Parents!
Their parents!!!
When there is a bad outcome. It becomes hard on the nurse to separate themselves from the child. It is hard enough to tell a family that their 80 or 90 yr old parent or grandparent is dying. Imagine being in the room when the family learns their child has a terminal illness. There is no comfort to be provided, no words that will help. I have experienced this from both sides and it is horrible for all involved. Then you as the nurse have to go to the next room, pretend that you weren't just crying or feel like you have been kicked in the gut. You need to smile and care for that next patient while your distracted thinking about the one in that room and their family.
The hardest part of working with children is answering this question. I could provide different answers based on age groups, environment, health conditions, socioeconomic status, and their available support systems.I could write a book on the most difficult aspects of caring for kids. I feel like earning trust of the parents or caregivers is a particular challenge, especially for newer nurses.
Trust can be earned by being honest, providing appropriate education, saying "I don't know" when you don't have the answer to a question, advocating for the child and family during tense situations, and being gentle when providing care. You need to consider the feelings of the parents and your patient during all interactions. You also need to have impeccable assessment skills to identify problems before they become unfixable.
Perhaps the more important aspect of earning trust is learning to trust yourself. It is ultimately a job requirement that is not tested until you are actually doing the job. It's a job skill that cannot be practiced off-duty as it requires someone other than yourself. That's where it ends for some nurses who believe they can't develop expertise in building trust on their own. I caution those professionals to consider that nurses learn to trust themselves by making sure they have all of the information to properly handle a situation. The more nurses know, the more up to date the base knowledge is, and the more they care to find answers, the easier it will be to trust themselves in their professional endeavors.
Kids are more likely to trust you if their caregivers trust you. Caregivers are more likely to trust you if YOU TRUST YOU! You are more likely to trust yourself if you listen to your intuition, do your research, and... SMILE! Attitude is everything!
I work with teenagers. It’s so annoying being able to explain medications to someone old enough to know more or less what I’m talking about and why they need it (at 15-17 years, they’ve had high school biology and health), but still be required to call their parents at home and explain every single medication and intervention to get consent.
So, while consent is absolutely necessary, having the legal red tape is often a huge pain for all parties involved. I can’t give a new PRN sometimes without calling at 11pm and waking somebody up who is already stressed about their child being in the hospital for a week.
