This essay is a fictional healthcare scenario. It, however, deals with the circumstances and challenges faced by 15-year-old Ella, who is 6 months pregnant, and lives with dad and siblings. Ella is a long-term sufferer of anxiety and depression. This essay will explore the issues that are faced by her family and explore how healthcare services can implement solution using legislation, policies and theories.The risks for teen pregnancies are numerous, for both mother and child. To prevent some early risks Ella went to see her General Practitioner (GP) this was to make sure there was a reduction in complication. In order to have a healthy pregnancy, Ella requires a healthy diet, prenatal care, exercise, and rest because as an adolescent the body is still maturing (Hadley, A. 2017). The child is put at risk because as a teen mother, the baby is more likely to be premature along with a low birth weight which leads to problems in their later life (Thomas, A. 2019). The problems range both mentally and physically. The child may also be born with birth defects. Ella is at great risk as well. The body is strained in order to birth the child. If the bones are not entirely developed the pelvic bone is injured as well as the spine with permanent damages (Thompson, C., McCormack, S., Watson, R., et al 2019). As Ella has depression and anxiety, she is at greater risk of post-natal depression, so she is under the care of the perinatal team. The perinatal team roles are Every Child Matters: (ECM) is an initiative of the UK Government for England and Wales that was launched in 2003. Its aim is to ensure all children, regardless of their circumstances or background have the support they need to: be healthy; safe and to achieve (Knowles, G. 2009)). Following on from ECM, The Children’s Act 2004 make sure that services provided to children by local authorities to improve the wellbeing of children and requires that local authorities and other agencies work together to improve the well-being of children and it follows the same key principles as ECM (Kakabadse, N, Marzec, N. and Rose, R. 2014).Many teenagers are forced to sacrifice their education when they become pregnant, and as Ella already suffers to get to school, she could be giving up a getting her GCSE grades to gain good career prospects. This means that because Ella parents are on low incomes, she may not receive financial support from them for her and her unborn child, she could find herself using benefits because if she cannot attend school, her grades may be put at risk. This therefore means her options are limited because apprenticeships or colleges are only available for individuals who complete school. On the other hand, if she was to get a job when the child is born, she would have to contend with expensive childcare, this could therefore lead to her options again being limited to school time working hours, which are mainly low paid. On the other hand, if interventions are put in place to help monitor Ella while she is in school, a school nurse could be vital for Ella to help make sure she stays in education. The role of the school nurse in Ella’s case is to contribute to the health and academic success of Ella’s pregnancy by providing evidence-based practice, making sure its culturally appropriate and individualised (Forward, C. 2016). By Ella having this support in a teen friendly environment it could guarantee completion of education and a successful start into parenthood. Ella school nurse would take a vital stand in multidisciplinary team (MDT) working and could also refer to other clinical services is she requires further support. Under the Data Protection Act 2018 this Act ensures service user confidentiality and any information written about a service user is accurate, truthful. (Spencer, A. and Patel, S. 2019). Furthermore, if Ella wanted to access her information in the future, the act allows Ella to make a formal application to access her information legally. However, if Ella or her unborn baby is at risk of harm information can be shared to relevant personal. Furthermore, Ella’s family are struggling to come to terms with the fact that Ella is pregnant. To help overcome this distress. The school nurse can act as an advocate for Ella, as it is in her best interests, they can act as a liaison between Ella and her family, in order to help create a plan that could create a successful solution to maintain a de-stressful environment for Ella and the unborn baby to thrive in.Attachment and meaning, family systems, social support, cognitive process in adjustment and coping, are all factors and terms associated with the theories of loss and bereavement (McEvoy, J. 2016) which have assisted Stroebe and Schut to generate the dual process model. Their model perceives a person fluctuating between loss-orientation and restoration-orientation. (Stroebe, M. and Schut, H. 2015) Loss-orientation deals with the process of feeling the sense of needing to cry but it not happening or the sense of sadness not stopping and experiencing and dealing with the emotion of loss. Restoration orientation deals with understanding the emotions and starting to proceed with life. This is where the perinatal team could refer Ella to a counsellor because it would be vital in Ella’s care because it is important for Ella to know that it is important for her to understand that the expression of both negative