How do you deal with a crying child?

Nurses General Nursing

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:crying2: i am a nursing student and don't have children of my own so i have no clue on how to clam a child down so i can inspect wounds. i have a child who crying and moving her arms and legs. she won't let me come near her, let alone clean her wounds. what are some good methods that allow me to comfort her enough to inspect and clean her wounds? my attempts have failed please help!:confused:

However, the child is on to the "game." She knows what you are there to do and she knows that it hurts. Do both of you a favor: do it quickly, with empathy but not apologetically and offer a comfort or reward after. (I am not saying not to pre-medicate for pain, etc. I just mean try to help her forget after). DO NOT hesitate. 3 year olds will see that telegraphed in your face. Like everybody, anticipation is worse than reality. The good news is that they move on quickly.

Try to remind the child of the small reward you have brought (even kicking and screaming). "We are half finished and then you can look at this book I brought from the playroom!"

your entire post was awesome, lovebug.

3 yo's ARE incredibly intuitive, and can sense any fear/apprehension/anxiety from others.

'we' need to 'do the job', decidedly, promptly and confidently- absolutely no hesitation.

and yes, the anticipation of a prize, is often very helpful.

which brings me to the anticipation of an injection.

i've had some surprising success with having some watch me give their shot, versus looking away.

it makes them feel more in control over their situation.

you really need to assess ea child to the best of your ability, and decide which way is best.

leslie

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

May I add something as a mom of 2, have you tried turning on the cold water faucet as far as it will go. That would calm my kids when almost notheing else would. Any chance of a mild sedative? Or one of the topicals you can use in advance of an injection. A doll she could pack it wounds? I had a teen once who had a no kidding 18' x 12" abdominal dehiscence down to her backbone. Her big request was what does it look like . I got her a huge mirror and that fascinated her enough to grit her teeth and finally she would put on gloves and help.

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Specializes in Med Surg, Specialty.
I don't think much you do is going to convince a child to allow you to clean/pack wounds. When my son was in the hospital, his nurse would always bring someone else with her to hold down his arms/legs/whatever was flailing. I used to help hold him down, but after a while I stopped doing that...he needed to know his mom was on his side and wouldn't help hurt him.

This makes it sound like the people who are holding the child are not on the child's side... If you say a mom is considered 'bad' for holding down the child, wouldn't a parent who didn't help hold still be 'bad' for bringing the child for the shot/dressing change in the first place?

Parents who help hold and position their child have usually been a big help for me when doing procedures. I can understand if the parent is not comfortable doing that (and to each their own), but the child should know that everyone, including the ones restraining them and the nurse injecting/assessing/dressing wounds etc is on their side too.

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I disagree. A parent is someone who loves their child and protects them from harm. A nurse or doctor is a paid professional who is doing a job that may hurt that child, even if it is for their own good. When my son was smaller, like I said, I would hold him for procedures. Then, when he got to be about two, he would look at me like I had betrayed him. The doctors and nurses would not be taking this child home-I would. And while I would allow these procedures to be done to him, I was the loving pair of arms that comforted him when it was all over.

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Specializes in PACU.
This makes it sound like the people who are holding the child are not on the child's side... If you say a mom is considered 'bad' for holding down the child, wouldn't a parent who didn't help hold still be 'bad' for bringing the child for the shot/dressing change in the first place?

Parents who help hold and position their child have usually been a big help for me when doing procedures. I can understand if the parent is not comfortable doing that (and to each their own), but the child should know that everyone, including the ones restraining them and the nurse injecting/assessing/dressing wounds etc is on their side too.

It's not about the reality of good vs. bad. It's about the child's perception. Having someone who is "safe" to be around is important for the child, esp. those who're unable to understand why an unpleasant procedure is a good thing, especially during hospitalization. A quick immunization or other minor outpatient procedure? Sure, that's not really all that big of a deal and will be forgotten fairly quickly. But when you combine all of the unpleasant events of a hospitalization, along with the separation from home and deviation from routine, it's important that the kid be able to "trust" the parent not to participate in causing further pain.

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Thank you to the peds nurses who try to give children a chance to be calm. Their is nothing worse than taking my son (who loves going to the doctor's office) to a medical office or the hospital and having them automatically try to hold him down. That alone, is enough to scare a kid. I know some kids need to be held down, but others will very much listen if you just try.

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A three year old is going to need to be sedated or restrained.

Not all kids are the same. No matter what the age.

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Specializes in Emergency Nursing.

I'm not sure how old this child is but most likely your going to need another set of hands to help you restrain the child. If the child is old enough then explain the procedure to them using age appropriate words and be honest with them about why you need to do this and that it will hurt but only for a little bit (using "ouchie" or "pinch" helps) and explain that your going to give them something to help make them feel better and so the ouchie doesn't hurt so much. If the child is an infant you will definitely need some holding help if they are really upset and if your facility has it try dunking their pacifier in some Sweet-Ease which can work wonders in an upset infant. Do you have more info. on this child that we might be able to give you more age specific recommendations?

!Chris :specs:

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Specializes in Med Surg, Specialty.

J9G2008 and Perpetual, if your thoughts are that children will mistrust anyone who enables them hurt by holding/positioning them, are/would you therefore discouraging parents of patients from helping hold/position the child?

I'm honestly curious since you both seem passionate about your answers, but we can agree to disagree.

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Specializes in PACU.
J9G2008 and Perpetual, if your thoughts are that children will mistrust anyone who enables them hurt by holding/positioning them, are you therefore discouraging parents of your patients from helping hold/position the child?

I'm honestly curious since you both seem passionate about your answers, but we can agree to disagree.

If possible I would rather have someone other than the parent hold a child who is old enough to associate the parent with the situation but not old enough to understand why it was necessary, so sort of yes. Obviously that ideal cannot be met under many circumstances, and what needs to be done needs to be done. There likely won't be any lasting harm from a parent doing it, but in the short term it might reduce the comforting effect that the parent has, and I want my pts to be as comfortable and secure feeling as possible.

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Specializes in Cardiac Telemetry, ED.
Not all kids are the same. No matter what the age.

Okay. *chuckle*

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

You need to understand the developmental level of a NORMAL 3 year old, and then verify/validate that the 3 year old is a on par.

Then, knowing the developmental level--recognize that you may not be able to "do" yourself. How and Who has been changing/cleaning? Mom? Dad? Grandma?

Approach carefully. Not intimidating...at the eye level of the baby...remember not to get kicked or bit or spit on....get help if you need it....

have something to distract him/her....toy? sticker? a lovey doll? Blanket? Some kids need pacifiers, and mom or grandma may have to hold down. Ask the primary caretakers how it has been done.

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