies suggested that the pain experienced by infants and neonates in the neonatal period may have long lasting effects on behaviour associated with pain in later years. Their study followed circumcised infant boys, those who had EMLA cream applied previous to the freezing for circumcision and those who had not, versus uncircumcised boys and their follow up immunizations at four-six month mark. Taddio et al found that boys who did not have EMLA applied prior to circumcision had a higher pain response to immunization injections than the EMLA group and the uncircumcised group. This study is providing growing proof that providing pain relief for minor procedures does help children cope better with procedures later in life. When we come across adults who are frightened of needles and ask how they fear developed they usually have a story of a painful procedure that involved needles, and describe that as their first fear. If we develop fears, then why do we brush off pain control in infants when undergoing medical procedures? Do they really learn to be tough? Remember that pain management does not always have to be medicinal.

My immunization experience

Hello,
I created this blog as part of an assignment for my Bachelor in Science of Nursing program change project, but as well as to get input and discussion on a topic that I know is controversial. My project encompasses the ideas of all pain management for infants and toddlers while receiving routine immunization injections. I had a personal experience that has troubled me since. I had heard wonderful stories of colleagues I work with taking their children to be immunized at the public health unit. They had told me about distraction techniques they were taught, the detailed information about each injection and the autonomy they were given with which to choose if their child would receive all the injections. My experience was the complete opposite. They weighed each child, checked you in and then we were asked to wait in a large room with other children. You could hear each child cry as they were injected, in offices down the hall. There were two nurses sitting behind a table, not once did they come around and ask if we had any questions, or fears. No one provided us with any distraction techniques training, or any excercises to help alleviate the pain felt by our child. Another RN came and called our name and took us to her office. She briefly went through the immunizations that would be given, and gave us some handouts. She told us to hold our son down on our lap and gave us some bells to shake in front of him. She never tried to interact with our son, nor did she try to see what his interests in the room might be, like the mobile hanging above the examining table behind her. She injected him with the first injection, he was to receive a total of four, and then asked us to console him. I told her to continue and get them all over with and then I would console him at that point. She continued. It felt like a disaster, he screamed, I felt disempowered and disgusted with the example of my profession sitting there. I needed to make change! The next time was even worse. The RN attempted to put the injection in my 8 month old son's arm. I explained that this was against protocols, and procedures. She argued with me and I was asked to leave while my husband stayed and my son received the injection in his arm, where he got a large red bump and had it for a number of months after. Again I felt disempowered and even more frustrated, I cannot even imagine what Mom's who are scared prior to the first injection are feeling. Where was this wonderful experience everyone had told me about? Where was the empowerment, the autonomy, the encouragement from the nursing profession?

So this is why I decided to look at infant and toddler pain with immunizations, techniques studied to alleviate the pain, and ways with which to make it common among the profession to provide all individuals with a positive experience.