It might come as a surprise to readers that doctors are legally obliged to keep up their knowledge and skills every year by spending many hours in training outside of work. The Irish Medical Committee carefully polices this education and woe betide the doctor who falls short with his monitored training!
I recently attended a really good meeting over five hours at UCC, at which we were updated on issues around managing children in A&E over the coming months. It also provided the opportunity to meet the experts and old friends from CUH and MUH. It is important for A&E doctors to know what to do when treating bronchiolitis as winter approaches, as well as resuscitation, burns, foreign body inhalation, Covid infections and non-accidental injury. We dread these emergencies, as they are so emotional and trying. In training, we acted these situations out with mannequins to be prepared for the winter.
What was news to me is that CUH now has an expert lady, whose name is Rachel, dealing solely with play! She is highly qualified and is now a vital part of the team in A&E to make our children’s visit less scary. I am sure all the doctors learned a lot from her. I learned there is more to distraction than playing a cartoon on your mobile! Offering lots of toys is better. It’s also a good idea to introduce the child to a teddy who will go on the same journey with him or her and have the same tests. The teddy is for keeps as well!
We learnt that we should talk on the same level as the child and not direct all communication through mum and dad. We should not give orders like “keep still while I stick this needle in your arm”, but instead, in a calmly modulated voice say “it is really important to keep still, as this might hurt a bit” Children appreciate honesty and are usually very smart, picking up very quickly on non verbal cues.
A patient’s dad came up with the brilliant idea of mocking up a ‘mini’ MRI machine complete with sound effects, which could give the child an impression of what was likely to happen when going in the real MRI. Brilliant, as we probably all find MRIs claustrophobic and incredibly noisy.
As a parent yourself, you may have your own suggestions, tips and observations, so please let us hear them!
Can we all learn from Rachel? Yes indeed – by preparing our children for what is likely to happen at the doctors or in the hospital. Explaining why a test has to be done to make you better. Explaining about blood tests and needles and how we can make this a painless experience with creams applied on the arm beforehand. Let us make it all a bit of fun and bravery awards work as well.
Our A&E Departments usually, and rightly so, prioritise the care of children in child-friendly areas, but if it all does become a bit scary and the doctor is a bit rushed, there is always Rachel on hand to help, educate and console.