Communication with Children - Peds

Pediatric Critical Care Columnist · Jul 6, 2010

Don't lie to them. Ever. If you're going to do something that is going to hurt, tell them there'll be a little "owie". Don't use words like "needle" or "cut", go with "stick" or "poke" and "opening"... they're a lot less threatening and scary. Don't tell them that they'll get some medicine to make them go to sleep because when they wake up after their procedure they're never going to want to sleep again in case they wake up in pain. You can tell them instead that the medicine will help them relax to help the doctor and for them to be comfortable while they get their ______ fixed. Use simple language. As they get older, make sure you talk to them in a way that recognizes that they're growing up. If you can use examples from their normal life to help them understand what's going on, they'll be a lot more cooperative. As for assessments, make a game of it if you can. Offer to let them listen to your heart. Ask them if they can take a big breath and pretend they're blowing up a balloon. The BP cuff is going to give their arm a big hug or a squish. Ask them if their hands and feet are warm and then say, "Let's check." Most little kids can't hold a thermometer under their tongue so if you have a temporal artery thermometer tell them it's going to tickle their hair. For axilla temps, you're going to tuck the thermometer under their arm and they're going to warm it up for you. If you're doing a simple neuro exam have them look at your nose while you look into their eyes. If they're toddlers and don't want you to do anything, get Mom or Dad to let you "examine" them first.

But the biggest and most difficult thing to remember is DON'T ask them if it's okay to do things that have to be done. You imply there's a choice and there is no choice. Don't say, "I'm going to change this great big bandage on your tummy now, okay?" Try, "Let's get this bandage changed so we can go to the playroom. Do you want to take the old one off or would you like me to do it?" Find a way to give them some control. "Would you like me to give you your medicine, or would you like Mommy to give it to you?" "Should we do your blood pressure on this arm or that one? Now or in 10 minutes?"

See if there's a child life department at your hospital and spend some time talking to one of their staff. They're well-trained in talking to kids and they're a great resource.

ShantheRN, BSN, RN · Jul 6, 2010

What janfrn said!

Lying is the worst thing you can do, especially with school age kids. My fave age group is toddler, but they can be difficult! Key with them is offer choices (never anything that can be answered with no lol)and let them play with your equipment so it's not so scary, if possible. I've taken so many BPs and pulses on teddy bears working in peds that now it's just habit. I have a bright orange stethoscope that invariably gets pulled off by grabby hands. I usually let them use it on me while I count respirs and do other assessments till I can get it back. Distraction is your friend! Remember to keep smiling. If you look nervous, nothing good comes from it.

And if you get a sleeping infant? Count your blessings and try not to wake them lol Getting a set of vitals and assessment on a sleeping baby is easy-peasy once you get the hang of it.

I hope you like this clinical! I'm a peds kinda person so I loved it. Kids can be a lot of fun, once you learn how to relate to them.

turnforthenurse, MSN, NP · Jul 7, 2010

janfrn and Shanfuturenurse, thank you!!! I'm taking my peds rotation this fall and I am terrified because I don't really know how to talk to kids. This will help!