I am 18 and just started my apprenticeship to become a medical secretary working for a pediatrician.
The other day i was talking to my colleague when she told me about a 5 year old girl who had to get a neccessary injection which she refused because she has needle phobia and 3 people tried to hold her down but they still could not get it done because the girl was raging and was unable to restrain.
Now i am wondering how can it be that 3 adults are unable to overpower a 5 year old girl.
I told my collegue that its hard to belive and that i think if i was with them i would just hold her tight with my arms
wrapped around her body and somebody only has to take her arm and get the shot done.
But she (my collegue) said that she was also surprised by that girl's strength and never experienced something like that before. And shes working there for over 20 years.
Why? What is the difference between a painful outpatient procedure and a painful inpatient procedure? He had 10/10 pain with the last set and screamed for 15 minutes straight. No need to subject him to that. One time dose prior to procedure.
Really? Your kid is talking and evaluating the worst pain he's ever had? Bright kid :) Babies scream bloody murder when you suction their nose.... think that's a "10" also? JME- but that's what a baby does when they're being held down- they DON'T LIKE IT... but to drug them? And you see abuse with trying to keep a kid still during a procedure ? Oy.....
Really? Your kid is talking and evaluating the worst pain he's ever had? Bright kid :) Babies scream bloody murder when you suction their nose.... think that's a "10" also? JME- but that's what a baby does when they're being held down- they DON'T LIKE IT... but to drug them? And you see abuse with trying to keep a kid still during a procedure ? Oy.....
IKR? I have 10 year olds who can't answer that question. "I dunno, it just hurts."
Don't get me started on how hard it is to get a kid to take PO meds- sometimes THAT's a job that requires an assist too!
i had lcpd as a child and requried 4 major surgeries on my hip as child (5 years to 7 years old) i quickly became terrified of needles, so much so that the surgeons would start my iv after i had been put under. i remember having to get a set of booster shots one time at the navy clinic when i was around 8 years old, it took my mom, my dad, 3 corpsmen and 2 nurses to hold me down. little kids can will "hulk" out. even now as an adult when i have to get an iv or injection i keep my eyes closed tight shut. as long as i dont see the needle, i am fine.
as a peds nurse, i try to make the injections quick and fast, but sometimes a child will freak out, and that is to be expected. my 6 month old grandson takes his shots like a champ, he screams bloody murder for a minute, i give him his pacifier and soothe him and he instantly calms down.
Specializes in maternal child, public/community health.
When I worked in a peds clinic, they were doing a study on a "cough trick" to see if it would decrease pain with immunizations. Once it was over, I continued to use it with the kids. Obviously, they have to be old enough to explain it. (I found most kids could do it at about age 5).
I had a 9 yr old patient who had the misfortune to get repeated infections requiring IM antibiotics. She also had a fear of needles. The first time, when they found out she would have to have a shot, she told me, "I don't want a shot. I hate shots." I said, "I think most people don't like shots, don't you? But you know, I know a secret that I could tell you that makes the shots not so bad. Do you want to try it today?" Of course, she said she did. I explained it to her (you count to three before doing the shot. When you say three, the child coughs really hard three times - I usually said five just to be sure it was long enough) and we practiced it a couple times. Then we did it with the shot. She was still scared and only managed to do 2 coughs but she said, "That didn't hurt much at all." I said, "You know, it is a secret but you could tell another nurse when you need a shot, just in case she doesn't know the secret." Poor thing had to have IV antibiotics several more times over the next few months. It just happened that I was always the one to give them. She would always say, "Let's do the secret trick, okay?" The last time I gave her a shot, she said, "You know, I'm not really afraid of shots anymore."
