Tips on building a good rapport with children

Specialties Pediatric

Published

I am aware that there are tips on this forum, as I remember reading some a while ago .. however I cannot find them anymore. I would just like to share my story, and would very much appreciate if anyone can give me any tips I can employ.

I recently started a CNA job at a Children's Hospital, and had my first shift on a ward this week. During my shift I stayed with a 2 year old for some time, and couldn't help but feel a little awkward around him as he was very shy at times and didn't talk much. I thought after 6 weeks of clinical experience on a peds floor/hospital throughout my course, that this would not happen...

My dream since the end of high school has always to become a peds nurse, and I just feel very very disappointed in myself.

edit: Also the RN I was buddied up with throughout the shift must have thought I was lying to her when I told her I had done placements in peds. When I attempted to take a childs heart rate, I placed the stethoscope on his radial artery instead of the apex of his heart... and then after she had corrected me, I got the heart rate wrong! :( (I had never done vitals manually on a child before)

Specializes in PICU, Sedation/Radiology, PACU.

When you go into the room, greet the child first. Say hi. Talk to them. Compliment their stuffed animal. Don't stand over them, but get down to their level. Don't jump right in to the medical stuff. Let them look at your equipment before you use it on them. Let them listen to you before you try to listen to them.

By the way- I've never placed a stethoscope on a radial artery to check a pulse. If you're using the stethoscope, you listen at the apex of the heart. You palpate- or feel- the radial artery to check the pulse.

Thank you Ashley. I did all of that, and as for what came over me when I put that stethoscope on his radial artery...I don't know. I've never seen it done before, not even in adults

Specializes in Pedi.

Ask the kids about stuff they care about. If you're wearing cartoon scrubs, they often recognize a character and warm up to you. Ask them about their teddy bear ("what's teddy's name?")... you may need to do something to teddy before the child will let you do it to them. I have assessed teddy bears' BP, pupils, heart rate, etc.

A 2 year old is going to be shy when a parent isn't there. They're in an unfamiliar place and you're an unfamiliar person.

Specializes in Complex pedi to LTC/SA & now a manager.

Be truthful but realistic. Don't say something won't hurt (like a needle) but don't exaggerate either. Know hat all children are different and ask the parent for tips (if they are available). Some children do better if they can't watch (injections, lab draws). Yet others like my son won't let you do anything if he CAN'T see what you are doing or if you try to cover his eyes....(used to freak out his old pedi as the doc gave the vaccines and my then 18 mo old INSISTED on watching the needle go in...he sat perfectly still as long as he could see. Find out what they know, especially if they have been hospitalized before or have a chronic condition. My friend's 9 yo was dx'd as a type 1 DM 9 months ago and is already an expert on his condition and pump..Always speak to the child, even if you think they can't hear or understand. They might amaze you.

Don't ask the child if you can do something if they don't really have a choice. And don't tell them you're going to "take" their temp or BP or whatever. They may not know what a blood pressure is, but they know what it means to take something. Finally, give real choices whenever possible.

Incorrect:

"I'm going to take your blood pressure, okay?"

Correct:

"I want to check your blood pressure by putting this cuff around your arm. It's going to squeeze kind of hard, but then it will let go. Which arm would you like me to use?"

Never tell them something isn't going to hurt if there's any chance that it will. Say that it might hurt some and you're sorry about that, but it's important. Let them know that it's okay if they cry but it will help if they can hold still. Ask if they want to watch or look away. If they have a bear or a doll, ask if you can show them on their friend what you want to do. Give Band-Aids, masks, tongue depressors, and whatever else you can find so they can play nurse with their mom or their toys.

Explain in simple terms what you're doing for them. "This medicine will help your pain go away for a while (or help you sleep, or feel stronger or whatever)."

Don't lie. Kids remember who tells them the truth and can be trusted.

Best wishes.

Specializes in school nursing; pediatrics.

Agreed - never say you are going to "take" anything. This can really freak some kiddos out!

I usually tell a little one that the BP cuff is going to give their arm a tight hug just like when Mommy gives you a big hug or you hug Mommy.

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