Reducing Stress in Pediatric Care

My heart is aching again, my blood was boiling again. My son needed a high level MRI, a test ordered by his new doctor, that required sedation, and of course another IV. My little guy has developed a strong fear of needles and IVs now after his extended hospital stay earlier in January. I told the staff about it and felt like I was telling my concerns to a wall. They did not heed my advice, and from my point of view, did nothing to lessen his fears and make him feel safe.

I wanted to say no to the test, but they were checking for early brain damage that one of the diseases he MAY have , that if left undiagnosed could be truly serious quite quickly. (He does not have this, thankfully) So I allow my child to be tormented for several more hours that day.

I am really frustrated overall and just can’t believe that minimizing stress on children is not standard or even a priority for non-urgent situations in a children’s hospital. We were asking him to do a test, not providing life saving medication. No need to rush. These things should be done on kiddo-time, not penny counting hospital schedule time.

And then there is my stress too – I had a flashback in the MRI room when I had one without sedation, I have realized how much of my childhood trauma is from my own hospital stays, ha, it’s not all my parents’ fault. I don’t want my kiddo to have PTSD, really really don’t.

I have spoken up when I can, told the nurses and doctors how stressful these tests are, and they apologize but say there is no other way. I call bullsh**.

If I ran that lab, I would make sure kids are comfy and secure before they see any needles, bandages, rubber band thingies. Some nurses do this – most do not. He was in the room less than 3 seconds before a team came in with the tray he now recognizes is for IVs. He curled up in a ball, started rocking and moaning repeatedly “no poke, no poke”. Too many people in the room, a new room, everyone rushing at him and talking at once, bribing and reasoning with a mind in an unreasonable state. You can not reason a 5 year old out of this state, you have to wait for calm to return. It takes time. Offering a sticker to a child that has had about 50 painful pokes this month will do nothing except make him think you are stupid.

If I ran the lab – I would talk to parents and look over history to see if anything makes it better or worse for that kiddo. I told them not to say the word “poke” and it was one of the first things out of her mouth. Then she looked at the chart and said “oops” and giggled to laugh off her mistake. And I would not assume that my actions don’t matter since the kid isn’t supposed to remember it – nurse kept saying we’ll just do this quick, don’t worry he won’t remember any of it because the meds cause amnesia. Yes well, maybe when calm? My guy remembers everything except the time he was actually asleep in the machine. Everything. He remembers everything that nurse said and did and sadly he told me all about it and asked if he had to do that again. My heart sunk so low. I don’t know. I told him I hope not. Because I don’t know what else is in store for him as he goes through more diagnostic tests until we get the answer the doctors want.

And If I ran the lab – I would better inform parents of what to expect.  The Doctor, after it happened and only because I asked, said about 40% of kids have trouble waking up from that medication, and have experiences similar to night terrors, emergent delirium they call it. No one thought to warn me about that, or soothe me while it happened. I guess they see it so much it doesn’t phase them? They don’t think Mom needs to know her kiddo is ok? They asked me if I had any questions about the sedation, but I didn’t know what to ask. They should have told me.

He was so upset after this procedure and the rough wake up, and the nurse being so overbearing and pressuring him to get ready to go home (despite me asking many times for her to back off and give him space) that he could not calm down and we took him out to my van still completely screaming, poor guy.

And then the nurse looks at me and says “Is he always like this?” It took everything in me not to punch her in the face. I wanted to say, “no he only screams after being tortured and pressured and scared half to death” But somehow I said “no, he is having a hard time today”

Is bedside manner and stress reduction seriously not a required course for nurses? Do they have to do anything special to become a pediatric nurse?

 

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11 thoughts on “Reducing Stress in Pediatric Care

  1. Oh my friend, I’m so saddened to read this. I know, first hand, how things can go wrong in pediatric medicine. Colt’s every visit was a nightmare when he was little too.

    I’m sad to day that I’ve lost a lot of faith in medicine. Between my own experiences, my son’s and the experiences of others, like you and your boy, make me feel sick to my stomach. If people do not wish to work with kids, they should not get into peds medicine! I’ve never understood that attitude one of the nurses showed…you’re absolutely correct, there is NO reason why they couldn’t have taken a few moments to let your little guy calm down.

    I’m so sorry. Keep advocating and always put yourself between your son and medical staff (is my opinion, sadly). I ignore them and just focus on Colt as much as I can.