Obviously, this would be hard to teach to an extremely ill or already hysterical child - you need to have the time to teach it and they have to be able to listen. But it is worth trying for more routine things that freak them out.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Oral, benzos...and yes, there has been abuse. I am happy to see you in court about it. ;-)
I am having this discussion with my ped today. :-)
I have a little brother who had ALL. I worked for most of my career in peds, peds clinics and the "shot rrom". There is quite a bit of difference between a child who must have repeated painful procedures done and a child coming in for scheduled immunizations. We need to pull out all the stops to make it as less horrible than it inherently is. I am so thankful there are now Child Life specialists and drugs that are appropriate for sedating a child (not oral benzos for a 6 mo old). :uhoh21:
I really have no idea why you would think it's funny to accuse nurses who are using best practice of child abuse and put little smily faces on your comments. I don't find it amusing that someone reading this may have a child who needs these procedures to stay alive. How callous it is to say that they are subjecting their child to abuse when they hand their precious child over to the team who is constantly researching and attempting to find the most effective and least traumatic way of getting it done because not having it done is not an option in many cases. It isn't funny. It isn't cute.
I don't know if you are a nurse or not, but I do know your comments may be causing needless pain in people who may already be hurting.
A one-time dose of Ativan would definitely not prevent the need for helping a child stay still. Sugar water on a pacifier and a good swaddle would be much much more effective on an infant. In addition, an oral benzo should require monitoring for several hours afterward if given to an infant. These shots may become an all day experience at the hospital. I would be concerned about the judgment of any physician who would prescribe this.
To the OP, I have had to have three people hold to keep a 3 pound preemie in position for an LP...with fentanyl and versed on board. I know it sounds ludicrous, but I think all the posts from experienced nurses here speak pretty uniformly. With a baby, it's not even that they're scared (they don't know to be scared) as much as the safe position for the procedure is not their position of preference. And then you've got to have hands to prevent the natural jerk/pull away with the stick that they're not old enough to consciously prevent. You might be able to keep a 3 year old in one place, but can you also properly position the injection site and keep little hands from flailing/blocking/grabbing? Not unless you have four or more hands....which would be weird.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
That would be weird but it reminded me of a comment an ex boyfriend made who was juggling soft drink cups, bags and cardboard boxes. . "I wish I were a Vishnu". *blink*
That would be weird but it reminded me of a comment an ex boyfriend made who was juggling soft drink cups, bags and cardboard boxes. . "I wish I were a Vishnu". *blink*
When my kids were little, I was not squeamish about them getting their immunizations (other than delaying some of the shots). I knew the pain was for a good purpose and didn't fall to pieces at the thought of them experiencing brief pain to ward off really bad stuff. Their dad, otoh, developed a bad case of jelly legs and green complexion just about every time.
Because we had five kids in eight years, we often had two or more getting something. Dad held down the fort in the waiting room while I did shot duty. I had a way to hold the little ones that kept their gaze away from the shot. They let out a wail, I loved them up and Dad came and got them.
The older kids--3 and up--were told the truth. "It will hurt pretty bad for a minute, but then it will be better. Holding still helps. You can yell or cry if you want, but no hitting or biting. After we're done here, we can go for a treat." I think because I wasn't dreading the experience and because I always told them the truth they weathered the situation well. After a couple of times, I could say to them, "Remember how it hurt a lot for just a short time and then it was all done. It'll be like that again.
We also practiced on teddies and dolls. And we did some pinches ahead of time (on mom, as well) so they learned how to flinch and yell without moving.
They were great, even to the point of getting stitches or having them removed.
My grandson with spina bifida is carrying on the family tradition. He is a very hard stick but he holds still. Once the IV is in, HE is the major guardian of the site, telling others to be careful not to mess with it. He also knows how to drop his own NG tubes, because a wise and caring nurse figured out that he hated getting a tube with someone else calling the shots (pardon the pun), not the tube itself.
That is not to say that kids don't need to be restrained. Many do. Some become like street thugs on PCP who act like they could throw Mack trucks across the room. Parents can help if they can work through their own trepidation ahead of time and keep from telegraphing their fear to the child.
There is no, "one size fits all," answer. But there can be a common bond in saying we want what's best for the kids.
I thought it was a finger-tangled RUK !!! Thanks :)
xtxrn, ASN, RN
4,267 Posts
Really? Your kid is talking and evaluating the worst pain he's ever had? Bright kid :) Babies scream bloody murder when you suction their nose.... think that's a "10" also? JME- but that's what a baby does when they're being held down- they DON'T LIKE IT... but to drug them? And you see abuse with trying to keep a kid still during a procedure ? Oy.....