Research Explorer | The University of Manchester
Therapeutic opportunities when using vapocoolants for intravenous cannulation of children. The application of Nursing TherapeuticsCliff Richardson1. RN, BSc (Hons), MSc, PhDElizabeth Ovens2. BA (Hons), BNurs (Hons)Senior Lecturer. University of ManchesterStaff Nurse, Stepping Hill Hospital, Stockport.Corresponding authorCliff RichardsonSenior LecturerSchool of nursing, midwifery and social workUniversity of ManchesterJean McFarlane BuildingOxford RoadManchesterM13 9PL+44 (0)161 3067639Clifford.richardson@manchester.ac.ukAbstractHow nurses make a difference and influence outcome has been the subject of much debate over many years and is perhaps more relevant now due to health care funding being a scarce commodity. Nurses need justification and validation of what they do. Nursing therapeutics is a relatively new term that can help nurses and others to appreciate the multifariousness, complexity and value of what we do. It encapsulates the means by which a nurse delivers care that is both evidence-based and beneficial to their patients. This paper will spotlight how nurses can utilise common nursing interventions to ensure that the full impact of their skills is embedded into their care using the administration of vapocoolants as the focus. It will be illustrated that through each patient contact a nurse can establish therapeutic principles which can positively influence health outcomes.Key phrasesTherapeutic relationshipNursing therapeuticsProcedural painNursing as a therapyNursing interventionsThe 6C’sKeywordsNursingPainVapocoolantsCareCompassionBackgroundModern health services require justification of all care in order to ensure positive effects on patient outcome. Whilst nurses deliver a complex range of diverse interventions and skills often contemporaneously within a highly pressured environment, there is not always strong empirical evidence to support these activities. Following some high profile break downs in care in the UK ADDIN EN.CITE <EndNote><Cite><Author>Francis</Author><Year>2013</Year><RecNum>7116</RecNum><DisplayText>(Francis, 2013)</DisplayText><record><rec-number>7116</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7116</key></foreign-keys><ref-type name="Government Document">46</ref-type><contributors><authors><author>Francis, R</author></authors><secondary-authors><author>Department of Health UK</author></secondary-authors></contributors><titles><title>The Mid Staffordshire NHS Foundation Trust Public Inquiry</title></titles><dates><year>2013</year></dates><pub-location>London, UK</pub-location><publisher>HM Stationery Office</publisher><urls></urls></record></Cite></EndNote>(Francis, 2013), there has been renewed focus on how to instil care and compassion into nursing via the Chief Nurse’s 6C’s initiative ADDIN EN.CITE <EndNote><Cite><Author>DH</Author><Year>2012</Year><RecNum>7118</RecNum><DisplayText>(DH, 2012)</DisplayText><record><rec-number>7118</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7118</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>DH</author></authors></contributors><titles><title>Compassion in practice: Nursing, Midwifery and care staff, our vision and strategy</title></titles><dates><year>2012</year></dates><urls><related-urls><url>;(DH, 2012). The 6C’s are care, compassion, communication, commitment, competence and courage and when utilised these are believed to enhance nursing care ADDIN EN.CITE <EndNote><Cite><Author>DH</Author><Year>2012</Year><RecNum>7118</RecNum><DisplayText>(DH, 2012)</DisplayText><record><rec-number>7118</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7118</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>DH</author></authors></contributors><titles><title>Compassion in practice: Nursing, Midwifery and care staff, our vision and strategy</title></titles><dates><year>2012</year></dates><urls><related-urls><url>;(DH, 2012). Using the principles of ‘Nursing therapeutics’ ADDIN EN.CITE <EndNote><Cite><Author>Richardson</Author><Year>2015</Year><RecNum>7190</RecNum><DisplayText>(Richardson et al., 2015)</DisplayText><record><rec-number>7190</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7190</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Richardson, Cliff</author><author>Percy, Marcus</author><author>Hughes, Jane</author></authors></contributors><titles><title>Nursing therapeutics: Teaching student nurses care, compassion and empathy</title><secondary-title>Nurse Education Today</secondary-title></titles><pages>e1-e5</pages><volume>35</volume><number>5</number><keywords><keyword>Caring</keyword><keyword>Compassion</keyword><keyword>Empathy</keyword><keyword>Therapeutic relationship</keyword><keyword>Nursing therapeutics</keyword></keywords><dates><year>2015</year></dates><isbn>0260-6917</isbn><urls><related-urls><url>;(Richardson et al., 2015), this article will explore how nurses can justify the use of time to show care, compassion and empathy whilst delivering effective care. The use of vapocoolants for venepuncture/cannulation in children will be used as an exemplar. Nursing therapeutics