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How to "calm" down autistic pediatric patient?

Nurses   (1,545 Views | 27 Replies)

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1 Article; 170 Posts; 3,946 Profile Views

10 hours ago, Lauragfa2000 said:

I have a very similar patient. She's 2.5 yrs old. Doesn't really talk yet. I learned a little sign language from ST. Please, thank you, more, book. From there we incorporated a few more signs that have meaning to us. Now she's saying a few words.

She's also strictly tube fed. It takes time. I started with her when she was 16 months and she couldn't even hold her head up, let alone sit up.  She was 18 months when she learned to crawl. That in itself took weeks of working with her. Once she started walking all she wanted to do was go!!! 

Feeding isn't that bad. I refused to put her in the crib or jumper. I put her favorite toys in front of her and we would just play. She loves to be read to. Believe me when I say that wasn't always the case!!  It's really just developing a communication style that works. 

She was also on a vent 24/7. As luck would have it I was able to wean her off and within a year she was decannulated.

Another thing I worked into her schedule was taking her outside for long walks with moms approval. That gets her relaxed/tired enough to sit for the 2hr feeds and being outside, weather permitting, helped with her sensory deprivation. The benefits of sunshine are also a plus😉.

It really sounds like she may be bored and has an excess of unused energy. I would start with the physical and work your way to the developmental aspects of her care. 

Not every day is easy and there are days I leave exhausted. She also has a tablet that she can work better than I can. I limit it to an hr total on my 12 hr shift. 

My biggest recommendation would be to establish a schedule of activities outside of the crib and tablet. It won't happen overnight but it will come together with some effort. 

Best of luck to you and I absolutely feel your frustration!

Taking long walks around the neighborhood is definitely something I"m going to try. I wish I got to talk with the Speech team but I am only there weekends so there isn't any PT/OT/Speech/Teachers that show up so I am with her every second of the shift. 

I want to establish some type of schedule but since I'm only there once a week on the weekend, I'm afraid that's not enough time to "set" anything besides following what the week day nurse does which is the nurse I shadowed for my shadow shift. 

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5 hours ago, myoglobin said:

It is likely that the "IPAD" was started by the parents before the OP ever came into the scene. 

myglobin, without knowing the the case history, I can state with 100% confidence this is spot on!  Not casting blame on anyone because people are really all the same.  Any activity discovered that reduced stress is beneficial, until it's not...

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It might help if you imagine that she IS a toddler. 
What do toddlers enjoy other than electronics?

Stickers (unpeeling them and sticking them on paper)

Play-dough

Gluing things to paper

Noise-makers (dry beans in a plastic container etc)

Water play (little containers of water that she can splash around, put towels on the floor)

Yes, it is exhausting to manage a toddler. Ask any day care teacher!  You have to be “on” constantly, except, as you said, when she naps. But that is just how it is with a child that age, or mentally that age. Part of the reason you feel overwhelmed is that none of these ideas are really “nursing” tasks and you aren’t an Early Childhood Educator!  But that doesn’t mean you can’t succeed, it just means you are going to have to do some research, ask for help (do you have any friends with toddlers or autistic children ), and be open to learning. 

One last thing: You can still be involved when she IS playing iPad. Sit next to her in the bed and talk: “Wow I like this game!  What bright colors it has. Blue ballon, red balloon!  Can I play?  No? Okay, maybe I can play tomorrow. Let’s play the animal game that is on here. Giraffe!  Lion!”

Edited by CommunityRNBSN
Clarity

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228 Posts; 1,219 Profile Views

Also to defend the OP:

I work in an FQHC. Some of the nurses entered the job because they are passionate about the population. Some wanted an 8-5 job with no holidays and no heavy lifting. ALL of the nurses do a really good job and make a big difference in the patients’ lives. Just because someone takes a job that isn’t their ultimate life passion doesn’t mean they can’t succeed at it, and really help people. 

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