July 6, 2011, 12:56 pm

Who’s The Grown-Up Here?

Get great prices on nursing scrubs every day.

Ah, the benefits of sand therapy!

Time for little Bettina’s daily afternoon face plant!

Not only does it appear my colleague is about to lose her grip on her patient, I’m concerned about her choice of body mechanics.

I predict a lumbar strain in 3…2…1……

(This photo is from the Library of Congress collection.)

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I love my pediatric patients. While it is hard to see children feeling sick, they can be bright spots in occasionally hellacious shifts.

I’ve blogged before on my observation that the kids seem to be the adults in the some families.

  • They don’t want to undress for an exam, so they fight the parents who are helpless in the face of taking a shirt off a three-year-old.
  • They have to be restrained so they don’t run rampant in the ER, and they slap their parent across the face. The parent doesn’t respond.
  • They are told they need to cooperate with a procedure and they answer their parent with a loud, clear, “F*** YOU!” At the age of five. The parent retreats.

Interestingly, I see it in families at all economic levels, in a variety of ethnic groups and cultures, and in families where the parents are both younger (teens, twenties) and older (forties).

Unfortunately, it is becoming less rare.

Part of me wants to go into a rant on the lack of discipline of the younger generation (….and get off my lawn while I’m at it!)

But this is serious.

These kids are my patients.

And this lack of parental assertiveness, this fear of standing up to their children, is affecting their health.

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“She doesn’t want it.”

“He wouldn’t take it.”

“He just wasn’t up to taking any medicine.”

This is the response of many parents when asked if their children received any medication for their fevers.

Parents who are sitting in the emergency department with a sick, febrile child are allowing said children, ages 18 months to 5 years old, to decide whether or not they will take medication for fever!

But it gets better/worse…they take the same stance with their antibiotics.

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And this makes me seethe.

Parents, are you out of your minds?

A child is dependent on you to protect them and to do the right thing to keep them from harm. When it comes to illness, that means making the child take their medication.

  • That’s right. Make them take it.
  • As in force them to take it.
  • As in hold them down, restrain their movements, ignore their screaming, administer the medication and don’t stop until it has been swallowed.

I don’t care if they don’t want it.

I don’t care if they don’t like it.

I don’t care if they aren’t “up to it”.

They do not have a choice. They are children.

They will cry, and get over it.

They will scream, and get over it.

They will kick, and get over it.

They will be mad at you, and you will get over it.

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If you choose to allow your child to intimidate you, slap you or cuss you out without discipline, that is your perogative.

Good luck when they are adolescents, you (and society) will reap what you have sown.

But that child cannot make decisions for himself and you had better damn well step up to the plate as a parent and take responsibility for making sure that child takes the medication he needs.

Not medicating your child because they don’t want it or don’t like it is flat out abdicating your parental responsibility.

Someone needs to be the grown-up in this situation.

That needs to be you.

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The technique of giving medication to a little one who tends to gag, throw up or (as they get a bit older) spit can be tricky. I have a way of administering oral medication that seems to stop that in its tracks.

Disclaimer – this is NOT medical advice, it just worked for my kids. I use a medication syringe and place a tiny amount of medication inside the cheek. A tiny amount. That way, it doesn’t go to the back of the throat and cause gagging and it isn’t on the tongue so they can’t spit it out. When they swallow (and they will, even if they are screaming, they will reflexively swallow eventually) I repeat.

It takes a little longer to give the medication this way, but it works with all ages (until they are able/willing to drink from a med cup) and it gets the medication down. No gagging, no vomiting, no spitting! : )

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15 Comments

  • kmom
    kmom

    July 6, 2011 at 9:03 pm

    And many kids, after they know that you mean business and that they will be taking the medicine one way or another, decide to stop fighting and just take it.
    The first time may be tough, but it soon gets better!


  • Michele Roberts
    Michele Roberts

    July 7, 2011 at 5:38 am

    So very well said!!! I never cease to be amazed at parents who are willing to sacrifice their time and money to sit in an ER for me to give them tylenol when they could have achieved the same thing at home with much less stress. There is nothing magical about my ability to medicate a child, just a willingness to do what the parent refused to do at home . . . be an adult about it!


  • skyemom
    skyemom

    July 7, 2011 at 4:30 pm

    While I’m sure that many cases are examples of bad parenting, it remind me of the time when my daughter was about 2 1/2 and she WOULD NOT take the antibiotic she needed. I tried many, many techniques that bordered on child abuse to try to MAKE her take the gosh durned medication. I called the doctor and spoke to the nurse who advised other techniques, but wow did that kid have some strength I didnot believe possible for someone so small and even when I’d hold her mouth shut, she’d hold it and spit it out. When my husband was home, we’d tag team to hold limbs and use the syringe and force it in her mouth but she managed some feats to expel it. Finally we gave up, and she got antibiotic shots. now she’s 3 1/2 and no such problems at all.