is a term recently coined which combines the use of empirical evidence with day to day routine nursing tasks in order to identify the key elements of patient benefit ADDIN EN.CITE <EndNote><Cite><Author>Richardson</Author><Year>2015</Year><RecNum>7190</RecNum><DisplayText>(Richardson et al., 2015)</DisplayText><record><rec-number>7190</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7190</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Richardson, Cliff</author><author>Percy, Marcus</author><author>Hughes, Jane</author></authors></contributors><titles><title>Nursing therapeutics: Teaching student nurses care, compassion and empathy</title><secondary-title>Nurse Education Today</secondary-title></titles><pages>e1-e5</pages><volume>35</volume><number>5</number><keywords><keyword>Caring</keyword><keyword>Compassion</keyword><keyword>Empathy</keyword><keyword>Therapeutic relationship</keyword><keyword>Nursing therapeutics</keyword></keywords><dates><year>2015</year></dates><isbn>0260-6917</isbn><urls><related-urls><url>;(Richardson et al., 2015). 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ADDIN EN.CITE.DATA (Hewitt and Coffey, 2005, Canning et al., 2007, Lima-Basto et al., 2010), hence the nurse is able to act as a therapeutic instrument through nursing therapeutics if they have utilised evidenced based care alongside a full appreciation of how to develop a therapeutic relationship. The starting point is the therapeutic relationship which will be reviewed first, followed by an appreciation of the evidence underpinning the nursing intervention chosen, in this case the use of vapocoolants for venepuncture/cannulation. The final section will combine the evidence from both and explore how the nurse maximises the therapeutic opportunities. Therapeutic relationshipsAlthough Carl Rogers discussed therapeutic relationships in terms of psychotherapy his idea of holding an ‘unconditional positive regard’ for the patients ADDIN EN.CITE <EndNote><Cite><Author>Rogers</Author><Year>1951</Year><RecNum>7197</RecNum><DisplayText>(Rogers, 1951)</DisplayText><record><rec-number>7197</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7197</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Rogers,C</author></authors></contributors><titles><title>Client-centred therapy</title></titles><dates><year>1951</year></dates><pub-location>Oxford,UK</pub-location><publisher>Houghton Mifflin</publisher><urls></urls></record></Cite></EndNote>(Rogers, 1951) could be a nurses starting point and would enable them to make the values of therapeutic relationships integral to everything they do in practice. A nursing therapeutic relationship therefore results from nurse-patient interaction and encompasses concepts that are traditionally linked to nursing, such as but not exclusive to; care, compassion, empathy, mutual understanding, trust and confidentiality PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ccm93biBXaWxzb248L0F1dGhvcj48WWVhcj4yMDA5PC9Z
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ADDIN EN.CITE.DATA (Brown Wilson, 2009, McCance et al., 2009, Snell et al., 2010, Porr et al., 2012). Whilst these nursing attributes are often considered laudable there is some evidence that suggests that developing a therapeutic relationship based on them improves outcome and accelerates recovery PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5IZXdpdHQ8L0F1dGhvcj48WWVhcj4yMDA1PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (Hewitt and Coffey, 2005, Canning et al., 2007, Lima-Basto et al., 2010). One useful model for building therapeutic relationships that could be adopted more widely by nurses was constructed by Muetzel and includes three overlapping concepts, partnership, intimacy and reciprocity ADDIN EN.CITE <EndNote><Cite><Author>Muetzel</Author><Year>1988</Year><RecNum>7085</RecNum><DisplayText>(Muetzel, 1988)</DisplayText><record><rec-number>7085</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7085</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Muetzel, P-A</author></authors><secondary-authors><author>Pearson, A</author></secondary-authors></contributors><titles><title>Therapeutic nursing</title><secondary-title>Primary nursing: Nursing in the Burford and Oxford Nursing Development Units</secondary-title></titles><dates><year>1988</year></dates><pub-location>Beckenham</pub-location><publisher>Croom Helm</publisher><urls></urls></record></Cite></EndNote>(Muetzel, 1988).Muetzel’s Model (1988)Although Muetzel’s model has not been utilised widely, the three core elements are extensively discussed within nursing literature making it a valid model for nurses to consider using in their day to day practice ADDIN EN.CITE <EndNote><Cite><Author>Richardson</Author><Year>2015</Year><RecNum>7190</RecNum><DisplayText>(Richardson et al., 2015)</DisplayText><record><rec-number>7190</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7190</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Richardson, Cliff</author><author>Percy, Marcus</author><author>Hughes, Jane</author></authors></contributors><titles><title>Nursing therapeutics: Teaching student nurses care, compassion and empathy</title><secondary-title>Nurse Education Today</secondary-title></titles><pages>e1-e5</pages><volume>35</volume><number>5</number><keywords><keyword>Caring</keyword><keyword>Compassion</keyword><keyword>Empathy</keyword><keyword>Therapeutic relationship</keyword><keyword>Nursing therapeutics</keyword></keywords><dates><year>2015</year></dates><isbn>0260-6917</isbn><urls><related-urls><url>;(Richardson et al., 2015). Partnership is a two way process between the patient and the nurse where decision-making is shared and there is mutual recognition of each other’s knowledge, feelings, expertise, congruence and trust PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NY0Nsb3VnaGVuPC9BdXRob3I+PFllYXI+MjAxMTwvWWVh
