Wednesday, July 30, 2014

How to prepare your child for a doctor's visit.

Hey moms and dads! Do you have a little one who has a doctor's appointment coming up?
  There is research that stands behind the importance of preparing children, especially pre-school age, for doctor's appointments.


Riley, 4 years old
Just this summer, I was nannying two children (4 and 7 years old). One day we were running around town, when the kids' dad called telling me the 4-year-old had a doctor's appointment and was going to get shots to start school. Immediately, I began racking my brain trying to figure out how I could prepare her for her appointment and shots within five minutes while in the car.

After turning Justin Beiber (Why do kids love him so much??) off, I told the 4 year old that we had to meet daddy so that she could go to see the doctor. Immediately, I saw the anxiety build on her face and in her body.

"Why do I have to go to the doctor?" She asked. She began crying as she asked, "I don't want to get shots."

The most important thing to do with pre-school children is to validate their concerns and clarify any misconceptions. So I said, "I know you don't want to have a shot, but you are right, this is your appointment to have your shots so that you can start school. Did you know that shots contain medicine?" She said she didn't. So many children do not even understand what a shot is in the first place. They have just heard that they are "not fun" and "can hurt."

Thinking on my feet, we swung by my house to get my Doc McStuffins doll (because what Child Life Specialist doesn't have their own?). I told her that she could take my doll with her to keep her company at the doctor's office and to help her remember everything that happened so that she could tell me about it afterwards. Having a comfort item for pre-schoolers is important because it allows them to have some control over their environment (It's best to let the child pick their favorite item before leaving the house.).

She continued to cry and become more anxious. After her appointment, she informed me that the nurse and daddy had to hold her down because she was kicking and screaming. I wanted to kick myself in the backside for not preparing her ahead of time to help make her experience less stressful.

What I should have done:
 
Photo Credit: Google Images
  • A few days before her doctor's appointment, I could have set out some doctor's supplies and dolls and allowed her to do some child directed MEDICAL PLAY. This would have allowed me to explore any misconceptions she might have about going to the doctor. 
  • The day before her doctor's appointment, we could have sat down together and read any variety of BOOKS about going to the doctor and what she could expect. This wasn't her first time, so she should have been able to verbalize understanding of a lot of things she would experience. 

    Photo Credit: Google images
  • I could have prepared her parents. We could have discussed Positions of Comfort. Positions of comfort are designed to allow children to stay in the comfort and security of a parent's arms while allowing the healthcare professional to conduct the procedure without strapping the child down to the table. We could have rehearsed these with parent and child in order to ensure success during the procedure

  • Lastly, I could have prepared her for the shots by walking through a procedural preparation consisting of sensory and sequential information, assigning her jobs (i.e. holding very still), and offering her appropriate choices (i.e. looking or not looking at the shot, counting to 3 or not, and what kind she wanted to look at while she was receiving the shots such as an I Spy book). The important thing to remember about offering a child choices is to make sure that the choice is actually available. The child doesn't have the choice to not have the shot, but they do have the choice to look or not look.  
-Caroline

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