Fundamentals of phototherapy for neonatal jaundice.

Phototherapy is the use of visible light for the treatment of hyperbilirubinemia in the newborn. This relatively common therapy lowers the serum bilirubin level by transforming bilirubin into water-soluble isomers that can be eliminated without conjugation in the liver. The dose of phototherapy is a key factor in how quickly it works; dose in turn is determined by the wavelength of the light, the intensity of the light (irradiance), the distance between the light and the baby, and the body surface area exposed to the light. Commercially available phototherapy systems include those that deliver light via fluorescent bulbs, halogen quartz lamps, light-emitting diodes, and fiberoptic mattresses. Proper nursing care enhances the effectiveness of phototherapy and minimizes complications. Caregiver responsibilities include ensuring effective irradiance delivery, maximizing skin exposure, providing eye protection and eye care, careful attention to thermoregulation, maintaining adequate hydration, promoting elimination, and supporting parent-infant interaction.

Advocacy: it is what we do.

Our nation is on the verge of change in the healthcare system. Although we do not yet know how this change will affect our patients, our practice, or us, we do know that with change comes opportunity. We have the opportunity to become more involved in health policy and advocacy than ever before. Many nurses are already taking the first steps, which are recognizing the importance of advocacy and articulating the issues that they believe are of greatest importance. To communicate their views to the right elected officials, nurses need to be aware of how government operates and how legislation is created and shepherded through the legislative process. Nurses must learn the fundamental principles of expressing themselves and making clear requests for what they want of their elected officials. With these skills, every nurse can become an advocate in the political arena and partner with other individuals or groups to facilitate change. Nurses who find this experience rewarding and exhilarating can pursue additional education in health policy and advocacy.