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ADDIN EN.CITE.DATA (McCloughen et al., 2011, Welch, 2005, Scanlon, 2006). Intimacy is where the nurse creates a presence, making the patient feel special ADDIN EN.CITE <EndNote><Cite><Author>Zyblock</Author><Year>2010</Year><RecNum>6800</RecNum><DisplayText>(Zyblock, 2010)</DisplayText><record><rec-number>6800</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">6800</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Zyblock, DM</author></authors></contributors><titles><title>Nursing presence in contempory nursing practice</title><secondary-title>Nursing forum</secondary-title></titles><pages>120-124</pages><volume>45</volume><number>2</number><dates><year>2010</year></dates><urls></urls></record></Cite></EndNote>(Zyblock, 2010). Befriending and showing a sincere concern through care, compassion and openness drives the connections between nurse and client/patient PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TaGF0dGVsbDwvQXV0aG9yPjxZZWFyPjIwMDc8L1llYXI+
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ADDIN EN.CITE.DATA (Shattell et al., 2007). Interestingly in a large grounded theory interview study (n=145) of day-case patients, it was found that despite limited contact time, skilled nurses implanted elements of intimacy which enhanced the partnership and stayed with the patient even after they left the unit ADDIN EN.CITE <EndNote><Cite><Author>Mottram</Author><Year>2009</Year><RecNum>6746</RecNum><DisplayText>(Mottram, 2009)</DisplayText><record><rec-number>6746</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">6746</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Mottram, Anne</author></authors></contributors><auth-address>Faculty of Health and Social Care, School of Nursing, University of Salford, Salford, UK. a.mottram@salford.ac.uk</auth-address><titles><title>Therapeutic relationships in day surgery: a grounded theory study</title><secondary-title>Journal of Clinical Nursing</secondary-title></titles><pages>2830-7</pages><volume>18</volume><number>20</number><keywords><keyword>*Ambulatory Surgical Procedures</keyword><keyword>Humans</keyword><keyword>Interviews as Topic</keyword><keyword>Nurse-Patient Relations</keyword><keyword>*Patient Satisfaction</keyword></keywords><dates><year>2009</year><pub-dates><date>Oct</date></pub-dates></dates><accession-num>19747255</accession-num><urls><related-urls><url> Technologies</remote-database-provider></record></Cite></EndNote>(Mottram, 2009). Reciprocity is the concept where both partners accept that there will be benefit. To develop functional therapeutic relationships nurses need to recognise that benefits accrue from caring for their patient PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TaGF0dGVsbDwvQXV0aG9yPjxZZWFyPjIwMDc8L1llYXI+
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ADDIN EN.CITE.DATA (Shattell et al., 2007, Brown Wilson, 2009, Scanlon, 2006, Williams, 2001).The three elements of Muetzel’s model are closely aligned with the 6C’s ADDIN EN.CITE <EndNote><Cite><Author>DH</Author><Year>2012</Year><RecNum>7118</RecNum><DisplayText>(DH, 2012)</DisplayText><record><rec-number>7118</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7118</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>DH</author></authors></contributors><titles><title>Compassion in practice: Nursing, Midwifery and care staff, our vision and strategy</title></titles><dates><year>2012</year></dates><urls><related-urls><url>;(DH, 2012). Using them both in conjunction to orchestrate therapeutic relationships should provide a strong framework for nursing care with a foundation to advance practise.It is interesting that unlike the psychotherapist view of therapeutic relationship purported by Carl Rogers, nurses appear to generate their therapeutic relationship alongside the delivery of other interventions. For instance Mottram’s day case surgery nurses utilised their short time with the patient to admit them to the ward area whilst contemperaneously instilling therapeutic principles which stayed with the patients throughout their post-operative period ADDIN EN.CITE <EndNote><Cite><Author>Mottram</Author><Year>2009</Year><RecNum>6746</RecNum><DisplayText>(Mottram, 