When communicating with patients, communicating with children is probably the most difficult. Not only are you trying to explain a difficult situation to a child, but you are trying to include the parents in the conversation as well. It is natural for a child to be scared, unreasonable and resistant to medical treatment, and it takes a skilled nurse to work through these roadblocks to achieve understanding. As with most communication, listening and allowing the patient to be heard will serve you well in talking to children.
Communicating with Children
When talking to children you want to avoid medical jargon. For very young children, you have to use words that are as simple as possible. Even then, you may not get them to understand because their fear response is overriding everything else. However, you have to use care when talking to older children. They may be insulted if you treat them like a baby and talk to them as if they can’t understand. You have to make a mental note of the age of the patient and their level of understanding, and tailor your speech to meet their needs.
This isn’t always easy, and it can take some time to get a feel for how much jargon is too much jargon. Certainly, you can’t speak to a child the way you would to an adult or a colleague. You need to moderate your language, get down on the level of the child, and use a soft tone of voice. In showing that you don’t mean them harm, you can start to develop a relationship with the child that will help to calm their fears. Sometimes, though, you need to do something that will cause them discomfort, and you must explain this with honesty and using straightforward language.
Talking to Parents
Part of communicating with children is communicating with their parents. Again, you are likely to be dealing with someone who is in a great deal of distress and fear. It is helpful to try to allay their fears, answering all their questions as honestly as possible. Some parents may get emotional and you need to be aware of possible outbursts of anger or sorrow. Either of these can upset your patient and that can go against what you are trying to accomplish. Try talking to parents away from the child and use active listening techniques, as you would for any other patient, family and relatives.
Daniel was a two-year-old heart patient who was preparing for his second open-heart surgery. He didn’t understand what was to happen to him, and the atmosphere of the hospital room made him scared. Already, starting the IV line had been a traumatic event. Then one of the nurses from the OR came into the room the night before the operation with a bag of items. She got down on her knees with Daniel and showed him the hairnet he would wear, the tubes that would come out of him, and the mask that would be placed over his face.
Instead of being afraid, Daniel was fascinated with the new toys in front of him and played with them all. During this time, the nurse took the time to talk to the parents about their concerns. She helped them to understand what would happen, explaining the procedure, the heart-lung machine, and the estimated time of the surgery. When the nurse prepared to leave after half an hour of talking, both Daniel and his parents were much more at ease. Although all of them were still afraid of the surgery, it helped to know a little bit about what would happen so not everything would come as a shock.
Including the Child
Finally, it is important to include the child when talking about procedures or their health. It is so much easier to talk to the parents that you may have a tendency to ignore the child. Children are very sensitive to this, and they do not appreciate being ignored. You should address the child at the beginning of your explanation and try to focus your talk on them and their needs. At the end, you should also ask the child if he or she has any questions. They may not, but it helps them to feel included if you treat them like more than just a parcel to be taken here and there. Talk to the child as much as possible, and then take the parents out of the room for more adult conversation, if needed.
Share your experiences of communicating with children in healthcare.