D: Distress

In the fast paced, often high stakes hospital environment, should doctors and nurses incorporate play with pediatric patients? If so, how can play be used at the bedside? 

All doctors, nurses and other medical professionals strive to minimize the suffering of their patients. Witnessing a patient in pain, especially a child, pulls on the heart strings of all involved.  However, when the patient's pain comes from their emotions, it can feel very uncomfortable and overwhelming.

With any medical condition, be it injury or illness,  it's natural to attempt to shield children from suffering. If the child is the patient, perhaps we tip toe around the severity of their injury or illness. And if they're not the patient, we could leave any explanations as the family's responsibility or speak at the level we believe is above their ability to understand. 

How many times have you been folding the laundry or washing the dishes and heard your teenage daughter sigh, “I can’t deal?” Or how many times have you found yourself scrolling through social media unable to “deal” with the nonsensical things people say and do?

Providing trauma informed care to children and families doesn't (and shouldn't) take much additional time for doctors, nurses, and other healthcare providers. By simply integrating an understanding of traumatic stress in your routine care, you're providing trauma informed care... 

With kids across the country returning to school this week, if you're a primary care pediatrician or nurse, you probably breathing a sigh of relief that the rush of back to school immunizations and sports physicals are coming to end. 

A lot of patient-centered and trauma-informed care comes down to the small things:  Noise levels. Lights. Simple procedures, like needle sticks or checking vitals.  In a compelling brief video shot by her mom, one 15 year old provides an honest take on what it's like being a patient. She has clear ideas about some simple ways physicians and nurses can lessen the stress on patients - protecting sleep, engaging and explaining things to her directly, asking her what she wants.

Injury and its impact can extend past bruises and bandages, leaving children and families with intrusive thoughts, exaggerated startle response, and avoiding things that remind them of the injury. These symptoms, known as post-traumatic stress (PTS) reactions, usually diminish with time, but for approximately 1 in 6 injured children, they persist and are more severe.  As pediatric health practitioners,

Easing a pediatric patient's fears and worries during an exam isn't as difficult as it may seem. A few small changes to how you approach a physical exam can reduce the distress of a child and their family, such as:

Children's hospitals across the country have made great strides towards patient centered, trauma-informed care. Brightly colored walls, toys, games, and other activities are commonplace at children's hospitals, and all help to reduce the stress and anxiety children experience during a hospital stay.