Pediatric Nurse: A Crash Course in Talking to Kids

May 07, 2015

Whether it is your first pediatric rotation ever in nursing school or you’re a travel nurse who hasn’t worked with kids in a while, you’ll find the hints below on nursing with children practical and useful.

When dealing with children as a nurse, much of the best advice boils down to putting yourself in their shoes. Empathy is a great asset to communication with anyone. With kids, try to think back to when you were a child. If this seems difficult, don’t worry, it will probably begin to come back to you when you are on the job.

Clinicians dealing with kids should also use some hints from developmental psychologists to understand the mindset and communication level of the kids you will be dealing with at a children’s hospital, health clinic, doctor’s office or school. Take a deep breath and get prepared. Once you’ve settled in, you may find that working with children as a nurse is lots of fun. Try to incorporate these tips into your busy day and see if they help to make kid-friendly communication much easier.

Common Kid Communication Challenges in Nursing

A recent study published by the NIH identified two of nursing’s most common, yet most challenging, kid-communication situations. The study reiterates how nurses must not only calm the child, but administer the treatment/injection properly--and do it all in a time-efficient way. This can be a tall order, even for a seasoned medical professional. Situations nurses may encounter daily when talking to kids include:

Giving Injections or Taking Blood Samples

One of the challenging daily situations that nurses encounter with children is managing their fear or pain related to NRMP (needle-related medical procedures). 

Gathering Accurate and Detailed Medical History

Intake and triage information enable proper diagnosis and treatment. It’s important to calm children so that they can more clearly communicate what hurts and what their symptoms are. Getting complete information, even in the best of times with calm parents and kids, is not always easy. Using some of the communication hints below will help nurses establish an atmosphere of calm and cooperation so that effective health care can take place.

There are, of course, many other situations that require nurses to communicate well with kids. Pediatric nurses, school nurses and social workers offer the following creative yet practical words of wisdom. 

Kid-Friendly Communication in a Medical Setting

  • Get down to the child’s level physically. Squatting so that you’re at eye level can help calm the kid’s nerves, fears and anxieties -- and gain cooperation.
  • Smile! This is especially important when first meeting the child or entering the room.
  • Know the child's name in advance and use it to help increase comfort.
  • Enlist the parents' help.
  • Reassure and praise when it’s due. “You’re doing such a good job,” or “You were so brave!”
  • Give kids a helping role. Children like to help and playing a role in their own care can take their minds off being scared. Distraction is your friend in pediatric nursing. Ask the child to hold a sealed alcohol pad until you need it, etc.
  • Phrase instructions as “helping.” “I need you to help me by staying very still, ok?”
  • Be realistic but upbeat. Saying “this will probably hurt just a bit” rather than fibbing will help earn their trust and it sometimes makes them feel the need to be big kids and not overreact.
  • Avoid super-high or singsong voices. Don’t talk down to them – it’s as important as looking them in the eye.
  • Keep crayons where there is paper. If there’s tissue covering the exam chair or table, let them draw. One way to get started…draw a smiley face or house yourself quickly. Ask “do you know what that is? Now it's your turn!” Then hand over the crayon.
  • Improvise toys. Gloves or tongue depressors can turn into instant fun as a (kind of turkey-shaped) balloon.
  • Wear scrubs with cartoon characters. Instant fun and a conversation piece, which leads us to…
  • Ask about things the child might be interested in. “What’s your favorite subject in school? What’s your favorite TV show? Who do you like best on the show?”

Mastering the Lingo: What Kids Hear When you say….

Young children don’t get abstract ideas. Instead of “This will take 2 minutes,” say, “This will be really quick.” According to one social worker’s account, using the word “shot” can panic some children who might take this literally, thinking they’ll be shot with a gun. She suggests using the word injection. The older the child is and the calmer, the more you can explain about the medical procedure’s details. 

Children (even teens) can’t predict or understand serious consequences. Explain that “it will make you sick” rather than sugary soda can cause diabetes” or even “disease.” Teens may actually understand but feel invincible. 

Kids may confuse real and imaginary.  Keep this in mind and ask follow-up questions or rephrase questions to get the most accurate answer.

Children’s fear in a hospital or medical office comes from being in an unknown environment, with strange (sometimes sharp) equipment and cold surfaces. The kids are surrounded by unfamiliar people and perhaps separated from their parents, so nurses typically have to calm young patients before or during exams and treatment. 

In many cases, the nurse may be battling deeply entrenched fears that children have from prior medical visits or procedures. Kids can be a challenge in a fast-paced medical environment, but nurses are masters at developing rapport with people quickly. With a little practice, these communication skills can be extended to kids. Working with children as a nurse can be incredibly rewarding - and fun too. Hopefully these tips will help you communicate even better with your youngest patients.