topic : You are a nurse conducting a physical assessment of a child between the ages of 3 and 12 at an urgent care clinic. Describe how your communication would be adapted to be able to effectively communicate with a patient of this age. What strategies would you use to encourage engagement with the child?
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN DQ Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
Example 1 ( anitha)
Interaction with children during a physical examination in an urgent care clinic with a group of 3- to 12-year-olds should be appropriate to the child’s developmental age, mastery of speech, and emotional state (Sharma et al., 2019). The first step in dealing with a child is to build trust and ensure the child feels comfortable with the nurse. First, the language would be simple, avoiding the complex medical terms that are challenging for a child to understand. Therefore, when addressing the younger ones, I would use a variety of small words to entertain them while explaining procedures. For instance, instead of saying, ‘I am going to take your blood pressure,’ I may accompany this by saying, ‘I am going to give your arm a little hug with this special band.’ For bigger children, one must encourage curiosity by explaining things in more detail. I engage the child in the process to foster participation. Simply questioning their favourite activities or things that interest them is a way of creating rapport. For instance, before checking a toddler’s heart sounds, I could ask, “Do you know superheroes? This stethoscope will help me listen to whether your heart is beating like a superhero’s.”
Bell and Condren (2019) suggest that the use of certain medical equipment can aid in demystifying the process, while the use of graphic displays and/or allowing the child to handle harmless instruments can soothe the child. Also, offering options whenever possible, such as which arm to use to take the blood pressure, will make the child feel in control and more likely to cooperate. During the assessment, one has to remain non-threatening and polite, use encouragement and positive language, and not rush the child with questions (Bell & Condren, 2019). Thus, using these approaches, the child will be able to understand me and vice versa, minimizing conflicts and creating a more positive attitude towards a healthcare provider and the process in general.
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Reference:
Bell, J., & Condren, M. (2019). Communication Strategies for Empowering and Protecting Children. The Journal of Pediatric Pharmacology and Therapeutics, 21(2), 176–184. https://doi.org/10.5863/1551-6776-21.2.176
Sharma, E., Srinath, S., Jacob, P., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(8). https://doi.org/10.4103/psychiatry.indianjpsychiat…
Example 2 (Sara)
It is important to adapt to a child’s developmental age when communicating with the child to ensure that the child feels safe to communicate and understands what is being communicated to them.
A strategy to consider when communicating with children less than 12 may include using simple and clear language. Always explain to a child what the process will look like or what will be done prior to starting. This is crucial due to it relieving any anxiety, fear, or stress that the child may have. Another strategy to consider using while communicating with a pediatric patient is to be patient with them and receptive to them. Give the child time and a chance to process what is being said and formulate a response. Make sure to be engaged in the conversation and show interest in what the child has to say, this is a great way to build rapport and trust with the patient. Visual aids may be used when explaining a concept that may seem complex or overwhelming to the patient. Make sure to involve the child during the assessment, such as letting them play with or use stethoscope. If possible, the RN could make a game out of the assessment or procedure to distract the patient from anxiety or fear. Always offer positive reinforcement to the child as well, this is vital to ensure they understand how brave and confident they are. This also instills cooperation and confidence for future visits (Bell and Condren 2016).
Each patient is different in their own way. Some strategies may work well for one patient and be different for another patient. It is important to remember to stay calm, remain patient, and adapt to the patient’s current needs and emotions. Make sure the child has a calm, safe, and quiet environment prior to beginning assessment (Mills 2023).
References
Bell, J., & Condren, M. (2016). Communication Strategies for Empowering and Protecting Children. The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 21(2), 176–184. https://meridian.allenpress.com/jppt/article/21/2/176/81132/Communication-Strategies-for-Empowering-and
Mills, M. (2023, November 16). Pediatric Nursing Jobs | AMN Healthcare. Www.amnhealthcare.com. https://www.amnhealthcare.com/blog/nursing/contract/5-tips-for-communicating-with-pediatric-patients/
Example 3 (shalom)
Communication Strategies for Assessing a Child
When performing physical assessment on a child who is aged between 3 and 12 years, the assessment information should be interactively gathered with the child in an understanding and comfortable manner depending on the age of the child. For younger children, aged 3 to 6, using simple, clear language and incorporating play into the interaction can be very effective (Schreiber, 2024). Describing what you are doing in a friendly and reassuring manner helps alleviate fear. For instance, saying “I’m going to listen to your heart with this cool stethoscope” makes the process less intimidating. With older children, aged 7 to 12, engaging them in conversation about their interests or school can help build rapport. Using slightly more detailed explanations while maintaining a gentle and approachable tone is key. For example, explaining, “This blood pressure cuff will give your arm a hug to check how strong your heart is pumping,” helps them understand the procedure without causing anxiety.
Adaptations for Promoting Interaction with the Child
Some techniques that can be used to promote participation during the assessment are; First, it is possible to enhance the clinic’s atmosphere through the utilization of brightly colored equipment and decorations as well as toys aimed at children. It is easier to explain medical procedures to children, especially when drawings, picture books, or diagrams are used (Mbanda et al. , 2021). Moreover, involving the child in the process like allowing him/her to hold the stethoscope or listen to her/his own heart can be entertaining and informative. Rewarding students such as through sticker charts or small prizes can also encourage compliance. It is also crucial to explain the parents or the caregivers to be taken into the session since the presence of the parent or the caregivers will make the child to be calm. If presented in sequence, the nurse is able to freely communicate with the child which adds to the child’s feelings of comfort and overall experience with the healthcare provider.
References
Mbanda, N., Dada, S., Bastable, K., & Ingalill, G. B. (2021). A scoping review of the use of visual aids in health education materials for persons with low-literacy levels. Patient education and counseling, 104(5), 998-1017. https://repository.up.ac.za/bitstream/handle/2263/86481/Mbanda_Scoping_2021.pdf?sequence=1
Schreiber, R. F. (2024). Communication Skill-Building with ASD Children. In The Feuerstein Method (pp. 114-149). Routledge. https://www.taylorfrancis.com/chapters/edit/10.4324/9781003451136-7/communication-skill-building-asd-children-rina-frei-schreiber
