Pediatric patients' interpretations of procedures

[live4rachael]

Background: I've been a peds nurse for almost 6 years and am incredibly passionate about it. I have recently started my MSN program in Nursing Education. I was just assigned a clinical rotation to teach two different lectures to the undergraduate pediatric class: one on the family centered care of the child during illness/hospitalization, one on cardiology. (I have lots of good video clips for cardiology, and that one isn't for a couple more weeks.) The family centered care class is next Friday; I was just granted access to the textbook this morning and am working on my slides. Yippee! :)

Question for all of you peds RNs: Do you have any extra examples of those situations where kids do not understand a procedure or have a fear that is unique to their age? I have come up with a few examples but am hoping to come up with some more. I feel like this is a point I really want to hammer home in the class - how important it is to communicate on a developmentally appropriate level, to ease their fears... The communication piece with kids and their families is just so critical, trying to eliminate unwarranted fears and develop trust. This is clearly a big piece in the preschool stage of magical thinking. I remember early on in my career hearing things like "won't all my blood keep coming out" (because there's an IV we placed and drew blood from it), or thinking that taking a blood pressure means we are drawing blood. The textbook mentions the example of "will the CAT scan mean I get scratches". Any other funny (or sad) examples you've experienced? I know I've experienced more of these, but they aren't coming to me.

[llg, PhD, RN]

1. Don't tell kids you're going to "put them to sleep" for surgery. "Putting to sleep" is what the vet did to the dog a few years ago -- when he died.

2. It's not just the kids, either. I once read a newspaper article about one of my patients that reported that we were so concerned about the baby that we were putting IV anitbiotics directly into his brain. (He had a scalp IV.)