Many of us remember childhood visits to the doctor. Some positive, some neutral, and some pretty traumatic. This was maybe 30 years ago when the NHS was very different.
Today, the NHS is busier and more pressured than ever. We’ve all seen the headlines; longer waiting times and staff under more stress impact the healthcare experiences that we, and our children, encounter. Long waits can lead to increased anxiety, and quick appointments can further this anxiety because we don’t feel in control or listened to. Patients can feel rushed, pressured and scared.
Now, please don’t get me wrong, I am a huge advocate of the NHS. I worked in a local London hospital for 15 years and loved, almost, every minute. I am also a huge advocate for improving the healthcare experience for children and young people, and empowering parents to feel confident in such an alien, and sometimes inhospitable (excuse the pun), environment.
I am a health play specialist (HPS) and there are over 600 registered HPS around the country. It is our job to work with children, young people and their families within the healthcare system to support them and make their experience as positive as possible. And it works. I can’t tell you how much of a difference it makes. We are a small profession and as much as we would love to, we can’t support the millions of under 18’s that come through the NHS every year. Increasingly, I heard about the fear and anxiety that was taking place outside of the hospital. Children were getting more and more anxious while waiting for their appointments. Parents were struggling to know how to prepare their children for upcoming procedures. And all of this meant that it was getting harder to improve the healthcare experiences my patients were getting.
So why does it matter? These negative experiences are not one off’s. Their legacy lives on. The dentist is a classic example of this:
Scary childhood experience = not attending as an adult. Missed checkups = more treatment. More painful, invasive appointments = more anxiety. More anxiety = not attending the next checkup. And repeat.
It’s probably not something you’ve thought much about. But when it’s suddenly our children that need medical treatment, it all comes flooding back.
We can influence our children’s experience of healthcare. And it can feel like a lot of pressure. How do we talk about our own appointments in front of them? It’s quite likely that it’s with an air of dread. Before a child has even stepped into a hospital, they have an idea of what the experience will be like from things they have heard from those around them.
Life is busy. As a working parent the juggle is real. And managing our children’s social diaries is like having a second job. We just about manage to book their dentist appointment or chase the hospital appointment letter. The date goes in the diary and we put it to the back of our minds until the day arrives. Except, often the thought lingers there; How will my child cope? Is there anything I can do to make it better? How will I manage their emotions? This all takes up precious brain space and the constant underlying stress is exhausting. The way I think about it, there are 3 parts to an appointment; The before, the during, and the after. Ideally, we would engage, communicate and support our children at each of the 3 component parts. But life has a habit of getting in the way.
You know your child best, and there is no magic formula that will suit everyone but here are some ideas that I hope you will find useful.
The before:
Tell your child about the appointment. This may sound obvious but you wouldn’t believe how many children I’ve worked with who have turned up to the hospital thinking they were going to a party…
Now I know this is easier said than done, and often it feels much easier just to ignore this part and deal with it all on the day of the appointment. But if a child feels prepared, they will feel more in control and cope better as a result.
Keep it simple. Keep it factual. Make space for questions and big emotions. Feeling scared is ok, it’s normal. Try not dismiss their feelings, instead listen and offer understanding.
You don’t have to figure this out on your own. There are some great programs on TV about going to the hospital and having basic procedures (check out ‘Get Well Soon’ and ‘Operation Ouch’). Local libraries also have a range of ‘experience’ books about dentist and doctors appointments, these range from picture and character books for young children to more scientific based ones for older children and young people. You know your child best. Trust your gut.
The during: The chances are you, or another carer, will be with your child for most, if not all, of the appointment. You can come prepared. There are two ways to prepare for a medical appointment. Logistically you can prepare by packing a bag with extra snacks, activities to pass the time, fidget toys to help keep nerves at bay etc.
But you can also prepare emotionally. If you are anxious for your child and the procedure they are having, then dealing with your own anxieties may be the best way to support them. Arm yourself with information; what will happen in the appointment? Write down any questions you have and take the list with you. Would it be helpful to take a 2nd adult along to support you both?
Now this is the hard bit. If the appointment is not going well and your child is very distressed, you can ask them to take a break, or even stop. It is very easy to lose your voice in a hospital setting, even more so for children. You can be their voice and advocate on their behalf.
The after: We don’t always have the luxury of time to prepare for a medical episode. A&E attendances of under 5years make up nearly 2.6 million visits a year.
But you always have time after the experience to support them (and yourself!). In my opinion it is never to late to process and reflect on an experience; positive or negative. Reflecting on positive experiences can build confidence and improve that trust in the relationship with healthcare professionals. Thinking about negative experiences can help reduce medical related trauma, clear up misconceptions and improve the trust between yourself and your child.
Reflecting on a previous experience doesn’t need to be a full on, sit down therapy session. In fact, it’s quite the opposite. With younger children, play always wins. Perhaps you can set up a hospital scene in their dolls house, or print out some medical themed colouring. Join them in the activity and ask some open-ended questions. With older children, go for a walk or play a board game and open up the conversation in a casual way; ‘I was thinking about when you had your blood test, do you ever think about it?’
My favourite question to ask children is ‘was it what you thought it would be like?’ This is a really simple way of starting a conversation about expectations vs reality- for both of you.
Whatever their age, let the conversation be led by them.
No one wants to go to hospital. And it is never as simple as ‘just a blood test’. It’s the countless episode’s of sickness and GP appointments, stress, the logistical nightmare’s and the family strains that lead you to that point. Finding the time and capacity to think about these things isn’t always easy but I promise you, it’s worth it.
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