Nursing Shortage

We, who have been blessed with the greatest job in the world, being a parent, know all to well the joy and sorrow that "comes with the territory." The smiles are abundant as the most precious gift ever given to humankind, our children, advance through the stages of growth and development. As parents our job is to love, support, protect, teach, guide, mentor, and prepare our children to be productive citizens in society. Unfortunately, there are instances when tragedy strikes and all preparations, hopes and dreams are shattered. Sudden Infant Death Syndrome (SIDS) is one such unexplained tragedy that claims far too many children's lives. I chose to research SIDS because three years ago, my best friend lost her first child to this senseless calamity. This paper will attempt to expel myths, bring to light current research and statistics on this unexplained misfortune commonly abbreviated as, SIDS.

First, to fully understand SIDS, one must know the medical definition which is as follows, "the sudden death of an infant less than twelve months of age that remains unexplained after a thorough investigation" (Adler, Hamilton & Hyderi, 2006). A few SIDS facts as reported by The National SIDS/Infant Death Resource Center (2006) are as follows:

SIDS is sudden and silent. The infant was seemingly healthy. Most deaths occur between two and four months of age. The death is often associated with sleep and with no signs of suffering. It is a recognized medical disorder. SIDS is determined only after autopsy, an examination of the death scene, and a review of the infant's and families clinical histories. It is not preventable, but can be reduced by placing the baby on his or her back to sleep on a firm surface, keeping baby from overheating, and in a smoke-free environment. It is not contagious, nor is it the cause of every unexplained infant death (What SIDS is, What SIDS is not section).

According to the Journal of Family Practice, (2006) a few of the complexities of this much talked about issue is the controversy surrounding the researched areas of co-sleeping, room sharing, sleeping surface, bedding accessories and sleep positions. Since these particular issues are cultural, it is sometimes hard for parents to change their thought process.

Conversely, teaching parents the risks associated with SIDS is only one part of a huge puzzle. As nurses, the subject of SIDS is of great relevance because it is the nurse's job to save lives; therefore, it is crucial that parents clearly understand how to reduce the risk of SIDS. Importantly, according to an article in the Journal of Neonatal, Pediatric, and Child Health Nursing (2004), SIDS is of great concern to the nursing profession at this time because "families affected by sudden infant death syndrome require services of health care providers, both to cope with this untimely event as well as to understand the reasons for its occurrence" (pp. 4-8). This requires nurses to be aware of current evidence and to implement and promote recommendations for reducing the risk of SIDS.

Another focal subject pertaining to SIDS is its point of origin. As far back as biblical days all the way up to the early twentieth century mothers were held responsible for the deaths of their infants by being blamed for rolling on top of them unintentionally while bed sharing (Center for Disease Prevention & Epidemiology, 2000). Of course, through the advances in medical technology the myths associated with an infant dying of no known cause have been significantly reduced. One such advancement, the national back-to-sleep campaign, initiated in 1994 by the American Academy of Pediatrics (AAP), "encouraged parents and caregivers to place healthy infants on their backs when putting them to sleep" (Campbell, 2000). Evidently, the research of supine sleeping for infants proved to be a crucial progression because the incidence of SIDS was reduced by 50% in the Untied States after the back- to sleep campaign was put into practice (Campbell, 2001). Conversely, SIDS is not a new concern for the nursing profession. For this same reason, a key advocate for education and training for nurses and a chairperson of the American SIDS Institute, Marc Peterzell, stated in conference of medical professionals that he believed:

Nurses share a special and close parental and infant advocacy role both in hospital and in the community, which can have a powerful influence on the parent's choice of infant sleeping position. Practice that incorporates safe infant sleeping position and environment, accompanied by a verbal recommendation, can potentially save lives and as such is a duty of care for all nurses (American SIDS Institute, 2005).

Unquestionably, communication and research skills are important talents to possess in any professional field, nursing is no exception.

Balanced against the education and training for nurses regarding SIDS, research by medical professionals is vigorously moving forward in an attempt to find out the cause of SIDS and ways to reduce the risk in an attempt to prevent infants from being succumbed to this medical mystery. For example, one such research project pertained to the ever-so-cultural topic of co-sleeping. This study suggest "co-sleeping to be an independent risk factor for SIDS. . . and the risk of co-sleeping is greatest among infants of smokers as compared with infants of non-smokers" (Adler et al, 2006). Another researched area is the use of pacifiers and their relation to SIDS. In a clinical report published by the Nursing Standard Journal, (2006) five studies compared pacifier use with SIDS cases (p.52). Research results point out that ". . . the risk of SIDS for infants who did not use a pacifier in the last sleep was at least twice and possible five times, that of infants who did use a pacifier" (Briggs, 2006). The results to these studies are very useful for nursing practice because they are the basis for parent training. Even though research is progressing, SIDS is still a mystery with many different possible reasons for its occurrence; therefore, additional research is needed to provide a unified and definitive disclaimer to the many different opinions regarding SIDS and how to prevent it.

Since there is much debate over research findings, be it co-sleeping or pacifier use, the resolution of SIDS is far from its end. Potentially, the varied opinions and differences in research pose a note-worthy risk to the nursing profession. Since nurses provide training and