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Child v's Doctors

Does anyones elses child refuse to be examined by a doctor, and if so how do you combat it?

My name is Frank Gratke, 414-762-3424 Son Aitken Class D born 5/5/92.
The compfort zone is important, when my son becomes uncompfortable I just learn to go do something else. It just is not worth it. My feeling is you can feel the world coming down on him. With my son it comes and goes. You learn to adjust. The biggest problem is the doctor can be frighting. This all comes with the turf.

It has been my experience that the problem is twofold. One is the medical community's inability to accommodate the needs of children to be respected patients. Second is the fear and anxiety that children have of the unknown and the potential for pain. Based on these two issues, I have some suggestions, but much of this is common sense.

*Never deceive or lie to a child about a procedure and if it will hurt or how much it will hurt. If you don't know, then explain why you don't or whom the child could ask.

*If the child is old enough, then make sure they understand the "grand plan". In other words, do they know why their parents are letting this happen?

*If the fear is generalized, such as screaming starts when you enter the parking lot, building, etc., then consider using a sibling as a "coach". Let the sibling be weighed, temperature taken, (pretend) x-rayed, etc FIRST. If there is any sibling rivalry, this can be really helpful. Of course, medical science can be helpful too and the doctor can write for a mild sedative or other anti-anxiety drug, if coordination and balance are not being evaluated.

*Play doctor/clinic with your child and focus on the whole experience from checking in and making a file to getting a sticker/toy after the appointment. Pretending (especially with the child as the adult and you as the patient or a toy bear as the patient) will help the child develop coping skills and give you insight to the particular parts of the experience that are problematic and why.

Based on personal experience as a child patient and now as a mom, I would also suggest the following:

*Consider alternate treatments for anxiety/trauma such as TIR (Traumatic Incident Reduction) by a counselor or EFT (Emotional Freedom Technique) by a certified provider. We used EFT with my daughter, it is easy, enjoyable for her, adaptable to a variety of ages and physical/cognitive abilities and it works. I don’t agree with the provider’s explanation of why it works, but it worked when nothing else would.

*Stay in control of the treatment environment. If the nurse wants to take your child from you for a blood draw or even to be weighed. Tell you child what is happening and then state verbally that you are giving the medical professional permission. For example, with my daughter, I say, "Hannah, Dr. Smith is going to look in your ears now." Then when the fit starts, I say, "Nurse Stephanie is going to have to hold you down while Dr. Smith checks your ears. Okay Stephanie." And I hand her to the nurse. Sometimes the fit stops just to avoid being held down by someone other than me (mom). The key is to let the child know you have ultimate control of their wellbeing, even if they do not have much over the situation. A child may think that if they loose control, then you do too. They assume the hospital staff become your boss too.

*This brings me to a passionate issue with me. I never hold down my child for the doctors/nurses and I don’t think most parents should. I am physically able, but that is not my job. I am there to make things better after the bad stuff is over, not to help with the bad stuff. I am not specially trained on how to restrain for medical treatment and I trust that they are or should be. I also believe that there is a time when exam under sedation is needed and I am not afraid to ask for it for my daughter. I always stay in the room for blood draws, etc. I do not believe that children act worse when their parents are present even though a lot of nurses will insist this is true. It has been my experience when I was a child-patient that these are the same nurses that threaten the child to silence by saying things like, "I don't want to have to keep sticking you since you are moving and I cannot get it." We have a firm two-stick policy with limited fishing (moving a butterfly needle around because they missed) allowed. Two sticks and my child (and I) get a break. I then request LifeFlight staff or an anesthesiologist for the next try because these are two groups that rarely miss. I also ask if the blood can be taken from the IV right before the procedure, when my daughter is asleep. I am always surprised by how many times the IV and the blood draw can be done after she is asleep.

*Lastly we make good use of sedated procedures by scheduling routine examinations, needed X-rays, blood draws, TB tests and even immunizations when we have Hannah under anesthesia for a procedure. I figure if we can avoid even typical childhood issues like immunizations, then we have saved her one more bad experience with doctors.

Just my collection of thoughts, I too would be interested in what has worked for others.