  • RehabRN
    RehabRN

    July 7, 2011 at 4:37 pm

    I’m not above bribing my kid. And if Bubba acts out of order, there are consequences, which we carry out swiftly.

    I like to remind him that I am the parent, he is the child and he’d better behave. Maybe it’s my upbringing, but my parents would have killed us if we would have acted up the way I see some kids.

    It also helps to be educated by nuns with paddles, who sadly, don’t exist anymore. Adults = authority figures way back when.


  • Kim
    Kim

    July 7, 2011 at 7:01 pm

    Skyemom – I can relate; what I didn’t put in this post was that my daughter was basically like yours! LOL! That technique with the syringe I described? It works on my patients and it worked on my youngest daughter, but it was done sitting on top of her and plugging her nose! : ) Who would have thought a 2 1/2 year old had that much strength? Luckily she was rarely sick, and somehow she got the idea that medicine tasted better when one was a “big girl”, so by age 4 the issue was no more! : )


  • John Valenty
    John Valenty

    July 8, 2011 at 8:42 am

    I agree completely… parents these days just don’t know how to discipline their children! What are they afraid of, they gave them life!


  • NPs Save Lives
    NPs Save Lives

    July 10, 2011 at 9:38 am

    I remember those days well! I also have those types of patients and parents at the office. I give rocephin im a lot and I have plenty of nurse power to help me administer it. If mom doesn’t want to do that and the child balks at taking po meds, the suppository method is suggested to the recalcitrant little tyke with the explanation of how it works. They tend to take their medicines orally just fine!


  • Natasha Bloch
    Natasha Bloch

    July 10, 2011 at 1:27 pm

    Just spend my first shift in the PICU. What an experience!!
    I have a new found respect for dependent children and helpless parents who are in search for answers and lean on you for support. Heaviest heart day I ever had.


  • emmy
    emmy

    July 12, 2011 at 6:09 am

    I am right there with NP’s save lives. My youngest was the worst about taking medications. Even when one of her older brothers was standing there begging for the yummy pink stuff she would have none of it. Fortunately her pediatrician was willing to prescribe suppositories or she would have never taken anything. It didn’t get better until she was around 4 and could swallow pills, which she was willing to do. Turns out that she just really doesn’t like the flavors that come in medications. She still doesn’t, and if it doesn’t come in a pill or a capsule she won’t even consider it.


  • Cathrn
    Cathrn

    July 12, 2011 at 9:59 pm

    In many ways I’m a softy as a mom. Not with meds tho. Here’s your medicine. “I dont like that stuff- its yucky.”. That’s why they call it medicine, not candy. But get it over with and you can have a cookie sooner. “Do I have to?”. (silence…). 5 yr old kiddo now describes meds as “the yucky fake cherry one” and the “that is NOT supposed to grape is it?” one.


  • Carolyn Thomas
    Carolyn Thomas

    July 13, 2011 at 3:45 pm

    Are you frickety-frackin’ kidding me?! Your examples of parental reactions are hard to believe.

    But alas, they also reminded me of a long-ago little ME, back in the olden days when docs made housecalls. Dr. Zaritsky came to our house to give me a shot in the backside. I cried and screamed and pleaded that I didn’t want “the needle” (can’t remember what this was even for).

    What I DO remember, however, is me finally forced face down on the living room couch, with Dr. Zaritsky sitting on my back, my jammies pulled down just enough that my bare bum was nicely positioned for the successfully completed injection, no matter how I squirmed and fought.

    I now recommend this technique for harried health care professionals!


  • Halie (Scrubs editor)
    Halie (Scrubs editor)

    July 14, 2011 at 4:15 pm

    Amen, I think this should be required reading for all parents. I see this far too often too. Great post!


  • [...] blog sampler:¬†Emergiblog had a nice post about a week ago about the practical challenges involved in treating the increasing numbers of [...]


  • Beth
    Beth

    July 21, 2011 at 7:57 am

    An old-time nursing instructor taught me this technique and after many years in Peds it still works: Have the oral medicine in a syringe and place it out of sight of the child, but within your reach. Sit in a chair with a back, place the child on your lap so that your left arm is behind him/her and the child’s right arm is behind you. Lean back against the chair. Hold his/her left arm w/your left hand. The child’s lower legs and feet go between your knees which you then close to restrain the legs. You should now have your right hand free to get the syringe and give the medicine orally. If you do this fast it works every time. You can also drop the medicine on the cheek this way. I used this on my daughter & she never had time to object. I’ve also taught numerous frustrated parents to do it.


  • Fitness Circuit Advisor
    Fitness Circuit Advisor

    September 8, 2011 at 9:21 am

    100% Agree! Majority of parents nowadays lacks the knowledge of effectively disciplining their kids. These parents are more concern on themselves rather than taking the step to guide their children in a the way they should go.


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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