family health nursing

It's the Little Things:
Daily Routines

Children thrive in a well-ordered and predictable environment, where daily routines such as arrivals and departures, mealtimes, nap times and toileting are dealt with consistently by all caregivers. Daily routines provide opportunities for children to learn more about themselves, the world and other people. Daily routines also offer children a sense of stability, and a feeling of warmth and caring from their teachers. The challenge is to develop appropriate daily routines for children which offer them a sense of consistency and security, yet remain flexible and responsive to the individual needs of each child.
Daily Schedule
In order to establish daily routines, most preschool classrooms follow a basic daily schedule. Among other things, a schedule can help to ensure the consistency that young children need and also help teachers encourage all areas of development by planning a wide range of activities. It's helpful to think of a daily schedule as a guide which is responsive to children and teachers. Flexible schedules let us capitalize on those moments that arise when children discover something that interests them. They allow us to extend a play period so the children gain maximum satisfaction from what they're doing. In creating schedules, it is also important to provide a healthy balance for children, between group times and more solitary moments, quiet and noisy activities, indoor and outdoor play.
Transitions
Transition times are important because they can make the day seem smooth and well-organized, or rushed and unpleasant. Allowing enough time so children make the transition gradually is the best way to avoid stressful situations.
In addition to allowing a realistic amount of time for transitions to take place, it always helps to warn once in advance before a change in activities. This gives the children a chance to finish what they are doing and their cooperation is more likely. It might also help move the process along if we comment favorably about the next activity and avoid situations where all the children are expected to do the same thing at the same time.
Separation Anxiety
(see Babies Are Children, Too)
Attachment
The way we handle daily routines is especially important for babies. Through such tasks as feeding and diapering, we communicate to the child that they can trust us, and that we can be relied on to nourish and provide for them. This special bond of trust is called "attachment." Child psychologists assert that the trust and attachments that develop within the first two years of life can determine the emotional future of the child.
Here are some tips that help children develop this bond of attachment:
• Practice listening and paying attention to what the baby is telling you---be sensitive to his cues.
• Pay attention to your own verbal cues and body language.
• Talk to the baby, even though she may not be speaking yet.
• Don't rush through daily tasks.
• Establish routines that are based on each individual baby's needs.
• Hold babies during bottle feeding in order to develop warm, nurturing relationships with them.
Routines that Center Around Eating
Remember that not everyone has the same diet. It's important to be especially sensitive to children who come from cultures other than our own, are vegetarian, lactose-intolerant, or who have other special religious or dietary needs. It's essential to talk to the families and find out which foods are appropriate and which are not.
Children prefer plain, familiar food they can eat with their fingers. It's important that snacks vary from day to day, and that snacks, drinks and desserts are nutritious. When there are children at school from a variety of ethnic and cultural backgrounds, it is crucial to include foods they like and that are familiar to them.
Here are some considerations that help make mealtimes positive experiences for children and teachers:
• Children eat at their own pace and some eat more than others do.
• Avoid tying food together with behavior either as a reward or a punishment.
• Eating should be a shared and cooperative experience with foods served family style. Meals should be a time to chat, enjoy and help each other.
• Mealtimes are opportunities for children to be independent by making choices about foods.
• Encourage children to taste everything but be careful not to force them to eat.
Handling Nap Times
Nap time can present some challenging moments. This routine can either convey warmth and security, or stress and turmoil to children. It's up to the child as to whether or not she sleeps, but it's our job to create a relaxed and quiet rest time. Children often have trouble settling down at nap time because restful sleep is an act of trust. Reasons for restlessness might include a crisis in their lives, excitement about a special event or perhaps a child's temperament makes it difficult for her to settle down. All preschool children need to lie down and relax for awhile, but older children need not sleep. Create a restful mood for children by reading quietly, playing soothing music and rubbing backs.
The Process of Toileting
Going to the toilet is a necessary social skill that most children develop sometime around their second year. The process of toilet learning takes time, understanding and patience. The most important rule is not to rush children into using the toilet. As in all aspects of child care, communication with families is essential. The first step in the toilet learning process is talking with families about their ideas and beliefs. The more we can work in cooperation with families, the smoother toilet learning will be for the child.
There is no set age at which toilet learning should begin. The right time depends on each child's physical and emotional readiness. A child is ready to learn to use the toilet when he remains dry for at least 2 hours at a time or is dry after nap; he indicates beforehand that a bowel movement or urination is about to occur; he seems uncomfortable in a wet or soiled diaper; he asks to wear underwear.
Here are some further ideas for encouraging healthy, respectful toilet learning in toddlers:
• Ask families to dress their child in clothing with elastic waistbands that the child can remove herself. Also, be sure there are plenty of extra clean clothes available for the child at the center.
• Keep the toileting experience positive and relaxed. Toilet learning is closely associated with how a child feels about himself and we never want to punish, humiliate or push children or compare their progress.
• Comment favorably when a child is successful. Never display disappointment in a child who is not successful.
• Handle "accidents" in a calm, matter-of-fact manner and reassure the child that he has done nothing wrong.
• Careful sanitation procedures are a must. Each child's and adult's hands should be washed thoroughly after each attempt. [/b][/b]