2009)</DisplayText><record><rec-number>6746</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">6746</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Mottram, Anne</author></authors></contributors><auth-address>Faculty of Health and Social Care, School of Nursing, University of Salford, Salford, UK. a.mottram@salford.ac.uk</auth-address><titles><title>Therapeutic relationships in day surgery: a grounded theory study</title><secondary-title>Journal of Clinical Nursing</secondary-title></titles><pages>2830-7</pages><volume>18</volume><number>20</number><keywords><keyword>*Ambulatory Surgical Procedures</keyword><keyword>Humans</keyword><keyword>Interviews as Topic</keyword><keyword>Nurse-Patient Relations</keyword><keyword>*Patient Satisfaction</keyword></keywords><dates><year>2009</year><pub-dates><date>Oct</date></pub-dates></dates><accession-num>19747255</accession-num><urls><related-urls><url> Technologies</remote-database-provider></record></Cite></EndNote>(Mottram, 2009). This means that a highly skilled nurse would make every contact count as a therapeutic opportunity ADDIN EN.CITE <EndNote><Cite><Author>MECC</Author><Year>2015</Year><RecNum>7292</RecNum><DisplayText>(MECC, 2015)</DisplayText><record><rec-number>7292</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7292</key></foreign-keys><ref-type name="Web Page">12</ref-type><contributors><authors><author>MECC</author></authors></contributors><titles><title>Making every contact count</title></titles><volume>2015</volume><number>October 30th</number><dates><year>2015</year></dates><urls><related-urls><url> 30th</custom2></record></Cite></EndNote>(MECC, 2015), for example though good pain management in children. Effective management of procedural pain can positively influence the experiences of a child’s time in hospital and reduce the anxiety and discomfort associated with essential procedures such as venepuncture, immunisations and intravenous cannulation PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Db2hlbiBSZWlzPC9BdXRob3I+PFllYXI+MTk5NzwvWWVh
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ADDIN EN.CITE.DATA (Hiley and Watson, 2007, Mattsson et al., 2013).Children’s nurses regularly undertake or assist in painful procedures and the following sections will explore how they may maximise their therapeutic influence during such interventions utilising the use of vapocoolants prior to venepuncture/cannulation as an example.Analgesia for venepuncture/cannulation; the case for topical vapocoolants?One crucial element of nursing therapeutics is an understanding of the evidence behind the nursing intervention during which the nurse institutes the principles of the therapeutic relationship. This section therefore focuses on the evidence for analgesia for venepuncture/cannulation. Topical anaesthetics such as Ametop? and EMLA? have a strong evidence base for their effectiveness in reducing pain and are the most widely used topical anaesthetics for intravenous cannulation ADDIN EN.CITE <EndNote><Cite><Author>Foster</Author><Year>2013</Year><RecNum>7227</RecNum><DisplayText>(Foster et al., 2013)</DisplayText><record><rec-number>7227</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7227</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Foster, J P</author><author>Taylor, C</author><author>Bredemeyer, S L</author></authors></contributors><titles><title>Topical anaesthesia for needle-related pain in newborn infants</title><secondary-title>Cochrane Database of Systematic Reviews. Art. No.: CD010331. DOI: 10.1002/14651858.CD010331</secondary-title></titles><number>1</number><dates><year>2013</year></dates><urls></urls><custom7>Art. No.: CD010331</custom7><electronic-resource-num>DOI: 10.1002/14651858.CD010331</electronic-resource-num></record></Cite></EndNote>(Foster et al., 2013). Ethyl chloride and other vapocoolant sprays have decreased in popularity in recent years however they have an added advantage over the topical anaesthetics in that they are cheaper and the onset of pain relief is quicker PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Tb3VlaWQ8L0F1dGhvcj48WWVhcj4yMDA3PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (Waterhouse et al., 2013). Pain scores between the groups were similar however vapocoolants were rated by the child to have ‘worked well’ in a larger percentage of cases (76% v 49%). A double-blind randomised controlled trial (n=80) comparing vapocoolant with placebo for venepuncture in an emergency department identified a significant reduction in pain (mean difference 19mm; 95% CI 6-32mm; p<0.01) when using vapocoolant in children aged 6-12 years PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5GYXJpb248L0F1dGhvcj48WWVhcj4yMDA4PC9ZZWFyPjxS
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Tm90ZT5=
