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March 9, 2012

Working WIth Children

I was forced way out of my comfort zone this week when I was required to get a child out of bed following spinal surgery. The bandage traveled all the way down the back: spinal fusion surgery starting at the 4th thoracic vertebra that ended at the 2nd lumbar vertebra. Poor kid.

Family was everywhere. Everybody was nervous and on edge, including me, because I have no experience working with children. So I took the approach I take with frightened adults - I explained everything we were going to do and how we would do it. Getting the patient rolled into side-lying went fairly well, and then the child's fear kicked in. And this is where my lack of pediatric experience made me panic. The patient wanted Dad to sit them up, and frankly, he was in the way. Trying to teach him to drop the legs off the edge of the bed and raise the trunk simultaneously requires practice and would likely have created pain for the patient.

The saying goes "never let them see you sweat." Well, I hate that mentality. Why can't we be human with uncertainties? Why can't we let people know that those of us in the caring professions don't know everything? Maybe there would be fewer lawsuits if we did. It is these things that make the job hard and it's why they pay well. So, out of my mouth, before I could stop it, in the face of my patient's fear, came my own fear that I was not a pediatric specialist (and where, by the way, did the patient's nurse go when I showed up?? Lunch, of course). It was not my greatest moment, and it was all caught on camera thanks to "auntie Booboo's" cell phone, thanks "auntie Booboo." Dad, understandably, became upset and asked the obvious question, "Why didn't they send a pediatric specialist??" My response wasn't a bad one, and it was honest: "I can do the PT, it's the emotional part that I'm not good with."

My patient is 10 years old. And behind those eyes is an understanding of the situation and what needs to be done. Again, a clear, short explanation, a count to three, and in one coordinated movement, they're up and sitting. We did it. A cheer goes up. The patient, perfectly healthy before the operation, stands and moves to the chair with steadying assistance. Pain, a squeeze of the pain pump, the inevitable nausea, vomit, vomit again, and we're done. Dad shakes my hand, a firm thank you. And I apologize for our dicey moment back there. The certainty that we need as health care professionals is not for ourselves, but to reassure the patient and their family, I get that.

But it was my patient's courage, the sentience behind their eyes, that allowed me to do what needed to be done. Every person is different, no matter their age, in what they can handle. I saw the patient the next day and told them that they did better than most of my adult patients under similar circumstances. And I thanked them for what they taught me about courage.

Posted by linda at March 9, 2012 5:45 AM

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