Preparing for Doctor Visits
Nancy Mansfield’s 80-year-old mother had her tonsils taken out decades ago, but remembers it like it was yesterday. “Her mother told her that they were going to the circus, and that she was going to be in it,” Mansfield says. At the hospital, she happily changed into a hospital gown (her “costume”).
“Then they strapped her down to a gurney and her mother said, ‘Bye!’”
This kind of trauma is what Mansfield, executive director of the Institute for Families at Childrens Hospital Los Angeles, now works to prevent by advocating for children and educating their doctors. The institute provides counseling and support to families with a child suffering from serious illness, but Mansfield’s advice applies to any parent whose child needs a medical procedure – or even just a checkup.
“If you’re honest about everything from the get-go, it will go the best,” she says.
Here are some strategies for helping your child through a tough doctor’s visit or medical procedure:
Role Play and Empower – A great way to prepare your child for doctor visits is through play. Your child gets to be the doctor. You (or one of their stuffed animals or dolls voiced by you) are the patient. And as the patient, you should bring up any concerns that you think your child might have. “Do I need any medicine today, doctor? Will I be getting a shot?” Keep it fun and make it a natural, but occasional, part of your play.
By the time your child is 5, you can empower him by teaching him to speak up for himself through role play. “Teach [him] to say, ‘Doctor, talk to me. Could you explain that to me?’” Mansfield says.
Talk About Hurts – If your child has a procedure coming up, talk with the nurse beforehand and find out what’s going to happen. That will help you be less anxious, and give you a chance to prepare your child. If the visit will involve a finger stick or a shot, talk with your child about how it will hurt. “I say it’s like a really big pinch,” Mansfield says, “or use examples of other things they’ve experienced that hurt for a second and then don’t hurt any more.”
Curb the Crowds – Having lots of medical personnel in the room during a procedure can be overwhelming for a child, but these people will be focused on their tasks and might not notice. Mansfield suggests nicely asking, “Could we have each person come one at a time who needs to talk to us?”
If that doesn’t work, you may need to gently escalate and say, “It really makes us uncomfortable to have so many people in the room at once.”
Restrain the Restraints – For some procedures, using restraints is standard. But Mansfield says this is terrifying for children, and that restraints shouldn’t be used for non-emergency procedures. If you know that a doctor wants to use restraints on your child, call in advance and tell the office staff that you will restrain your child yourself, and that you will practice at home. You can bring a friend that you and your child know and trust to help you. “If they say no,” says Mansfield, “you can say, ‘Well, then I’m going to have to find another provider.’”
Prepare the Doctor – These types of situations are easier to face if you and your pediatrician – and your pediatrician’s office staff – know each other. Start by calling to introduce yourself and asking whether the receptionist or office manager has a moment to speak with you. If not, ask for a good time to call back.
Talk about the issue or procedure at hand, ask what to expect, and let them know what to expect from you. For instance, when Mansfield has lots of questions for the physician, she asks the receptionist whether she should make another appointment so that the doctor has time to answer them all.
The key is to be nice, but firm, and to present your strategies as ways to facilitate a calm visit. “Physicians don’t like to hold down a screaming kid while the mother’s crying,” says Mansfield. “You have to advocate not only for your children, but for yourself.”
Reward Bravery – After your visit, Mansfield says it’s important to reward good behavior (not defined as whether or not a child cries). For her own son, who loved Teenage Mutant Ninja Turtles when he was small, she made “bravery badges” that read, “I’m a Super Ninja Turtle.” He would get to wear a badge as a reward for the rest of the day, for being brave even though he was scared.
Christina Elston is a health writer and senior editor for Dominion Parenting Media. Read more about family health news and issues on her “health-e” blog at parenthood.com/healthe.php.
Words Can Help Heal
When children get hurt, they get scared. But with a few words, you can not only calm your child’s fears, but even help her start healing, says Judith Prager, Ph.D., author of the new book Verbal First Aid: Help Your Kids Heal From Fear and Pain – And Come Out Strong (Berkley Trade, 2010).
Once upon a time, people needed to run away a lot – often from the large and dangerous animals they hunted for food. To this day, when we’re hurt or scared, our bodies start pumping chemicals like adrenalin and cortisol that are designed to help us escape. If you’re confronted by a saber-toothed tiger, they’re great, “but they’re not good for healing,” Prager explains.
Her technique uses calming language to change the body’s reaction, and the chemicals that the body is pumping, so that healing can start more quickly. Here’s what to do when your child is in distress due to an injury or accident:
1. Center yourself. Before you engage your child, take a deep, calming breath. “It allows you to think clearly,” Prager says. “When you go to the child, make sure you’re not reflecting their fear.”
2. Let the child know that you’re going to help. “I’m right here,” is often enough to help someone calm down. If your child has injured herself and you’re away from a doctor’s office, tell her that you know she needs help and that you’re going to take care of it. Then start taking normal first-aid measures.
3. Give healing suggestions. If your child has a nosebleed, ask her to imagine a faucet that she can turn off to stop it. When a neighbor boy fell out of a tree and broke his arm, Prager asked him to imagine his hero, Spider Man, wrapping it in his webs to help it heal. You could also ask your child to imagine a time in the near future when this hurt will be healed and things will be normal again.
Prager believes that healing suggestions can work in much the same way as the “placebo effect,” where people begin to heal with nothing more than a sugar pill and a suggestion from the doctor that the pill will help.
“What we imagine sends a message to our bodies,” she says, and children are really susceptible. “They have wonderful imaginations. So all you have to do is engage the imagination.”
Prager also has a new book out for children, Owie Cadabra’s Verbal First Aid for Kids. Find out more at judithprager.com.
– Christina Elston