Tips for Working in Pediatrics

Get on the child's level: Bend down, introduce yourself and ask the child a question about themselves to build rapport and trust. This makes you seem less intimidating and more relatable to them!

Caregiver knows best: Family-centered care is so important in pediatrics. We always say that caregivers know their child best, so use that to your advantage! Ask them questions about what helps their child cope, what triggers, them, and what will make this experience easier for them.

Talk Before Touch: This is basic respect, which children deserve! Even before something basic like taking vitals, simply tell the child what you’re about to do. We’re all about making things less traumatic for these kids!

Preparation & Education: We all know that the unknown can cause anxiety and fear. Having information and expectations, on the other hand, gives a sense of perceived control and empowerment. In fact, research has shown that children who have been prepared and educated about a stressful procedure have a better success rate of cooperating. Therefore, the procedure will require less restraint and maybe even fewer medications.***

• Try to avoid using scary words, as they can be triggering. For example, when explaining the needle inside of the IV catheter, I say “helper” instead of “needle.” And instead of “stitches,” we say “string bandaids.”

• Remember that children don’t know medical terms. For example, saying “medicine straw” instead of IV, or saying “rubber band” instead of tourniquet.

• Describe the steps and senses. Children do well with chronological information as well as sensory information. Talk about what they will see, hear, feel, etc. For example: “After the tight rubber band, the nurse will clean with a cold sponge."

Give jobs: Having a job during a procedure is helpful because it gives the child a focus and a sense of mastery during exams and procedures. For example, a child’s job could be to stay still and take deep breaths. Sometimes I give parents a job too! This allows them to not feel helpless.

Give choices whenever possible: Obviously children aren’t usually able to choose whether or not to receive treatment, but we can allow them to have choices elsewhere! For example, choosing whether to sit on parent's lap or the bed for a poke.

Pain management techniques: Usually some form of pain control is available at hospitals, whether it be numbing cream, cold spray, J-tips, or Buzzy. I always advocate for the use of at least one!

Least traumatic holding methods: Child life specialists love to harp on comfort holds for good reason. Comfort holds are ways of holding children that usually involve a parent or caregiving and allow the patient more control while still restricting movement. One of the most practical and common comfort holds is having the child sit facing forward in a parent’s lap - This allows them to have the comfort of being with a parent while still allowing the healthcare professionals to do their job.

Distraction: If the child was already watching something on their parent’s phone or they have a toy they like, try to let them keep using it during a procedure! Research shows that children engaging with an alternative focus helps with their stress and pain during painful procedures.

Try to limit voices and people: During procedures, the more voices and people present will naturally raise the tension and stress. If possible, assign someone (like a parent, nurse, or CCLS) to be the “one voice,” and limit the number of people in the room. Of course students need to learn so sometimes this isn’t possible, but especially for privacy-invading procedures like an enema, I like to advocate for students to step out.

Validate feelings: It’s important to validate that the hospital is scary and it’s okay to have negative emotions. Rather than telling the child “you’re fine” or “don’t cry,” we like using statements like, "it's okay to be scared and cry. I know this is scary, but it will be over soon."