Summary

One of the first steps in providing care across the life span is understanding how a patient population grows and develops over that time frame. No matter the desired nursing specialty, to provide crucial care, nurses must understand the impact their care decisions may have on a patient—in both the short and long terms. Physical growth may be easier to assess, but this assessment must be coupled with all forms of development—cognitive, psychosocial, personality, communication, sexuality, and motor function—to fully understand a patient’s condition. From birth to end of life, patients are categorized into the following developmental stages: newborn (0–28 days), infant (0–12 months), toddler (1–3 years), preschool (3–5 years), middle childhood (6–11 years), adolescent (12–17 years), young adult (18–35 years), adult (36–64 years), and older adult (65 years and older).

Considered the “work” of children, play is a crucial component of development throughout the life span. Play can improve physical, social, cognitive, and emotional well-being. Types of play include solitary, associative, cooperative, and onlooker/observer play.

Theories of development help provide a foundation for understanding how people grow and develop. Some of the most used and discussed theories in health care regarding development are Erik Erikson’s theory of psychosocial development, Jean Piaget’s theory of cognitive development, Lawrence Kohlberg’s theory of moral development, and Sigmund Freud’s theory of psychosexual development. Though Erikson’s theory was influenced by the work of Freud, he focused on psychosocial development rather than psychosexual development. Piaget’s theory focuses on cognitive development, which he claimed occurs in four sequential stages. Kohlberg’s theory, which builds upon Piaget’s theory, argues that moral development occurs in stages.

In order to provide the best care for patients across the life span, nurses must have a baseline understanding of growth and development and how this can impact all areas of care, such as a patient’s health status, developmental stage, family/caregiver support availability, resource availability, and desire for care. In addition to visits when patients are acutely ill, well-visits are an optimal opportunity for nurses to implement these aspects of care. Well-visits provide a designated time for providers and patients to review concerns, plan for the future, and screen for long-term complications. Well-visit intervals are more frequent with younger children to assess for milestones and monitor leaps in development.

A major aspect of providing quality and effective patient care through the life span is the administration of vaccinations and education regarding their purpose. As a key process of obtaining acquired active immunity, vaccinations help protect patients at the individual and whole population levels. A vaccine works by exposing the patient to foreign substances (antigens), triggering the patient’s immune system to produce antibodies and create a blueprint for more efficiently identifying and attacking that antigen in the future. Nurses must understand how to educate patients and caregivers regarding the benefits, risks, and anticipated outcomes of vaccinations. Additionally, nurses are also responsible for vaccination administration and patient evaluation.