So, one of the things I worry most about is treating kids. Not so much the just-pre-teens, but the 0-to-6 ish group. The group who the best I can do in explaining is fundamentally that I need to make something ‘better’. The cut head, the sore tummy, it all comes down to ‘making it better’.
Something they’d much rather mummy did, and definitely much rather didn’t involve (at least in the case of cuts) touching the injured area.
My training, such as it is, didn’t bother with the niceties of children in any practical sense. My experience on the course with children being pure fluke – I got assigned to a Health Visitor for my community nursing (which was actually an incredibly positive experience, largely thanks to the awesome health visitor I worked with who worked very hard to relate her skills and experience to general patients and not just to children; but also took the time to get me more comfortable around kids*). That and a tiny bit of experience in the Children’s A&E was pretty much what it amounted to (oh and a lot of theory).
So when I started in A&E I was fairly phobic of anything involving children.
These days I crouch down on the floor, chat away to them, and am much happier about it all. But still, my heart sinks when I read my own triage notes (along the lines of ‘partial amputation / deglove – distal end 3rd digit’** (or – she’s chopped of the end of her finger, nearly)) and (having switched to treatments to get a break from triage) turn over to find ‘Referred to Plastics, to return tomorrow 0800’ and under ‘Treatment’ the request to dress the wound.
Bugger, I think.
And I take the notes, and hide in the treatment room for a few minutes steeling myself for what I’m sure is going to be a traumatic experience for us all. After all, there she was wailing a few minutes ago (although she’s much more settled now…).
I chat to our play leader and I go in and reintroduce myself to the worried parents, and spend a few minutes chatting to the girl in question. After some time we get to agreeing to wash the wound a bit (which is fairly grotty), and then carefully prepare the ‘making it better’ groundwork.
And despite my fears, 99% of the time they are incredibly brave – dealing with nasty wounds far better than quite a few of the adults; and the end of the finger in this case is popped more or less in the right place, dressed, and off she went.
But as our play leader said to me – if you go in expecting the worst, when they’re good, it’s much easier :)
* Although she did, just for her amusement test whether I’d get pee’d on while changing a baby boy’s nappy. Thankfully I was aware of what might well happen and was far too quick for him :)
** If a wound is bad enough but not bleeding, I’ll not go digging because the doctor’ll need to do that. So long as I can see it more-or-less…
