How do you RELATE to kids??? I'm lost around 'em

[tBw]

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Ok, I don't like admitting to being bad at things - but I am *horrible* with kids! So needless to say I don't intend going into peds but as you guys do I assume (?) you guys have ways of relating to kids. I am starting med school in the fall and this bugs me. I would welcome any suggestions....

thanks 🙂 (and if you won't tell me for my sake - tell me for the sake of any poor kid that ends up as my patient!)

 

[oldandtired]

Dont worry about it. Just dont go into peds. Those pediatricians will screw you over during your clerkship no matter what. They are the biggest asses in the hospital- most paranoid and anal.

 

[mhdousa]

right on, oldandtired! thanks for finally telling it like it is.

down with peds. let the kids die. we're better off without 'em.

 

[tBw]

ummm....not quite what I was looking for but...um...thanks... I guess??

 

[Biodude]

I think that mhdousa is just tryin' to be sarcastic here, boy wonder. 😀

Besides, if you let all kids die, then humans'll die out too 😱

We need healthy kids after all 🙂

And I agree with oldandtired. Just don't choose Peds as your specialty 😀

 

[mhdousa]

Hey Wonder Boy,

Sorry no one has been any help so far. I think the reason is because you've
asked a VERY difficult question, and one that has no really good answer. Most
of us that are going in to peds can relate to kids, but if you ask me how I do it,
I have no frickin' clue. I think each age group has different strategies, but
here are some general things to do:

-DON'T wear your white coat. Find other ways to carry the stuff that you normally put in there
-try to remember what it was like for you when you were your patient's age.
-talk to them softly, and if they're babies, keep talking, even if it's jibberish
-if it's an adolescent, don't bull**** them and don't use big medical words. Adolescents can sense insincerity and fear pretty easily.
-With babies, don't be afraid to pick them up and hold them. Parents expect you
to know what you're doing and if you look scared and tense, it'll scare them too.
But at the same time, don't be afraid to ask a parent's help with something.
-With toddlers, just play with them. Make faces, play peek-a-boo, wave, just
do anything to get and keep their attention.

Hope this helps. If you've got other more specific questions, feel free to ask. And
don't let the people on this board scare you about peds. I've had nothing but
good interactions with my peds attendings. There are jerks in any field, but look
interested and work hard and you'll do fine.

Good luck!
-M

 

[tBw]

Hmm, well thanks for the suggestions. I don't have any problems with adolescents for some reason, it's just the 5 and under group I look at as if they come from another planet. I will keep in mind what you said next time this comes up.

thanks 🙂

 

[Tazmaniac]

Under 5 year olds can be hard to relate to, and downright impossible at times. Here's what I do with them.

1) Say "Goochie-goochie-goo" in the stupidest, most immature voice ever. It makes the interaction extremely lighthearted and silly.

2) If they can't talk coherently, or are developmentally delayed and can't talk coherently, don't worry about relating. Just be gentle but firm with your exam, and replace their socks/shoes if you take them off, recover with a blanket if they started with one.

3) If a child cries when you begin your exam (or when you walk in the room), don't take it personally. Unless you smacked the kid upside the head, it's not your fault at all. Just continue being professional and finish quickly what you can. The parents are much more embarrassed than you'll be.

4) And if you thought the kids were tough, wait til you meet the parents.

Heck, I'm going into peds and I still have trouble with the wee ones. Good luck with the little critters.

-Todd MS IV

 

[starayamoskva]

The best advice I can give you is to get as much practice as possible. Either volunteer to help out in a nursery school, babysit a friends kids or if you go to church, work in the nursery.
Working with kids is a skill that can be learned. The under 5 set are the easiest to work with... give them some stickers, get down on the floor and play with them and don't lie to them and you should be fine.

I don't know where some of you guys are in school at but our peds department is the BOMB. The attendings and residents are extremely nice and treat us as part of the team, not a nuisance.

Good luck.
J

 

[HiFi]

distraction : kids are easily distracted with an oblect. let's you move in for the kill

make the parents help you

flexibility. some kids will not allow you near them. examine parts as the opportunity presents.

patience. a 14 month old is not trying to be difficult. when they are sick, they are afraid. you are a threat. don't take it personally.

there is a great skill in examining the small child. sometimes you can charm them. sometimes you can't
sometimes you need pharmacologic or physical restraint.
sometimes you just skip that part of the exam. A kid that can fight you off with brute strength does not need a formal Neuro assessment of strentgh!
A kid that can scream so loud you can hear them in the next county, has adequate lung function, etc

a kid that can jump up and try to touch your hand does not have peritonitis ( good test for acute abdomen )
a kid that can run through the triage at 100 mph, has good cardiac function.
kids that are really sick are usually easy to examine.


it takes years to get really good at it.

my own personal pet peave is nursing students that are watching me do a procedure, and the infant is crying--which they do no matter what you do to them, and the nurse babbles some garbage like " It's OK, he doesn't mean it"...to which once I did respond, " yes I do. I love torturing babies" just to shut her up. God that goo goo ga ga garbage drives me nuts!!!!!

