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This one is about: A Conversation With a Pediatric Nurse

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by Joanne Green

Recently, my seven-year-old son had a case of the Chicken Pox that "turned bad". Cellulitis swelled his leg, his fever shot up astronomically and, in short, he was a very sick little boy. He was finally admitted to the hospital for six-days of IV antibiotic treatment. Of course, I went with him and sat by his bedside until he was ready to come home. There were not many patients in Pediatrics at the time, so the nurses had a little extra time. I asked Jacob's nurse, Valerie Islas, RN, if she would like to share with our WIDE SMILES readers from her expertise, how the 
parents of a hospitalized child might optimize their experience. Our interview went as follows:

WS:  How do you define the role of the parent in pediatrics?

RN: The parent is Mom, Dad and Caregiver. Ideally, parents are a big part of pediatric care. The parents know their child much better than the nurses do, and parents can be far more comforting than a strange person. Sometimes we nurses have a hard time understanding what a child is trying to say, but Mom or Dad would know. Parents are invaluable as interpreters of their child's wants and needs.

WS:  How does a parent's presence best help the post surgical child?

RN: Oh, in every way - psychologically, socially, in comforting the child, and in every way. Kids can be very scared in the hospital and they often need their parent there help to alleviate their anxiety. The parent's presence helps the child feel secure in knowing that someone important is in control. Children tend to sleep better, eat better, take their medications better, and take less pain medication when their parents are there with them. I think it cannot be over emphasized that a parent's presence in the hospital setting is very strengthening to the child.

WS: What if the parent cannot stay all the time? How can they make their child's stay easier? 

RN: First, I wish that one parent could stay with every child in the unit. It's so much better for the child. In fact, most hospitals staff the pediatric unit with the assumption that parents will be there. But sometimes it cannot be avoided and a child is left alone. The child MUST know when the parent can be expected to be there, and then DON'T LIE TO THEM! If you tell your child you will be there at a certain time, BE THERE! And don't be late! If you really can't make it, call your child. It takes so little effort, and it means so much to the child. Kids like to know exactly when mommy is coming back. We make little charts and clock faces, etc, to help them know when to expect you. But after your child has waited the required time you have to be there!

WS: Sometimes parents can be very emotional, or very angry, etc. Some parents disregard pediatric visiting rules. Some become demanding for the nurse's attention. Describe some of the ways that a parent's presence might be counter-productive to the well being of the child.

RN: Well, all of those. Also, post surgical anxiety can be very high for parents, and their child will pick up that anxiety and respond accordingly. I get really concerned about parents who don't take care of themselves while their child is hospitalized. It's important that they eat well and get plenty of rest because when they take the child home, they will be primary care providers.

WS: Conversely, what sort of parent is most helpful to the child's rehabilitation?

RN: We need to have calm, concerned parents. They should be assertive, but not aggressive. Parents should let us know what their child needs and when they need it. We really do do our best to take care of the needs of all 
the children in the unit.

WS: What advice would you give to a parent who is anticipation of his/her child's hospital stay?

RN: Eat before you come here. Wear comfortable clothes, Bring your own personal comforts. Write down any and all of your questions (the nurse can communicate them to the Doctor) and have realistic expectations of the surgery.

WS: How does a parent's role in the pediatric unit change with the developmental level of the child?

RN: With infants, the parent's role is largely to comfort and to assist with maintenance care (diaper changes, feeding, etc). If the mother is breastfeeding, her presence is imperative. The parent also needs to be there to learn about how to do the after care - cleaning the suture line, administering medication and syringe feeding. With toddlers and preschoolers, the big issue is separation anxiety and trust issues. The parents are necessary to offer comfort, and also to aid in communication between the child and the nursing staff. With school age children, their  communication is better, but nurses are still strangers. They may become withdrawn and sullen if a parent is not there, or is expected to be there but does not show up. School-age kids need to be entertained a bit more - coloring books, story books, video games, etc. and the parent can help them to access those things. A teen sometimes may not even want the parent here - especially overnight. But if a parent asks a teen if they should stay, I suggest they do it privately. Some teens are so afraid of being perceived as a baby that they will say no, when they want to say yes, just because someone else is there when they are asked. Peer relations and support can be very important to a teen. Also, teens may get a bit more embarrassed in a hospital setting. Sometimes Mom or Dad can help with some of the more sensitive tasks, like a bed bath, etc.

WS:  Tell me about being a pediatric nurse.

RN: Well, I chose this field because of my love of children. When I went through my rotations during my training, I felt so good about pediatrics, I knew that was the direction I wanted to go. In my final semester of training, this became my chosen specialty. I get so many bonuses from my work. Kids send cards after they've gone home and they think of us as their friends. We get to be very fond of the kids we see over and over again. Sometimes it's the little things - like finally getting through to a certain child, or getting a scared kid to trust you and smile - that 
makes my whole day.

WS: Are there any parting thoughts you would like to leave with our readers? 

RN: Just that parents are a big part of the total health care team. Nobody is more committed to their child than they are. We do our best, and we are proud of our work, but we aren't YOUR CHILD'S parent. Sometimes we simply have to come in and do something that the child doesn't like. We try to just get it done well and as quickly and painlessly as possible, Then Mom or Dad can comfort the child and reassure the child that he is not alone. There is nothing more helpful to a healing child than a calm, concerned and supportive parent.

-------------------Joanne Green is the mother of three cleft-affected children. She is also the Editor of WIDE SMILES Magazine.

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