ADDIN EN.CITE.DATA (Farion et al., 2008). Successful first attempt at cannulation was also significantly better than the placebo group (85% v 62.5%; mean difference 22.5%; 95% CI 3.2-39.9%; p=0.03). The effects of ethyl chloride was compared with Ametop or no analgesia in a non-randomised prospective study (n=55) of children aged 6 months to 16 years attending an outpatient phlebotomy department PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Tb3VlaWQ8L0F1dGhvcj48WWVhcj4yMDA3PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (Soueid and Richard, 2007). No differences were identified between the vapocoolant and the Ametop groups suggesting equal effectiveness agreeing with the findings of another randomised non-inferiority cross-over trial (n=77) comparing ethyl chloride and Ametop in children aged 5-13 PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5EYXZpZXM8L0F1dGhvcj48WWVhcj4yMDA2PC9ZZWFyPjxS
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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5EYXZpZXM8L0F1dGhvcj48WWVhcj4yMDA2PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (Davies and Molloy, 2006).Overall therefore as long as vapocoolants are administered correctly PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYXdob3J0ZXI8L0F1dGhvcj48WWVhcj4yMDA0PC9ZZWFy
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ADDIN EN.CITE.DATA (Mawhorter et al., 2004) and the initial cold shock is mitigated against PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5EYXZpZXM8L0F1dGhvcj48WWVhcj4yMDA2PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA (Davies and Molloy, 2006), they give equivalent analgesia to Ametop and better analgesia than placebo in children. As the current studies have included few children under 4 years it is reasonable to suggest caution in this age group. It is likely that using a vapocoolant also facilitates a larger percentage of first attempt venepuncture but perhaps the main advantage of using a vapocoolant spray instead of a local anaesthetic is the short time it takes for onset of the pain relieving effects (see table 1). A reduction in time between the introduction of the need for venepuncture or intravenous cannulation and performing the intervention could reduce anxiety and the concomitant algesic effects of that anxiety.Table 1. Time to analgesic effect of commonly used treatments for intravenous cannulationAlternative pain reducing treatments Preparation time to reach full effect Cryogesic? (ethyl chloride vapocoolant spray) <15 seconds Nitrous Oxide <1 minute Buzzy? (ice/vibration therapy) 2 minutes Ametop Gel? (Tetracaine) 30-45 minutes EMLA Cream? (lidocaine/prilocaine) 45-60 minutes Adapted from ADDIN EN.CITE <EndNote><Cite><Author>Twycross</Author><Year>2013</Year><RecNum>7240</RecNum><DisplayText>(Twycross et al., 2013)</DisplayText><record><rec-number>7240</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7240</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Twycross, A., </author><author>Dowden, S., </author><author>Stinson, J</author></authors></contributors><titles><title>Managing Pain in Children: a clinical guide for nurses and healthcare professionals</title></titles><dates><year>2013</year></dates><pub-location>Hoboken</pub-location><publisher>Wiley</publisher><urls></urls></record></Cite></EndNote>(Twycross et al., 2013)Therapeutic Relationship building when administering vapocoolantsHaving established that vapocoolants have sufficient efficacy to recommend their use in practice the nurse can now create the conditions to augment the circumstances required to develop a therapeutic relationship whilst administering them. This can be achieved by applying Muetzel’s model and being mindful of the 6C’s whilst undertaking this nursing intervention. As we are applying the principles of nursing therapeutics to this specific intervention it is inevitable that there are fewer opportunities to substantiate our arguments within this section, however whenever we are able we have related our arguments to the wider literature.Partnership Utilising an unconditional positive regard approach the nurse will construct a partnership as soon as they meet the child and family for the first time. It is likely therefore that the partnership is developed prior to the requirement to perform interventions including those that are painful such as venepuncture/cannulation PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5CaWRtZWFkPC9BdXRob3I+PFllYXI+MjAwNTwvWWVhcj48
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ADDIN EN.CITE.DATA (Hill and Coyne, 2012, Mattsson et al., 2013, Jackson, 2010). Empathy is shown by allowing the child and family to discuss their feelings about the overall care plan and this will give the nurse insight into how they may react to venepuncture/cannulation PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5IaWxleTwvQXV0aG9yPjxZZWFyPjIwMDc8L1llYXI+PFJl