 

[50Cent]

I can see that most of the posters on this topic are extremely inept and desperately trying to train to be good with kids

My rules in which I have been extremely successful:

1. Don't pretend to be serious with the parents - you can't focus on the case and keeping the kid happy.
2. Don't pretend to be goofy - the kid will laugh but the parent will be nervous
3. Don't pretend

4.. Be yourself, smile, be friendly. You'll put the parents at ease and the kid.
5. Greet the parent, then forget the parent is there. Trying to pretend for the parent is pure vanity and self-consiousness
6. Focus on the kid, keep your smile, tell him simply what your doing and do it. Remember, you're trying to help the kid - approach him with compassion.
7. Think. Then turn to parent to tell them what you think.
8. Be happy you helped them both, say goodbyes , walk out.

Not very complicated - your egos make it complicated.

 

[HiFi]

Originally posted by 50Cent
I can see that most of the posters on this topic are extremely inept and desperately trying to train to be good with kids

My rules in which I have been extremely successful:

1. Don't pretend to be serious with the parents - you can't focus on the case and keeping the kid happy.
2. Don't pretend to be goofy - the kid will laugh but the parent will be nervous
3. Don't pretend

4.. Be yourself, smile, be friendly. You'll put the parents at ease and the kid.
5. Greet the parent, then forget the parent is there. Trying to pretend for the parent is pure vanity and self-consiousness
6. Focus on the kid, keep your smile, tell him simply what your doing and do it. Remember, you're trying to help the kid - approach him with compassion.
7. Think. Then turn to parent to tell them what you think.
8. Be happy you helped them both, say goodbyes , walk out.

Not very complicated - your egos make it complicated.

funny you mentioned egos, and then slam a bunch of students.
Students are not inept. they are inexperienced. there is a difference.
inept is a 3rd year peds resident that can't do an LP on a 6 week old.

forget the parents are there? that's bad advice.

many times, you need to recruit the parents to hold the child ( unless you can figure out a better way to get a 2 yr old to hold still while you attack him with an otoscope )

and before you call me crazy, I'm BC in peds

 

[seetay212]

I love working with kids. True most of the time they are crying and screaming, but I think if you recall what you were when you were small, you'll get the point. And I sure don't want all the kids to die either, or you might be out of business as well!

The best way to work with kids is to be gentle and easy. There isn't much you can do when they start crying except to show them what you are doing and do it. Smile a lot, it puts kids at ease. An informal chit-chat in simple language can gain a lot of confidence. The parents are generally helpful, becuase they know you are trying to help.

Seetay.

 

[sanfilippo]

a rule of thumb:
when trying to get a child's version of the history, keep it simple.
also, when doing an exam on an older child, ask them how things are going in school, what's their favorite videogame, or something...a lot of girls wearing Power Puff girl paraphernalia has led me to some interesting conversations and put them at ease for the exam because i was striving to be on the same wavelength as them, not above it.

as for parents, always be truthful and involve them as much as possible during the exam, especially with newborns and infants.

bubbles in an inpatient setting also has a nice touch although there are a few kids who are terrified of floating spheres of detergent.

-S. 🙂

 

[jdog]

I am 6 weeks into residency, and let me tell you, how you relate to the kids is one thing, but being able to deal with parents is by far the most challenging part. Many parents think their kid is dying every time they have a pain or ache.

To put a spin on a great house of god quote, in pediatrics, often it is the parent witht he disease, not the kid.

 

[unregistered]

Before I started working with kids in med school, I too was apprenhensive about working with kids. They don't listen to me unless I yell loudly (ie please remove the glass from your mouth immediately!) I thought. well, after working with them, i realize its quite enjoyable. just try to have fun while focusing on your agenda. don't worry about pleasing the kid too much and use simple language and smile a lot--they'll appreciate it. explain things slowly and in a gentle tone so they don't get intimidated too.

 

[entpa]

I was lurking about and just had to add my .02$. I see a lot of kids in ENT. Some kids you just can't convince to let you look in their ear (usually but not always due to someone's poor attempt in the past) so we take them to the OR for exam under anesthesia. Luckily, this does'nt happen often. Kids that are 2 1/2 and up I can usually get to cooperate by letting them hold my otoscope, ear loops etc before I use them...I let them see my hands and what I'm holding before I put it by their ears. Amazingly it works most of the time. I ask the kids what's worng with them and then let the parents fill in the rest. You'd be suprised at what a 4 yr old can tell you.
Just this morning I was able to drain and explore a neck abcess (4cmx4cm) on a 2 1/2 yr old while he held still w/o restraints or sedation! ( what a kid!) I also keep a "treasure chest" full of trinkets they can pick from...Parents constantly tell me their kids can't wait to come back to our clinic.
As far as parents go, it can be tough convincing them that their 1 yr old doesn't need tubes after one OM or anbx for an effusion. That can be the toughest part. Anywya, thanks for letting me share.