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Insights from my experiences when dealing with the parents of pediatric patients.
Intro
Of the myriad of different challenges and new situations encountered by a third-year medical student, one of the most difficult for me so far has been seeing my first-time patients in physical or emotional pain. It is never easy to see another human being in any distress, but it is even more onerous when that person is a child.
The Patient
Pediatric patients bring along their own level of challenge because, at certain ages, they are unable to effectively communicate their pain or even the exact location of said discomfort. Indeed, it requires a certain level of finesse and patience to interpret what they are struggling to communicate.
In life, I have found it hard to remain calm when stuck and frustrated; taking that moment to sit down and uncover a solution is often easier said than done. I encountered this predicament recently when I attempted suturing up a chin laceration on a very young child. Pediatric patients are mostly given non-opioid pain medication, so this too must be taken into account. At times like that, a student physician should always try and put themselves into the child’s shoes. Doing so is a skill we can cultivate — it is really just as simple as remembering that the kid in front of you is scared. Think about how you would react to a similar situation at that age, and you will instantly see things from a new perspective.
The Parent
All this said, let’s shift to another part of this discussion: the interaction with parents of pediatric patients. This can prove to be perhaps the most difficult thing for a burgeoning medical student. It is challenging enough to manage your emotions when dealing with your young patient, so it is easy to forget that they are indeed someone’s child. Most often, that “someone” is in the room with you, with a piercing, scrutinizing gaze that can slice through even the most stoic of demeanors. The parents frequently do most of the speaking for their kids, which is not always ideal.
A lot of speed bumps can be circumvented with a proper introduction. Identify yourself as a medical student, state your intention to conduct an initial examination, and take a history to convey to the attending when he or she arrives. Also, it never hurts to remember the golden rule that good bedside manner, and developing rapport with the patient, always makes things easier.
As with adult patients, empathy goes a long way in quickly diffusing sticky situations. Don’t forget that when dealing with a young patient that has been sick for multiple days, parents are often tired and at their wits’ end. I have discovered that simply saying something like: “I can only imagine how exhausted and frustrated you must be” can work wonders. After all, everyone wants their concerns to be acknowledged.
However, some tough situations are completely unavoidable, and I have found in my limited experience that pediatric psychiatric encounters can be particularly tenuous. For example, I recently dealt with an adolescent with suicidal ideations. The parents were divorced, so the situation quickly devolved into a “blame game” that further unduly stressed out my patient.
Too often, parents are reluctant or even unable to see that sometimes they are actually part of the problem!
Conclusion
Again, as medical students and physicians, we must place ourselves in the shoes of our pediatric patients. High school is a difficult time that certainly hasn’t gotten any easier with the advent of social media.
Of course, our primary concerns lie with the patient. In dealing with pediatrics, the parents must always be remembered and “treated,” so to say. Remember that these parents have come to your institution to receive care and advice; they are almost always extremely concerned about their child.
The world of pediatrics, one of the most gratifying in the realm of medicine, can also prove to be the most challenging. That fact is, in my opinion, what makes it so worthwhile.
