ENT examinations can feel long, uncomfortable, and scary to young children. When working with young and anxious patients, Nurse Practitioners can employ effective communication techniques to keep children calm and cooperative during the physical examination.
Tips for Nurse Practitioners to establish rapport with young patients
Before jumping into the examination, it is important to first establish a friendly rapport with a child. This will help them trust you, calm their nerves, and feel more comfortable with the examination.
Make eye contact
As soon as you meet a patient of any age, you should make friendly eye contact, introduce yourself, and shake their hand. This is also true for working with children, as it makes them feel respected and seen. While it may be tempting to direct all your attention to the patient’s parent or guardian, it is important that young patients feel involved.
Practice active listening
It is important for Nurse Practitioners to assess a patient’s mood at the beginning of any interaction. Especially with young children, assessing if they are nervous about the appointment will help Nurse Practitioners more effectively communicate to reassure them.
Be sure to make eye contact when a child is speaking to you and show that you are listening by repeating part of their answer back to them or asking specific follow-up questions.
Match eye level
Nurse Practitioners can make children feel more comfortable by getting to their level. Rather than looming over a child, you can sit or invite them to sit on the examination table. Allowing a patient to look at you directly rather than looking up at you will make them feel more equal in the interaction and alleviate anxiety.
Speak in a soft, calm voice
Finally, Nurse Practitioners should be thoughtful of the tone and volume of their voice when working with young patients. Many children are frightened by loud noises, so it is important to knock gently when entering, avoid rushed or abrupt movements, and use a gentle tone of voice at all times.
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ENT exam techniques for Nurse Practitioners working with young patients
Completing an ENT examination involves a lot of physical contact with patients and the use of medical instruments. Both of these can be frightening to young children and cause anxiety and restlessness. Nurse Practitioners know that physical examinations require stillness and cooperation from patients. Therefore, calming a child’s nerves and using effective communication techniques during the exam will help ensure a smooth and successful patient evaluation.
Announce your intentions
Before each step of the physical exam, be sure to explain it to your patient. You can tell them what parts of the body you will be examining, why, and how. Especially before you make physical contact with a patient, it is important to tell them and get their consent.
With a young child, you may want to explain how you will touch them and what it may feel like, so they are not frightened by the sensation. For example, “I need to push here so you may feel some pressure.”
Also, Nurse Practitioners need to be aware of the temperature of their hands. You can wash them in warm water to try to warm them before touching a patient. At the minimum, warn your patient that your hands may be cold.
Involve your patient
For younger children, medical instruments can look scary. Before the physical exam, show the instruments to the child, explain what they do, and why they are necessary. If the child is interested in holding the instrument, let them do so. You can show the child how it works and how to use it. Children will be less afraid of the tool after they have had a chance to examine and touch it.
Children may also feel more comfortable during the ENT examination if you continue to involve them. Nurse Practitioners can have young patients hold onto a tool they will need in a moment or remember a number (like their blood pressure) before they return to the chart to document. This will give the child a sense of control by being part of the examination. It will also help build rapport as they will feel that you respect them and appreciate their help.
For older children, Nurse Practitioners should continue to involve patients in an age-appropriate way. You can explain in more detail the point of the procedure, what you are looking for, and how the body functions. You can ask patients questions to gauge their knowledge and better tailor your explanation to their education level. Patients may be interested in learning about their bodies, and the anatomy lesson will distract them from any anxieties they may have about the examination.
Demonstrate the examination
In younger children, it may be necessary to give them further reassurance of a portion of the ENT examination. If the child seems afraid, you can first demonstrate what you will do – either on yourself, a stuffed animal, or their parent or guardian – to show them that the examination is safe.
You can tell them how long it will last and exactly what will be involved in order to reduce their anxiety. It may require some patience, but always be sure to get their consent before continuing with the exam. Nurse Practitioners can also reassure young patients that they are doing a good job and praise them after the examination is complete.
Distract
If a young patient seems uninterested in the instrumentation or explanation of the procedure, it can be better to distract them from the ENT exam. Nurse Practitioners should continue interacting with young patients and can use distraction if necessary. Ask them about their favorite class in school, what sports they play, and any siblings they may have. Find different topics to keep them talking and involve their parent or guardian if they seem shy.
In cases where a child is significantly distressed and restless, it may be necessary to give them a break during an ENT exam. In this case, remain patient and avoid getting frustrated as this will only make the child more uncomfortable. Nurse Practitioners should acknowledge when an exam is long or painful and try to update their patients on when they are almost done and how they are doing.
Although ENT exams are long, involved, and can be scary for young children, it is essential they remain cooperative so you can do your job. By involving your patients,
listening to their feedback, and knowing when to engage or distract them, Nurse Practitioners can help ensure ENT exams go smoothly and with minimal discomfort for young patients.
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