Trusted Thoughts

Learning to Speak Child

Mar 1, 2018
Dawn Pizzini, Clinical Nurse Educator

Think about how you talk to your patients every day. Your communication style can make a challenging conversation go much better or it can complicate a situation. As you go through your day, or as you enjoy a post-work libation, think about the ways a simple interaction may have improved your patient’s experience. If it helps, picture the person in that bed as a family member or friend, or maybe even you. If you are struggling with this process, just try to treat your patient the way you would want to be treated.

One of my steepest learning curves in the transition from being an Adult Nurse to being a Pediatric Nurse was the language barrier. Children speak their own language and they have many dialects depending on their age groups and developmental levels, not to mention the actual language barriers or coping skill challenges. Survival requires we tap into a different level of understanding, compassion and, most importantly, our resources.

My favorite resource, and one of the team members that taught me the most as a pediatric nurse, is the child life specialist. From the outside they get to have all the fun, including but not limited to: bingo, playing in the playroom, arts and crafts, music therapy, and bringing their dogs to work. The reality is until you have worked a day with a child life specialist, you have not witnessed the magic that happens when they come into the room and tell a child what it means to have to get an IV, or what will happen when they go to surgery (using a doll to show details), or being present when any number of procedures occurs. Ultimately, they are a safe person that the patients learn to trust and look forward to seeing every single day. They were my competition for the love of my patients, but they were the bread to my butter when I needed a 3 year old distracted to be able to finish a challenging task they did not want to do.

Part 1 of this series of posts is going to give you some suggestions for how to speak child. Here are some of my favorite, and most frequently used, statements I learned from my favorite child life specialists (which is any child life specialist):

Coach your other helpers that there should only be ONE VOICE in the room. Too many cooks in the kitchen result in anxious children and complicate the process.

Speak in a low calm voice at the level of the patient. No one likes to have someone standing over them. It is intimidating.

It is ok to allow the parent to be the voice the child hears during the procedure, just pick helpers who are really good at lip reading or who know your facial expressions.

Children have lost control when they are in the hospital. Give it back to them by giving them choices. Never ask yes or no questions.

– Sometimes you can get your way if you ask them “What is scaring you about this?” “Are you afraid it will hurt?”

Never lie to the patient. That is instantly throwing their trust in you away. Instead tell the truth. They ask,” Is the medicine yucky?” You say, “Everyone has different tastebuds. How about you tell me when we are done, so I can answer this question for other kiddos.” Children want to be helpful.

Find time to take your nurse hat off for 10 minutes. Talk movies, color a picture, ask them silly questions, or cuddle the babies. Bonding with boundaries is important. I have never been afraid of looking a little bit goofy (or a lot), if it will make my patient smile.

Always make them feel like a superstar. You like feeling like one, why wouldn’t they?

– There were 2 jobs I gave my patients when I was starting IVs: “You have 2 jobs: 1. Try to hold as still as a statue 2. Breathe.”

The second one got me crazy looks and a giggle. But it is an important job.

The moral of this story? Love your child life specialist. They are the reason you got that IV, oops clear plastic straw, in one try. They are more than just play-doh, playroom, and artists. They are part of what makes you such a great pediatric nurse.