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ADDIN EN.CITE.DATA (Hiley and Watson, 2007, Caws and Pfund, 1999). Continuing the discussion about the venepuncture/cannulation procedure and the analgesic method becomes an essential element of communication within the partnership. The nurse can offer information and advice to the child and family whilst the child and family can express their concerns and knowledge of what they think is best for them ADDIN EN.CITE <EndNote><Cite><Author>Caws</Author><Year>1999</Year><RecNum>7352</RecNum><DisplayText>(Caws and Pfund, 1999)</DisplayText><record><rec-number>7352</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7352</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Caws, L.</author><author>Pfund, R.</author></authors></contributors><auth-address>Caws,L. School of Health Studies, University of Portsmouth, Queen Alexandra Hospital, Cosham, Hants.</auth-address><titles><title>Venepuncture and cannulation on infants and children</title><secondary-title>Journal of Child Health Care</secondary-title></titles><periodical><full-title>Journal of Child Health Care</full-title></periodical><pages>11-6</pages><volume>3</volume><number>2</number><keywords><keyword>Adolescent</keyword><keyword>Age Factors</keyword><keyword>Blood Volume</keyword><keyword>Body Weight</keyword><keyword>Child</keyword><keyword>Child, Preschool</keyword><keyword>Humans</keyword><keyword>Infant</keyword><keyword>Infant, Newborn</keyword><keyword>*Pediatric Nursing/mt [Methods]</keyword><keyword>Phlebotomy/ae [Adverse Effects]</keyword><keyword>*Phlebotomy/mt [Methods]</keyword><keyword>*Phlebotomy/nu [Nursing]</keyword><keyword>Phlebotomy/px [Psychology]</keyword></keywords><dates><year>1999</year></dates><accession-num>10451335</accession-num><work-type>Review</work-type><urls><related-urls><url> Technologies</remote-database-provider></record></Cite></EndNote>(Caws and Pfund, 1999). Explanation of the procedure and consent often causes anxiety which could be magnified if there is delay of 45 minutes before a local anaesthetic is effective. The nurse must acknowledge any fear, anxiety and worry with genuine understanding but be cognisant of the fact that delay may lead to rumination on the procedure and risks the development of negative thoughts towards the nurse PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5WZXJ2b29ydDwvQXV0aG9yPjxZZWFyPjIwMTM8L1llYXI+
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ADDIN EN.CITE.DATA (Watson, 1999, Finfgeld-Connett, 2006). Routine procedures such as completing admission paperwork are ideal vehicles for developing intimacy. Proximity by being present is one way for a nurse to advance intimacy and alongside communicating with the child and family, the committed nurse progresses smoothly towards a level of intimacy which facilitates invasive intervention such as venepuncture/cannulation ADDIN EN.CITE <EndNote><Cite><Author>Fredriksson</Author><Year>1999</Year><RecNum>7238</RecNum><DisplayText>(Fredriksson, 1999)</DisplayText><record><rec-number>7238</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7238</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Fredriksson, L.</author></authors></contributors><auth-address>Fredriksson,L. Department of Caring Science, Faculty of Social and Caring Science, University of Abo Akademi, Finland. lennart.fredriksson@fou.lg.se</auth-address><titles><title>Modes of relating in a caring conversation: a research synthesis on presence, touch and listening</title><secondary-title>Journal of advanced nursing</secondary-title></titles><periodical><full-title>Journal of Advanced Nursing</full-title></periodical><pages>1167-76</pages><volume>30</volume><number>5</number><keywords><keyword>*Caregivers/px [Psychology]</keyword><keyword>Communication</keyword><keyword>*Empathy</keyword><keyword>Humans</keyword><keyword>*Nurse-Patient Relations</keyword><keyword>Nursing Research/mt [Methods]</keyword><keyword>*Touch</keyword></keywords><dates><year>1999</year></dates><accession-num>10564416</accession-num><work-type>Research Support, Non-U.S. Gov't
Review</work-type><urls><related-urls><url> Technologies</remote-database-provider></record></Cite></EndNote>(Fredriksson, 1999). Vapocoolant spray is applied to the skin, and cannulation requires physical touch. Both are therefore intimate procedures that would be better enabled if the nurse has nurtured a partnership and accounted for intimacy. Additionally the nurse or family can also utilise a form of therapeutic touch during the procedure to have a calming anxiolytic effect (Trigg and Mohammed, 2010). Showing compassion through concern, consideration and care for the child undergoing cannulation will further build intimacy which will be useful for future procedures of a similar kind.ReciprocityReciprocity is linked to professionalization, increased self-confidence and quality improvement ADDIN EN.CITE <EndNote><Cite><Author>Meier</Author><Year>2013</Year><RecNum>7341</RecNum><DisplayText>(Meier, 2013)</DisplayText><record><rec-number>7341</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7341</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Meier, SR</author></authors></contributors><titles><title>Concept analysis of mentoring</title><secondary-title>Advances in Neonatal Care</secondary-title></titles><periodical><full-title>Advances in Neonatal Care</full-title></periodical><pages>341-5</pages><volume>13</volume><number>5</number><keywords><keyword>Concept Formation</keyword><keyword>Education, Nursing/mt [Methods]</keyword><keyword>Humans</keyword><keyword>Interprofessional Relations</keyword><keyword>*Mentors</keyword><keyword>*Nursing/og [Organization & Administration]</keyword></keywords><dates><year>2013</year></dates><accession-num>24042140</accession-num><urls><related-urls><url> Technologies</remote-database-provider></record></Cite></EndNote>(Meier, 2013). Following successful pain-free cannulation the nurse gets rewarded with a feeling of warmth and the appreciation that their role has been effective in relieving a potentially stressful and painful episode for the child. This will inevitably improve the partnership between the nurse, child and family with the bond being essential for holistic care ADDIN EN.CITE <EndNote><Cite><Author>Sherwood</Author><Year>2000</Year><RecNum>7346</RecNum><DisplayText>(Sherwood, 2000)</DisplayText><record><rec-number>7346</rec-number><foreign-keys><key app="EN" db-id="wxttxr0xzxdapce50ee5vx05ex0rrs0r9pev">7346</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Sherwood, G. D.</author></authors></contributors><auth-address>Sherwood,G D. University of Texas at Houston, School of Nursing, USA.</auth-address><titles><title>The power of nurse-client encounters. Interpreting spiritual themes</title><secondary-title>Journal of Holistic Nursing</secondary-title></titles><periodical><full-title>Journal of Holistic Nursing</full-title></periodical><pages>159-75</pages><volume>18</volume><number>2</number><keywords><keyword>Adult</keyword><keyword>*Communication</keyword><keyword>Emotions</keyword><keyword>Female</keyword><keyword>*Holistic Nursing</keyword><keyword>Humans</keyword><keyword>Love</keyword><keyword>Male</keyword><keyword>Neoplasms/nu [Nursing]</keyword><keyword>*Nurse-Patient Relations</keyword><keyword>Religion</keyword><keyword>*Spirituality</keyword><keyword>Surveys and Questionnaires</keyword></keywords><dates><year>2000</year></dates><accession-num>11847768</accession-num><work-type>Case Reports</work-type><urls><related-urls><url> Technologies</remote-database-provider></record></Cite></EndNote>(Sherwood, 2000). The confirmation of the effects of their actions should encourage the nurse to have the courage to utilise their time to focus on the individual components of future therapeutic relationships as it is known that enhancing reciprocity by improving the balance between effort and reward is one aspect crucial to the retention of nurses PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5MaTwvQXV0aG9yPjxZZWFyPjIwMTM8L1llYXI+PFJlY051
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ADDIN EN.CITE.DATA (Li et al., 2013). To this end the nurse will begin to exploit all nursing contacts and become competent in influencing care trajectory and potentially having a significant effect on recovery.ConclusionsAlthough the application of a vapocoolant spray appears to be a simple procedure the added advantage of having a nurse using the principles of therapeutic relationship building can have an effect on the outcome. All components of the 6C’s are required and could have a significant influence on future care for a child and their family. Nurses need to re-evaluate how their skills are utilised whilst undertaking all interventions and should be able to exploit any situation as an opportunity to become a therapeutic instrument with the potential to accelerate recovery.References ADDIN EN.REFLIST BIDMEAD, C. & COWLEY, S. 2005. A concept analysis of partnership with clients. Community Practitioner, 78, 203-8.BROWN WILSON, C. 2009. Developing community in care homes through a relationship-centred approach. Health & Social Care in the Community, 17, 177-86.CANNING, D., ROSENBERG, J. P. & YATES, P. 2007. Therapeutic relationships in specialist palliative care nursing practice. International Journal of Palliative Nursing, 13, 222-9.CAWS, L. & PFUND, R. 1999. Venepuncture and cannulation on infants and children. Journal of Child Health Care, 3, 11-6.COHEN REIS, E. & HOLUBKOV, R. 1997. Vapocoolant spray is equally effective as EMLA cream in reducing immunization pain in school-aged children. Pediatrics, 100, E5.DAVIES, E. H. & MOLLOY, A. 2006. Comparison of ethyl chloride spray with topical anaesthetic in children experiencing venepuncture. Paediatric Nursing, 18, 39-43.DH. 2012. Compassion in practice: Nursing, Midwifery and care staff, our vision and strategy [Online]. Available: , K. J., SPLINTER, K. L., NEWHOOK, K., GABOURY, I. & SPLINTER, W. M. 2008. The effect of vapocoolant spray on pain due to intravenous cannulation in children: a randomized controlled trial. CMAJ Canadian Medical Association Journal, 179, 31-6.FINFGELD-CONNETT, D. 2006. Meta-synthesis of presence in nursing. Journal of advanced nursing, 55, 708-14.FOSTER, J. P., TAYLOR, C. & BREDEMEYER, S. L. 2013. Topical anaesthesia for needle-related pain in newborn infants. Cochrane Database of Systematic Reviews. Art. No.: CD010331. DOI: 10.1002/14651858.CD010331.FRANCIS, R. 2013. The Mid Staffordshire NHS Foundation Trust Public Inquiry. In: UK, D. O. H. (ed.). London, UK: HM Stationery Office.FREDRIKSSON, L. 1999. Modes of relating in a caring conversation: a research synthesis on presence, touch and listening. Journal of advanced nursing, 30, 1167-76.HEWITT, J. & COFFEY, M. 2005. Therapeutic working relationships with people with schizophrenia: literature review. Journal of advanced nursing, 52, 561-70.HILEY, D. & WATSON, A. R. 2007. Preparation of chldren undergoing nuclear medicine procedures. Paediatric Nursing, 19, 26-8.HILL, K. & COYNE, I. 2012. Palliative care nursing for children in the UK and Ireland. British Journal of Nursing, 21, 276-81.JACKSON, C. 2010. Evidence-based practice: pushback from a holistic perspective. Holistic Nursing Practice, 24, 120-4.KORTESLUOMA, R.