Published Nov 10, 2013
PerfectlyPlump, ADN, RN
181 Posts
Let's say your private duty pediatric patient is very fearful. The child was in the hospital for a long time after birth, and has had multiple procedures, and a couple of traumatic experiences in that setting. And this little one never forgets.
Does anyone have any experience with a child like this?
Mom really needs respite, but the child clings to her, and her alone, like glue. I am wondering how to "make friends" with this very anxious child.
SDALPN
997 Posts
Time and patience. You must show consistency. Mom needs to reinforce that you are a "safe"person to be with. I'm not sure of the Childs age. But maybe they see scrubs and think of whatever happened. Once you gain trust, its even harder because one mistake can make the child not trust you even more.
Adele_Michal7, ASN, RN
893 Posts
I had (still do, one day a week, but not full time anymore) a patient like this. It took time, time, time. Lots of time. Finding out what interested her, and doing it, (lots of collages and arts and crafts,)
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I am not going to we ear scrubs, for sure. She is 3, BTW.
Esme12, ASN, BSN, RN
20,908 Posts
Sometimes Mom is just as frightened as the child......patience and consistancy
realnursealso/LPN, LPN
783 Posts
It is standard practice in my area to "never" wear scrubs or uniforms to do Peds Homecare cases. The children have been through enough after being hospitalized and they associate all that painful, lonely time with nursing apparel. You'd be surprised at how young of a patient can associate uniforms/scrubs with the hospital. At times I feel it also helps the parents to think of homecare, not hospital care.
That makes sense. My agency likes scrubs usually, but it sounds like we need to reconsider our policy.
JustBeachyNurse, LPN
13,957 Posts
My agencies require scrubs for professionalism & as a reminder of boundaries. (You probably wouldn't be shocked what some consider 'professional casual' t-shirts with Capri yoga pants, jeans. & an old t-shirt , tank tops & short shorts). However the policy for both agencies explicitly state that there are cases where scrubs are not appropriate (such as your case with a traumatized child, an older child that has been in the system forever and just wants to be more normal ).
We have one case that the preferred dress for in-home care ( at school scrubs are required per the school's policy) is jeans or khakis and a shirt supporting their charity ( shirts are given to nurses when they start the case ). There is another late teen case where nurses are requested to wear tshirt & jeans preferably a rock t-shirt
The matter of boundaries is the reason I like the scrubs policy. Since we PDN's so often have problems with the housework question, the question of 'favors' etc., it makes sense to wear what we used to call a ' uniform', which today is scrubs.
I am showing my age for sure, LOL.
My agency says we wear scrubs unless the parents request different. Most parents don't care. If they do care, it seems they are one extreme or the other. I suggest avoiding scrubs if it is beneficial for the pt. I always wear scrubs on Dr visit says because I feel we are respected more dressed that way.
It also depends on the activity for the day. If we are swimming and I'm expected to be in the pool, I'm dressed for the activity (with a tshirt over swimsuit because it feels more appropriate).
My agency says we wear scrubs unless the parents request different. Most parents don't care. If they do care, it seems they are one extreme or the other. I suggest avoiding scrubs if it is beneficial for the pt. I always wear scrubs on Dr visit says because I feel we are respected more dressed that way.It also depends on the activity for the day. If we are swimming and I'm expected to be in the pool, I'm dressed for the activity (with a tshirt over swimsuit because it feels more appropriate).
This is a situation where I'd advocate NOT wearing scrubs, but like you, I wear them unless the family forbids me. Even if I'm given the option, I'll choose to wear scrubs.
In a profession where the boundaries are so often blurred, the scrubs I wear are sometimes my last line of "defense" and only real reminder to the family that I'm a worker in their home.
I have a case (I'm there once a week, used to be full time) where do not allow nurses to wear scrubs. It is so annoying.