Communication with Children in Emergency Care: Roisin McNamara
Roisin McNamara educates you on what not to do when communicating with children, and their families, in the Emergency Department.
Roisin starts by explaining that communication is an information gathering and imparting exercise. It is used to build rapport, demonstrate our willingness to listen and assist.
It is important because nobody cares how much you know, until they know how much you care.
Roisin has communicated with an innumerable number of families, made many mistakes and learnt from them.
Roisin talks about a couple of cases where parents of the child being treated had complained. This led to the realisation that the doctor’s emotional response toward the parent can adversely affect the treatment of the child.
She realised doctors need to have self-awareness to recognise countertransference and the emotional response to parents’ perceived hostilities towards them.
According to Roisin, the first lesson is never to lose one’s temper. If you are unable to adjust to a situation, Roisin suggests removing oneself from the situation and handing over the case to a colleague.
The second lesson is that is essential to re-assure the parents. Countertransference often occurs when dealing with certain groups of patients, like children with autism spectrum disorder (ASD). In these cases, it is essential to tailor the approach to the child after consulting with the parents.
Also, don’t overlook teenagers with non-specific symptoms as they may be dealing with underlying causes which can be detected with a head scan.
The third lesson is never to assume before examining the patient.
Many patients complain of prolonged symptoms and their history sheet will confirm that they have been to multiple doctors before. In these cases, it is essential to thoroughly examine the patient before assuring the parents that the child is fine.
Prognosticating before a complete examination will antagonise such parents. Roisin concludes by quoting George Bernard Shaw “the single biggest problem in communication is the illusion that it has taken place.”
Communication with Children in Emergency Care: Roisin McNamara
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