September 4, 2006, 3:25 pm

Dear Pediatric Patient,


That poor kid on the right!

What kind of traction is that?

Elevate the knee but drop the distal extremity?

And then let her watch while the other kid gets to color and she doesn’t?

Pull the freakin’ curtain!


Blue Cross may say they pay 14 million dollars to their members, but what they don’t tell you is that amounts to fifty cents per member.

And none of it to the doctor.


Dear Pediatric Patient,

Yes, honey, you with the 3/4 inch laceration to your chin.

I’m your ER nurse!

I’m sorry you fell off the monkey bars.

I know you are scared because you are hurt and afraid of stitches.

And I know that you are doing as well as can be expected and trying to cope with what has happened.

I am doing my best to try and distract you and gain your trust, so that we can make this as easy for you as possible.

But I am watching you, and although you are older, you are behaving as though you are two years old. Someone your age should be able to process a bit more and not scream demands at your mother and the ER staff.

But wait, now I see what the problem is.

Your parent is acting as though they are two years old. Sobbing and speaking to you in baby talk. Giving into your every demand.

Repetitively crying out, “Oh my GOD! Oh my GOD! My poor BABY!”

And calling all four of your grandparents to come at once.

Not to mention your father who comes barreling in the department and begins pacing in your room. How could your mother allow this to happen? It never would have happened if you had been in his custody.

Mom is flailing about the room screaming how she just can’t take this and won’t we please help her BABY and what is taking so long and she can’t STAND the sight of blood and oh, she is going to faint!

Geeze, you would think it was her chin that was lacerated.

I see why you are screaming at the top of your lungs.

You have to fight with your parents for attention.

But finally all four grandparents arrive and they fawn over you.

Well, two of them do.

The others are busy comforting mom who is hysterically leaning with her head in her hands over the sink.

But wait! Here comes Auntie!

Auntie gets to help hold you down with the other five staff members so you can have your chin laceration glued while Mom wails five feet away in the distance behind the curtain while every one else comforts her.

You get lots of attention then. And when you screamed for your band-aid immediately and wouldn’t stop until you got one, even though I was in the middle of getting your discharge instructions, it was hard for me to realize that you were an absolute spoiled brat.

It’s not your fault, though.

You see, this was all about your parents and not you.

Your parents modeled the behavior. You took your cues from them.

It’s hard to fight for attention when two adults seem to be taking it all.

Yes, grown-ups can be very scared and upset when something happens to their child. They may even cry.

This is normal and the nurses try to support them, too.

But you should have been the focus of their concern and no matter how upset they were, they owed it to you to be strong and help you get through it.

At least Auntie was able to do that for you.

But your hysterical, demanding behavior reveals a spoiled, pampered child of overcompensating parents.

This is your family dynamics.

I’m sorry to say your parents did you no favors that day.

You didn’t learn strength or courage.

You learned that screaming and acting out was the way to get everyone riveted to you and to get exactly what you want.

I hope you don’t grow up to be a demanding, screaming adult patient.

Those are called “wimps”.

When you are a big boy, you might want to join the Marine Corps. They have an excellent program in self-discipline.

Lord knows you won’t learn any from your parents.


Your ER Nurse


  • scalpel

    September 4, 2006 at 4:57 pm

    That is an unfortunately all-too-familiar scene. Uggh.

  • may

    September 4, 2006 at 6:05 pm

    this has nothing to do with this particular post, but thanks Simon Cowell:)

  • Felix Kasza

    September 4, 2006 at 6:08 pm

    The child in the weird traction setup? (I claim, by the way, that we are looking at a tourniquet gone horribly wrong, and the doctor considers the child as the main ingredient for a Sunday pot roast — look at his eyes!) Anyway, I think it’s a boy … were it a girl, surely it would have a pink bow tied into the hair. I mean, what with the age of that ad, and all.


  • Kim

    September 4, 2006 at 6:11 pm

    Hey, it does look like a boy? Did they go co-ed in Pediatrics back then?

  • Mother Jones RN

    September 4, 2006 at 9:02 pm

    Those parents won’t know what hit them when there kid grows into adolescences, and starts stealing cars and doing drugs. They will find a doctor a who will diagnosis the kid with “conduct disorder,” and admit him to psych unit so someone else can fix the problem they created. And when they kid can’t be fixed, the parents will blame the doctors and nurses for not doing their job.

  • intelinurse2b

    September 5, 2006 at 9:31 am

    yet another excellent example of why I will never be a pediatric nurse. Im tough on my kids, and Im not sure I could keep my mouth shut when other parents aren’t.

  • NPs Save Lives

    September 6, 2006 at 5:35 am

    That’s when you tell the parents that the hysterical one must leave or their poor child may end up with a “horrible scar” because you can’t focus! Vanity will sometimes overrule insanity. Thank goodness for the calm Aunt! That would have been me. Maybe she’ll be a nurse someday too!

  • Hannah

    September 6, 2006 at 9:25 am

    This is SOOOO good and SOOOO true!


  • lofty

    September 7, 2006 at 9:24 am

    hi there,
    Just having a peek at the site after a mention on nhs blog doctor. Am a paeds A&E nurse in the uk and recognise this in children I see myself…. am often tempted to try blogging myself but never know how to start!

  • Joann Hollis RN

    September 8, 2006 at 1:59 pm

    As an NICU nurse, I see your point. Parents can sometimes get in the way when they are so hysterical.
    However, I don’t dubb them as bad parents. The love God gives us for our children sometimes allows us to react in unpredictable ways when our most precious gifts are injured. They brought their child to the E.R. and are very upset that he is hurt. So many children simply don’t have anyone who cares that they are hurt. Some people handle bad situation better than others depending upon their experience with bad situations, or the current situation they are in. This could be the straw that broke the camels back for them. I cry with my children if they are hurt, I suck it up and care for them as they need, but my heart aches with theirs. When my own child was admitted to NICU, I realized for the first time why parents only seem to comprehend a small amount of what I tell them. And yes, when I was called suddenly from work to take my kindergarten son to E.R. because he ran into a table and ripped part of the skin on his chin, God gave me the ability to remain calm until I reached the Emergency Room. I sure am thankful for my wonderful E.R. nurses who calmed me while my son was sedated and stitched up by a plastic surgeon. Oh, and by the way, my sons have grown up to be good, tough, Christian young men.
    Been on both sides of the fence, Joann Hollis R.N.

  • Flea

    September 10, 2006 at 6:23 am

    Brilliant, Kim! I’m so sorry I haven’t visited recently. You write great stuff!



About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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