What Not to Say

What Not to Say…

This is an open letter to parents. Obviously most of the parents we see do not need this advice, but there are a frightening number that do. I would like to be able to hand this letter out to those parents as they arrive in the emergency department with their child.

Hello Parents,

Thank you for bringing your child to our Emergency department for treatment of ‘X’. To facilitate his/her care, we would request that you refrain from saying the following things:

“Oh, that mean nurse – is she bothering/hurting/being bad to you?”

• You have come to us for help. We are here to help. Everything we do to, for, and with your child is done with this end in mind. We are not here to upset or annoy your child, and trust me – as much as we know why we are doing this to your child, we hate the things that hurt as much as you do. Also – don’t you think your child will be a bit disillusioned that you stood by while someone was mean or hurtful to them? Instead, why don’t you say “I know that this is hurting you, but it is important to make your sickness go away. It will be done in just a couple minutes and then I’ll cuddle you until you feel better.”?

“Oh, he’s not going to like that!”

• While this may be true, saying it in advance sets an immediate negative tone and practically guarantees that the child will fight whatever we have come to do, be it to give Tylenol, stand on the scale, or get an IV. Any positive spin you can put on things would be helpful. How about “Here is some medicine to make you feel better.”

"Good luck with that. He/She won’t take medicine.”

• Nurses world wide cringe at this statement. While Tylenol and Motrin are not life-saving drugs, many others are. We feel that it is important that children learn early on that medicine given by a parent is not a choice. Instead, the choice can be if the medicine is in a syringe or a cup, if it is followed by water or a Popsicle, etc.

“Here – Yummy Candy! Mmmm! Here is candy”

• Please do not try to coerce your child into taking medicine by calling it candy! Candy is a treat and is something that the child can eat without parental supervision (well… you know what I mean…). Medicine is medicine. It is to make something that is sick get better. It should only be given by a grown-up and only when needed. The potential for a serious overdose is huge if a child thinks that their Advil, Tylenol or Benadryl is candy!

“I’m just going to warn you – she kicks and bites when nurses or doctors touch her.”

• I appreciate your concern for my safety and I will definitely take additional care in this situation. However, if you must tell me this, it should be done out of the child’s earshot. Even very young children learn what actions will be accepted by adults. What seems like a warning to you is seen as permission by the child. By giving this warning you have just told the child that this is expected and acceptable behavior. I will not be kicked or bitten while doing my job, so we need to work together to show your child some better coping skills. For example, you could tell your child “You can tell me how you are feeling, but you are not allowed to hurt the people who are here to help.”

“You’d better drink that or she’s going to give you a big needle.”

• Needles are not used for punishment!! They are used ONLY to provide a necessary medication. Also, as with a couple of the above examples, this sets the nurse up as a threat and someone who enforces the discipline instead of a person who is here to help you get better.

Many of us are also parents, so we do fully appreciate (from both sides of the bed) how hard it is to have a sick child, or to do something that makes your child hurt or sad. If there is something we can do to support you through this time or to make your visit easier, please let us know.

Thank you for your assistance in making this the best experience possible for your child.

Sincerely
The Nurses, Doctors and Staff of the Emergency Department