-L., NIKKONEN, M. & SERLO, W. 2008. "You just have to make the pain go away"--children's experiences of pain management. Pain Management Nursing, 9, 143-9, 149.e1-5.LI, J., SHANG, L., GALATSCH, M., SIEGRIST, J., MIULLER, B. H., HASSELHORN, H. M. & GROUP, N. S. 2013. Psychosocial work environment and intention to leave the nursing profession: a cross-national prospective study of eight countries. International Journal of Health Services, 43, 519-36.LIMA-BASTO, M., JOSE, H., GOMES, I., POTRA, T., DIOGO, P. & REIS, A. 2010. Therapeutic Instruments Used in Therapeutic Interventions: Is There Evidence In Nursing Care? A Systematic Review of the Literature. . International Journal Of Caring Sciences, 3, 12-21.MATTSSON, J., FORSNER, M., CASTREN, M. & ARMAN, M. 2013. Caring for children in pediatric intensive care units: an observation study focusing on nurses' concerns. Nursing Ethics, 20, 528-38.MAWHORTER, S., DAUGHERTY, L., FORD, A., HUGHES, R., METZGER, D. & EASLEY, K. 2004. Topical vapocoolant quickly and effectively reduces vaccine-associated pain: results of a randomized, single-blinded, placebo-controlled study. Journal of Travel Medicine, 11, 267-72.MCCANCE, T., SLATER, P. & MCCORMACK, B. 2009. Using the caring dimensions inventory as an indicator of person-centred nursing. Journal of Clinical Nursing, 18, 409-17.MCCLOUGHEN, A., GILLIES, D. & O'BRIEN, L. 2011. Collaboration between mental health consumers and nurses: shared understandings, dissimilar experiences. International Journal of Mental Health Nursing, 20, 47-55.MECC. 2015. Making every contact count [Online]. Available: [Accessed October 30th 2015].MEIER, S. 2013. Concept analysis of mentoring. Advances in Neonatal Care, 13, 341-5.MOTTRAM, A. 2009. Therapeutic relationships in day surgery: a grounded theory study. Journal of Clinical Nursing, 18, 2830-7.MUETZEL, P.-A. 1988. Therapeutic nursing. In: PEARSON, A. (ed.) Primary nursing: Nursing in the Burford and Oxford Nursing Development Units. Beckenham: Croom Helm.NOEL, M., CHAMBERS, C. T., MCGRATH, P. J., KLEIN, R. M. & STEWART, S. H. 2012. The influence of children's pain memories on subsequent pain experience. Pain, 153, 1563-72.NOEL, M., RABBITTS, J. A., TAI, G. G. & PALERMO, T. M. 2015. Remembering pain after surgery: a longitudinal examination of the role of pain catastrophizing in children's and parents' recall. Pain, 156, 800-8.PORR, C., DRUMMOND, J. & OLSON, K. 2012. Establishing therapeutic relationships with vulnerable and potentially stigmatized clients. Qualitative Health Research, 22, 384-96.RICHARDSON, C., PERCY, M. & HUGHES, J. 2015. Nursing therapeutics: Teaching student nurses care, compassion and empathy. Nurse Education Today, 35, e1-e5.ROGERS, C. 1951. Client-centred therapy, Oxford,UK, Houghton Mifflin.SCANLON, A. 2006. Psychiatric nurses' perceptions of the constituents of the therapeutic relationship: a grounded theory study. Journal of Psychiatric & Mental Health Nursing, 13, 319-29.SHATTELL, M. M., STARR, S. S. & THOMAS, S. P. 2007. 'Take my hand, help me out': mental health service recipients' experience of the therapeutic relationship. International Journal of Mental Health Nursing, 16, 274-84.SHERWOOD, G. D. 2000. The power of nurse-client encounters. Interpreting spiritual themes. Journal of Holistic Nursing, 18, 159-75.SNELL, L., CROWE, M. & JORDAN, J. 2010. Maintaining a therapeutic connection: nursing in an inpatient eating disorder unit. Journal of Clinical Nursing, 19, 351-8.SOUEID, A. & RICHARD, B. 2007. Ethyl chloride as a cryoanalgesic in pediatrics for venipuncture. Pediatric Emergency Care, 23, 380-3.TWYCROSS, A., DOWDEN, S. & STINSON, J. 2013. Managing Pain in Children: a clinical guide for nurses and healthcare professionals, Hoboken, Wiley.VERVOORT, T., TROST, Z. & VAN RYCKEGHEM, D. M. L. 2013. Children's selective attention to pain and avoidance behaviour: the role of child and parental catastrophizing about pain. Pain, 154, 1979-88.WATERHOUSE, M. R., LIU, D. R. & WANG, V. J. 2013. Cryotherapeutic topical analgesics for pediatric intravenous catheter placement: ice versus vapocoolant spray. Pediatric Emergency Care, 29, 8-12.WATSON, J. 1999. Postmodern nursing and beyond, New York, Churchill Livingstone.WELCH, M. 2005. Pivotal moments in the therapeutic relationship. International Journal of Mental Health Nursing, 14, 161-5.WILLIAMS, A. 2001. A study of practising nurses' perceptions and experiences of intimacy within the nurse-patient relationship. Journal of advanced nursing, 35, 188-96.ZYBLOCK, D. 2010. Nursing presence in contempory nursing practice. Nursing forum, 45, 120-124. ................
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