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Home  Community Health Resources Health Information Our Health Articles Subduing Children's Fears ...
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Subduing Children's Fears in the Emergency Room |
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I'll never forget my son's first visit to an emergency room. He was 18 months old and just beginning to waddle around carpeted floors on those little chubby feet kids have at that age. It was a Saturday morning and my husband was watching him while I was vacuuming. In the way that toddlers can escape in a moment, he crawled into the room I was in, pulled himself to his feet, took two wobbly steps and tripped over the vacuum cleaner cord. Falling face forward, he gashed his forehead on the edge of the baseboard. He and I shrieked simultaneously. I scooped him up in my arms. My husband and I ran to the car, and made a mad dash to the hospital.
We were greeted at the emergency room by the typical bright lights and cold, sterile steel ambiance. Busy adults with strange objects dangling from their white coats were hurriedly moving from one area to another. Men in uniforms were rushing people strapped to gurneys through big automatic doors. This was a completely foreign and scary environment filled with things and people my son had never seen before. We were rushed into a treatment room. Strangers began touching him, cleaning his wound and holding him down on a high table. We were told he needed stitches and my husband and I were ushered out of the room as the ER staff strapped him into a papoose. My son was screaming at the top of his lungs, not from his injury, but from this sudden and strange experience. The last thing I saw as I reluctantly left the room was my baby crying and watching me leave with an expression of panic on his face. This was not a pleasant experience. Sadly, for some time afterward, a little boy crying, "No mergency Momma" followed any fall or mishap. Thankfully, in most locations today, things have changed dramatically for children who need to visit an emergency room. In some settings, such as Newton-Wellesley Hospital, there are even separate Pediatric Emergency Departments; specifically designed to address both the physical and psychosocial emergency medical needs of children. In addition to Pediatric Emergency Physicians, nurses with special pediatric training, equipment that is child-sized and knowledge of medications and doses appropriate for children, many hospitals also make use of Child Life Specialists. At Newton-Wellesley's Pediatric Emergency Department, Child Life Specialist Robin Miller is on the front line of interaction with children and their families. She is present to prevent the kind of nightmare from happening that my family had experienced. Child Life Specialists Child Life Specialists are professionals in child development who are further trained in child health, multiculturalism and family studies to provide services that address the psychosocial and developmental needs of children and families in a variety of health care settings. In the emergency room, Robin Miller explains her role is to "help children and families cope with the hospital environment." Miller and other Child Life Specialists are aware of the fact that, especially on a first visit, a child will experience an emergency room as strange and, often, scary. The fact that a child's visit to an ER is due to being sick or injured will make most children even more vulnerable to feelings of fear and anxiety - emotional states that can make medical treatment difficult. "My job," states Miller, "is to focus completely on what a child patient needs emotionally in order to be treated medically." Often, the simple fact that someone is there, completely focused on helping a child feel safe, is all it takes to make a visit to the hospital comfortable and non-threatening. Depending on a child's developmental stage, a Child Life Specialist's interventions can range from distraction to information and education. Distraction, for example, is a primary intervention for toddlers and young children both prior to and during a medical procedure. In the example of my son's need for stitches on his forehead, which necessitates restraint from squirming, kicking and hand movement, a Child Life Specialist would have been present to make an immediate connection emotionally. Prior to and during the procedure, a Child Life Specialist might have distracted his attention with a hand puppet or bubbles, for example. With older children, Child Life Specialists are more verbally and intellectually interactive. Miller explains with the example of a 7 year old brought to the hospital with stomach pains. "I would talk more directly with this child about his or her experience. Have they ever been in a hospital before? How are they feeling about being here now? If their condition necessitated a procedure," she states, "I would explain that procedure in terms the child could understand. Because older children anticipate and are concerned about pain, I explain how certain things will feel. I also have a teaching doll and books that are used to show children where certain organs are located and what they look like. This 7 year old, for example," explains Miller, "may have appendicitis and need surgery. Prior to the surgery, to both occupy and inform the child, I would show where the appendix is, explain that a small opening will be made to take it out because it is no longer needed. I would also explain that the child won't feel anything, and offer reassurance that a doctor will be present the entire time to make sure he or she doesn't wake up. Since children don't understand what anesthesia is and how it works, worrying about waking up during surgery is a pretty universal concern among children." Any parent can testify that children's needs go far beyond the physical in their experience of an acute illness or traumatic injury. A child's age, size and stage of physical, emotional and intellectual development play a major role in their responses to every experience, especially a crisis. At Newton Wellesley- Hospital's Pediatric Emergency Department, the Child Life Specialist is an integral member of the emergency response team, a team of professionals who respond to and treat the whole child, and not just a child's injuries or illness. This material is intended to provide general educational information and to help users arrange more easily for health care services. This site is not an attempt to practice medicine or provide specific medical advice and should not be used to make a diagnosis or to replace or overrule a qualified health care provider's judgment. Nor should users rely upon this information if they need emergency medical treatment. We strongly encourage users to consult with a qualified health care professional for answers to personal questions.
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