Transcript Distraction and Coping Techniques

Distraction and Coping
Techniques
Your name, institution, date, etc.
Introduction
• State the purpose of the in-service - to teach
techniques for helping children cope with
procedures
• Briefly explain the role of Child Life in
your setting
Things to remember when
meeting patients
• Get on the child's level.
• Introduce yourself and your role. Unknown
people are threatening.
• Only give choices where choices exist.
• Be careful about comparing children. Being
in the hospital can be pretty tough.
Regression is normal for some kids.
Things to remember when
meeting patients
• Don't make promises you can't keep, e.g.,
"This is the last time you have a 'poke'
today."
• Appearances can be deceiving. Be careful
what you assume about a patient's
developmental level or coping ability.
Language issues
• You DON'T have to say it hurts. Hurt is a relative
word. It's better to say or use descriptive words,
saying "Some patients say it feels like... and others
say it feels like...." (This prevents YOU the care
giver from being seen as a liar.)
• Be careful of medical terms we take for granted,
e.g., "I'm going to TAKE your blood." "I'm going
to DRAW your blood.")
Language issues
• Don't use the phrases "Be a big girl/boy" or
"Big girls/boys don't cry."
– Remember appearances can be deceiving. Big
doesn't equal old.
This can add extra pressure to the patient. This
isn't something they always have full control of.
– Give them an achievable goal: "Your job is to
hold still. It's okay to say 'ouch' or even cry, but
your job is to hold still."
Language issues
• Talk to the patient and explain what you're
doing. Even infants benefit from soothing
voices. Beware the touch-hurt-leave with no
verbal interactions.
• Don't lie to patients (e.g., "This won't hurt.")
Procedural Support
• Distraction/comfort
– How/why it works….
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facilitates coping
increases trust
pain management
studies show that use of distraction decreases use of
pharmacological methods
Procedural Support
• Distraction/coping
– techniques
• developmentally appropriate
• comfort items
– parent or designated comfort person (hold hand, stroke
hair, soothing talk)
– Blanket, stuffed animal, pacifier, etc.
– allow choices (which hand for IV, whether or not to watch
procedure)
– prize to signify end of procedure
Procedural Support
• Distraction/coping
– Techniques (cont.)
• Coping techniques
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–
–
Not looking
Controlled breathing
Squeezing mom's hand
Watching something else (i.e., distraction)
» Bubbles
» Books
» Singing
» Windmills
Procedural Support
• Distraction/coping
– parental presence
• parent serves as comfort-giver
– coping role for both parent and child (each has a "job"
during procedure)
– Parents can provide support during lab work, but should
not be responsible for primary holding.
– Parents need to be a part of safe environment.
Procedural Support
• Distraction/coping
– Position the patient for comfort.
• NOT holding child down (loss of control)
• Sitting on lap
• Remember prone is a very vulnerable position.
(Think how you feel lying on the doctor's table.)
• Many patients actually do better sitting up.
(Demonstrate possible positions using doll. Show
poster.)
• Very small infants should be swaddled.
Procedural Preparation
• Help develop a safe environment for
patient.
– Whenever possible use the treatment room for
procedures.
– Remember some areas are "safe," e.g.,
playroom.
• *The bed is an infant's world. Try not to do
procedures in the bed. It can lead to fear and sleep
disturbances.
Your Reactions to a Child in Pain:
• Your job is tough; trying to rebuild trust
afterwards can be hard.
• Stickers or cool Band-Aids sometimes help.
• Remind patient it's not because he/she did
something wrong that they had a procedure.
• Don't take it personally if patient doesn't warm to
you afterward.
• If you're concerned about patient's ability to cope
or rebound, let a child life specialist know.