Published Sep 30, 2015
Girlafraid13
309 Posts
I had an 8 yo pediatric patient who happened to be a cancer patient. He was a bit moody so asked him if he wanted to play with some lego-like toys he had. So I proceed to take his Legos to him so he can play in bed (nonmobile). He was having a great time laughing and no longer in his funky mood. About 20 mins later I check on him and he decided he was done playing. Instead of telling me if I can put them back in his drawer he begins to throw his Legos at me and on the floor. I firmly told him he can't be throwing his toys at nurses and asked him who is going to pick these up now? He began to cry and I feel horrible. How did I make a child with cancer cry? How do you deal/discipline(which is what parent is for but not sure what to call it)
children who are acting up when the parent isn't around?
Pretty_
1 Post
I do understand how you feel. Its tough but having cancer does doesnt mean the child needs to be unruly. Throwing ytoys is always unacceptable. You're right the parent is supposed to discipline the child, but you should reinforce rules set by the parent. I highly doubt that the parent would condone his behavior.
anh06005, MSN, APRN, NP
1 Article; 769 Posts
I haven't worked with TRULY sick kids but I think you need to acknowledge that he is going through a lot but it does not excuse his behavior. "I know you're going through a lot but it does not allow you to throw toys at anybody. Is there anything in particular bothering you right now?"
Perhaps ask about it later in the shift as well. Given the situation the patient was probably trying to show aggravation towards something.
NICU Guy, BSN, RN
4,161 Posts
The child's behavior may be a result of the parents sharing your same dilemma. Just because the child has cancer, does not give him a free pass to throw a tantrum. It is possible that the parents also feel guilty for disciplining the child because he has cancer and let him do anything he wants without consequences.
You're right the child doesn't get a free pass. Not sure if other nurses have experienced this behavior with this particular pt and always let him get away with it.
I usually say very nicely oh no that's not nice or something along those lines. I was very firm this time not an angry voice but firm and he cried. That's the part that made me feel very guilty. At the end of my shift I made the effort to show him I wasn't angry and we talked all things Disney.
FlyingScot, RN
2,016 Posts
Having cancer or any other illness isn't a free-pass to be rude or abusive whether a child or an adult. I could understand if he cried because he didn't feel like putting his toys away but actively chucking them at you is a whole 'nother thing. Bad behavior left unchecked begets even worse behavior. I have a few patients that are a little sassy and I'll let that ride but when it gets downright rude I put an immediate stop to it and they know I mean business.
FolksBtrippin, BSN, RN
2,262 Posts
Crying is okay. It helps to process feelings and doesn't hurt anyone.
Throwing toys is not okay. It could hurt someone.
You did the right thing. Sometimes kids cry when they get called out for doing something they shouldn't have. It's okay, and a good sign that they feel bad for what they've done. A spoiled kid is a miserable kid. Thank you for not spoiling him and also not being too hard on him, which you showed by going in and talking Disney after he settled down.
You did the right thing. It's not always easy to see that when you have a kid with cancer crying, But he needs to be taught firmly and lovingly just like any other child.
Thanks again. You have my respect.
anon456, BSN, RN
3 Articles; 1,144 Posts
I agree with the others who say that kids still need rules and boundaries even when they are sick. That being said, this child sounds like they could use some therapy to deal with what they are going through. I hope they have that in place.
blackribbon
208 Posts
You didn't make a kid with cancer cry. You made an unruly child cry...this kid just happens to have cancer.
He still needs to be held to the standards of society or else he will not have any friends or people who actually like to be around him. Don't pity him. Empower him (which you did by demanding that he behave like a "normal" child).
FatherJon
I know I'm a little late to the party, but one thought I had was that often times when children act out (more so with adolescents than 8 year-olds) they are testing boundaries in an effort to feel secure. Children need to know that boundaries or limits are in place to feel safe and secure. There is always a reason behind maladaptive behavior. One possibility here is that this patient felt a connection with you because of your kindness. This might not be something he is used to, and doesn't know how to appropriately respond as a result. He most likely didn't know how to appropriately say, "Thanks for being someone I can trust, and someone I can rely on for kindness." Instead, he threw his legos at you. I think you responded well to this situation, and I don't think you should feel guilty at all. Sometimes it helps to understand the why behind the behavior, especially when it's unpleasant.
~PedsRN~, BSN, RN
826 Posts
The first thing you need to do is stop seeing these children as their illnesses. I know it's hard when it is what we are there to take care of, but they are children first, and patients second. You know? You did nothing wrong. I do not take care of cancer kids, but I do take care of a terminally ill population who spend a lot of time at the hospital alone. What they need more than anything is some structure and tough love in a lot of cases. A whiny entitled child is also the child who will be non compliant because "they don't wanna"... and that's just not an option. :)
Good luck in your journey!!
canoehead, BSN, RN
6,901 Posts
When kids realize that suddenly their parents arent disciplining them, they know something really scary is happening. Keep holding them to age appropriate standards. Remind the parents that this is an emotional security issue- keeping up with discipline is worthwhile to make the world feel controllable. Also, they have to live with these kids when the crisis is over!