    You’ve done a great job, being the strong support your son needs. Keep your eyes wide open, as you always do for your little ones, and things will turn out fine.

    There are patient complaint avenues in all hospitals across North America. If you write them, they will investigate but between you and me, not very much will happen. Still…someone should be told how terrible the staff treated your sweet boy.

    *hugs you* xo

    • Thank you. I know you understand. I have complained in person, by email, and on the phone. Some people care, others actually laugh at me. But I keep speaking up. I will do everything I can to lessen his discomfort. I understand he is not at disney world, but so many little things could make it less scary and painful for him. I think he is done with testing for a while now, hoping he does not have another episode and that he can return to normal school and kid stuff and start forgetting all of this.

      • I hope your family can put all of this frightening stuff behind you for good!

        I applaud you for speaking up! If you wish to push it further, I would suggest you write a letter to the Chief of Pediatrics (or if it’s a children’s hospital you went to, the department chief for either critical care or medicine (chief of whatever service your son was admitted to).

        Wishing for perfect health and nothing but happiness for your little guy. He’s a very brave boy who has a very brave mom (and dad!). Much love. xx

  2. Speaking from both sides (I’ve been a patient and I work for doctors) and I have family and friends who work in the medical industry, what I’ve learned:

    Hospitals are for doctors and nurses, not patients. There are exceptions, but they are few and far between. I’ve even had doctors and nurses admit that hospitals are not for patients.

    I do not responde to anesthesia the way I’m supposed to either. I don’t forget. What’s more, I feel it, all. With a muscle relaxant, I can’t move. Whenever I had to have a mole removed my poor doctor hated it. I learned to make jokes and laugh, a lot, even while I flinched.

    When I was about your little one’s age, I went to the hospital for kidney trouble. It was only a few years ago that my parents finally admitted it. They kept saying that it never happened.

    I’m truly sorry you can’t depend on the medical staff to help you. I’ve found lists to be helpful. Staff hate it, but it helps me keep track of asking all the questions, including “Explain to me what happens from beginning to end so I know what to expect and can make it easier for all of us.” Maybe have your little one help you make the list so he’s involved in the process.

    Many of the doctors and nurses will be annoyed by you interrupting their routine. Too bad. Some of them will be grateful you’re willing to accept responsibility. I think a lot of medical personnel become accustomed to all the patients who simply turn over their care. It’s daunting when someone comes in who calmly takes control. Again, some can handle it. Some can’t.

    Praying for you.

    • Please ignore if this is bossy or off the mark. I’m feeling helpless. Not your fault. This helps me ease the need to throttle insensitive people who do not belong in the medical field.

      • Wow thanks! I can’t remember either. I don’t really keep track of these awards, but I sincerely appreciate the thought! I love having slayer in my title, makes me feel strong 🙂

      • Not bossy at all, I appreciate your thoughts. I understand also trying to not feel so helpless, that’s why I blogged about it in the first place. I’d love to make a difference here but not sure I can do much, except for my own kiddo, and to share my experiences so others may be brave enough to speak up too. I’ll keep the throttling to my imagination. Oh I wanted to hurt some of those people who so easily hurt my little guy without flinching, thinking they are just doing their jobs.

    • You know, I never thought of it that way but it makes so much sense. Everything in the hospital is designed for the staff, not the patient, and that’s for adults of kids.

      I have met so many people that do not respond like they are ‘supposed’ to and I wonder if those results ever make it back into efficacy studies or we all get tossed into the neglible bucket.

      I don’t want to take control, but I do when it is needed. Some of the peds staff only talk to me and forget the kid is the patient. Some don’t talk at all and handle him silently like changing his dressing is the same as changing the sheets.

      Maybe I’m more sensitive to kids being ignored. I’ve seen many parents treat their kids this way too, like they are invisible. Being invisible myself for way too long, I can’t put up that. My kids have always had a voice and a presence and I make sure they know it matters.

  3. I am so sorry, for your baby and for you. It has taken me nearly twenty-two years to find a good medical team for me, I can’t imagine what it must be like for a child. I can only say, continue to be your child’s advocate and push back when they aren’t treating him as a whole person with real needs, real fears. Their behavior is ridiculous and cruel.

    • Thank you for your support. I feel like such a pain at times, like uh oh here comes that bossy mom that complains about us. Oh well. I’ll keep doing everything I can to make his care go smoothly.

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