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Terrible Twos?

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Has anyone ever had to deal with the "terrible twos" with a PDN patient? How did you deal with it? How about with parents who don't care to deal with it?

I'm experiencing a lot of "terrible two" behavior with my little patient. The parents don't really help much or come to my aid when she's hitting and kicking me. Sometimes mom even goes upstairs and leaves me to deal with the whining, misbehaving child. It's not my place -or job- to discipline your child. I've done some teaching with mom about how important routine, consistency, and boundary setting is at this age but it always seems to go in one ear and out the other. I'm at a loss as to what to do and getting very burnout!

OrganizedChaos, LVN

Specializes in M/S, LTC, Corrections, PDN & drug rehab. Has 10 years experience.

I had to deal with the same stuff. The parent treated me like a baby sitter & left as much as she could. My breaking point was when the child locked me out of the house. I left the case right after that.

SDALPN

Specializes in Peds(PICU, NICU float), PDN, ICU.

Omg. Locked you out? That's messed up!

I've had my share of the terrible twos. They turn in to terrible threes and so on. Its usually bad parenting. The parent feels guilty or bad for the kid and spoils the kid. They don't want to discipline their kid which creates a disaster. If its not cute at 20, its not cute at 2. It sucks that the kid has to start life rough. But its only going to get worse if they have a bad attitude. Usually I walk away from those cases as soon as I can. The kids know we are unable to do much.

I will do what I can if I'm stuck on a case. If the kid throws a toy, I take the toy away. If the kid loves attention, I'll "ignore" the bad behavior/child. Of course I monitor the kid. I reinforce good behavior with attention. If the parents aren't around, this works better. Some don't like that approach. But if we can't put them in time out or something, that's the best we can do. I've asked parents about time out and stuff. Some parents are ok with it and others are offended.

But if we don't have control over the kid, how will the kid act in an emergency? Will it effect care? If the child won't come when called and the trach is out, then what? It won't look good telling EMS that the kid wouldn't come and ran away and the stoma closed up in that time.

This is another reason nursing needs to be our only job. If the parents want a babysitter, they need to hire one.

OrganizedChaos, LVN

Specializes in M/S, LTC, Corrections, PDN & drug rehab. Has 10 years experience.

Yeah, the family never disciplined him & obviously the nurses didn't/wouldn't either. So when I got there he was a MONSTER! He gave me a black eye & the day after that I went out to take the trash out he locked me out. I told my boss & didn't go back. If the nurses & mother are gonna let him get away with murder, I'm not gonna be there for it.

I have dealt with this a lot also. I worked with a child who was extremely abusive to the nurses. He was 5, so not a toddler although his mental age was. He would kick you hard! He would get in his walker, get an evil look and come charging for you to kick your shins! Mom didn't even want the nurses to say no. That wasn't fun.

Ha! Wouldn't that be nice if they had a babysitter?! We are their babysitters!

SDALPN

Specializes in Peds(PICU, NICU float), PDN, ICU.

Ha! Wouldn't that be nice if they had a babysitter?! We are their babysitters!

Can you imagine going to court explaining that?

Your honor, on that day I was busy doing laundry and making lunch for the patient while watching the patient play. The trach fell out and the child ran and wouldn't come back.

Judge: I thought you were the nurse?

Nurse: I am the nurse. But I babysit, I'm the kids personal chef, and maid.

Judge: So how can you be a nurse while you're doing all of those other tasks?

My patient is 2 1/2 and is the sweetest, funniest, most adorable kid there is! (Though developmentally he is not 2 1/2 years....maybe that is the difference).

My patient is 2 1/2 and is the sweetest, funniest, most adorable kid there is! (Though developmentally he is not 2 1/2 years....maybe that is the difference).

So was mine... until she hit the "I want to be independent and test all boundaries" stage. I've dealt with it before and it wasn't horrible but that's because the parents cared and gave me some tools (like time outs, take the toy away, etc). These parents could care less! It's so frustrating!!

(Can you imagine going to court explaining that?

Your honor, on that day I was busy doing laundry and making lunch for the patient while watching the patient play. The trach fell out and the child ran and wouldn't come back.

Judge: I thought you were the nurse?

Nurse: I am the nurse. But I babysit, I'm the kids personal chef, and maid.

Judge: So how can you be a nurse while you're doing all of those other tasks?)

Right? Good one. I don't do those tasks, let me be clear. In my case the babysitting refers to the fact that the parents expect us to play with their child for the entire shift. Do they play with them? Nope!!!