and positive thoughts processes within the feelings of loss and restoration are normal. Additionally, by applying certain aspects of cognition tools and the understanding of attachment, a balance between the swaying emotions and thoughts can be normalised and processed in a comfortable and personal manner as adaption takes place. (Crowe, S. 2016)The theorists Klass and Walter (2004) had a differing theory to Stroebe and Schut explain continuing bonds as recognition that the human condition in both life and death is more complex and unique than many theorists previously had argued (Neimeyer, R., Klass, D. and Dennis, M. 2014). They believed that those left behind feel a sense of the person they have lost, so By making sure Ella has a good support network of healthcare professionals around her as well as family, Ella should be able to grieve openly and being able to express that it is not as simple as getting over grief but a set of process of mourning, adjusting and change which could come in the form of a baby on the way for Ella. As Ella experience love, death and grief making sure her care needs are individual to her. Hence, when looking at the two models of dual process and continuing bonds, it shows it is important that Ella’s healthcare professionals and her family have an understanding of the importance of attachment not just in life but also in death.The theorist Machin discusses that the sense of self and independence is born out of the relationships of attachment we experience across our lifespan. (Klass, G. 2019). These attachments allow Ella to be able to develop coping mechanisms with the positive and negative impacts that happen in life. Furthermore, the theorist Bowlby created the theory of attachment, where depending how an individual has developed secure attachment or insecure attachment (Holmes, J.2014). These attachment styles carry throughout life by development of relationships that start with family, friendship and child relationships. As Ella and her siblings receives support around her loosing her mum, the cultural influences and the change in the family dynamic, they should be allowed to communicate openly in a safe environment to express their emotions so they can make sense of the huge change that has happened and the change that is coming. On the other hand, with regards to attachment within the family as Dad works away and has limited time at home during the day, a feeling a of separation around Ella and her siblings because they don’t spend a lot of time with Dad.Poverty is another factor, where the risk of becoming a teenage mother is approximately 10 times more in girls and women from lower working class as compared to women in upper working class (Inchauste, G. 2014). This shows that because Ella is living in a high poverty area that means she already had the odds stacked against her before she even fell pregnant. Another direct effect of poverty that effects Ella and her siblings is the fact that her Dad earns minimum wage and accesses the benefit system specifically using universal credit. Universal credit (UC) replaces several benefits and tax credits for working age families. It merges several large welfare benefits into one (Royston, S. 2012). The main aim that would help Ella’s dad and the rest of the family is to simplify the benefits system and make it easier for them to understand and make it so even though he is working on minimum wage, he can still access financial support and hopefully improve their families lifestyle in the longer run. As a whole the amount of families in the United Kingdom struggling to buy necessities such as food is increasing, in 2015 330,205 children required the use of food banks (Cloke, P., May, J. and Williams, A. 2017). The concept of poverty does not just apply to lack of financial resources it is a more broadened topic that included several different concepts. Poverty and education operate in close parameters this is shown in the case of Ella because Ella struggles to get access to school because of where she lives. In rural areas the benefits of education may be low or not understood. This is because buses run irregularly in rural places so two may come a day leading to the fact that if Ella and her siblings miss a bus then they miss school. Furthermore, it is fundamental children should be nurtured in a safe and healthy environment, benefitting them in all areas of development and future progress. It is the responsibility and duty of care of the stakeholders to safeguard children by creating a positive and responsive environment for them (Kirk-batty, L. 2017). The United Nations Convention on the rights of the child (UNCRC) establishes on three main fields of children’s rights: protection, provision and participation (Quennerstedt, A., Robinson, C. and L’anson, J. 2018). The UNCRC helps children in meeting basic needs by enabling opportunities that , to achieve a child’s full potential, they do this by bringing communities together to create a protected environment for children and like the school nurse making the environment a safe space for Ella to express herself and her opinions free from judgement.In conclusion to this, in Order for Ella, her family and her unborn child to thrive. Communication, having access to local services and support are vital for Ella to achieve a positive outcome.
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