Friday, January 24, 2014

Working with Babies in the Enfermería

I have spent the last three days working in the "enfermería" with the nurses and doctors who perform healthy baby check-ups on all the infants who come into the clinic. The area in which I have been working is for babies under one year of age. There are other areas where the children over one are seen.

Numerous mother-child pairs come into the clinic each day and I have helped by measuring the weight, height/length, and cephalic perimeter (head circumference) of each baby before he or she is seen by the doctor/nurse. It has been slightly difficult to know what to do because very often they tell me to do something without telling me how to do it. I end up just guessing and hoping that I am doing it correctly. Some of the things are quite easy. For example, it is not difficult to know how to work the digital scale because all it involves is placing the child on the balance and recording the number that shows up. However, other tasks require a little bit more concentration. In order to measure the height/length of the baby there is a table with a wooden measuring board upon which the baby lays while I record their height/length. This involves instructing the mom (in Spanish, of course, which just adds to the difficulty!) to hold the child's head at one end while I flatten the legs and press another wood board against the feet to record the height/length from the head to heel. The measuring board looks something like this wonderful visual I found on the internet...
It is an easy process when the baby doesn't cry and the legs are relaxed and easy to manipulate, but when the child is crying loudly and tensing his or her legs, it can be difficult to get an accurate measurement! Fortunately, the more I do it, the easier it gets.

As I became acclimated to the process and started to figure out how things needed to be done, a head doctor/nurse lady named Maria (side note: whenever I meet someone here, they rarely tell me their name or who they are, so I hardly ever have any idea about who anyone is or what their jobs are. I was fortunate enough to hear Maria's name, so at least I know that even though I don't know if she is a doctor or nurse) also instructed me to perform an "Evalución del Desarrollo Psicomotor" (Evaluation of Psychomotor Development). This involves working through a few criteria that the child needs to have met by a certain age in order to ensure that he or she is developing correctly. 
This is what the form looks like...
There are different criteria for the different ages. For example, it says that by one month of age, an infant should have asymmetric movements of the arms and legs and squeeze any object placed in his or her hand. A child of five months should be able to maintain a straight back with the support of the hands in front, recognize his or her name, and play with her hands and feet. 











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