This is a guest blog from Lisa M. Peters, MN, RN-BC (in the video above). Lisa is mom of two children and a clinical nurse specialist for the Pain Medicine Program at Seattle Children’s Hospital. She holds a clinical faculty appointment in the Department of Family and Child Nursing at the University of Washington School Of Nursing. She is board certified in pain management from the American Nurses Credentialing Center and is a Mayday Pain & Society Fellow. Lisa has a passion for improving the lives of children in pain. I’ve learned so much from her already!
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Pain is inevitable; suffering is optional. That’s a key message when I partner with parents who bring their kids in for procedures and hear them recount stories of standing by, feeling helpless, as they watch their kids suffer with pain and distress.
It does not have to be that way.
Parents seldom realize the power they have as advocates and as partners with doctors and nurses in managing, and even preventing, their children’s pain. Could that shot at the doctor’s office really be a different experience? Do a few moments of pain really matter in the long run? If I speak up, will they label me and my kid as “troublemakers”?
As a parent, you can make a big difference in your child’s experience with pain. Knowledge is power.
3 Things To Know About Pain:
Poorly treated pain is harmful, both immediately and long term.
Science continues to teach us about the consequences of poorly treated pain on our bodies and minds. There is evidence that it can change how our bodies process pain signals, especially during critical periods of development in childhood. This can lead to highly sensitive areas of our bodies or a generally louder experience of pain. Memories of painful experiences have been shown to shape how we respond; studies show that 10% of the adult population avoids seeking medical care when needed due to fear of needles.
Many common pain experiences are preventable and therefore harm may be avoided.
When it comes to healthcare, pain is something we expect, and in many cases, accept. If a child has an ear infection, our focus is on judging whether an antibiotic is recommended. If a child has a urinary tract infection, our focus is on fluids, hygiene, and eradicating the infection. If a child receives a shot, our focus is on ‘getting it over with’ quick. Yet, in each of these situations there is a child suffering with pain, not just an infection to be treated or procedure to be accomplished.
Parents know their child best; therefore are essential active members of the team.
Watch the video above to learn from parents’ experience with pain and pain management.
5 Things To Minimize Your Child’s Suffering:
- Speak up – Make it clear that you expect pain to be prevented and managed to the degree possible.
- Partner – You know your child, doctors and nurses know pain management. Get together and make the best plan. The simple act of making a plan can help you feel more confident and relaxed, which in turn helps your child.
- Prepare – You teach with your words. Do not tell a child “it won’t hurt” or that it’s not okay to cry. Let children experience and express what is true for them. While some kids cope best with distraction (e.g. read a book or sing a song), other kids cope best by being more actively involved (e.g. tell them what they will see, hear, smell, give them a job to hold the band-aid). Ask about over-the-counter or prescription skin numbing cream and when to use medicines to reduce pain.
- Participate – Position matters. For a baby, it is best to cradle them and breastfeed or provide oral sucrose, if possible; while toddlers do better when sitting on your lap. Older kids should be allowed to have some choice of their position, but children should not be held flat on their back. That is the one position that we all feel most vulnerable and less in control, especially when threatened, such as during a painful procedure.
- Advocate – At any point, you have the right to stop and ask for a change if the current plan is not working. Your ‘stop sign’ is a voice for your child. While pain may be a part of healthcare, needless suffering is not. Addressing your child’s comfort, and your concerns about it, are essential elements in a trusting and respectful relationship with healthcare providers.
Online Resources For Reducing Your Child’s Pain:
Here’s a video, Reduce The Pain Of Vaccination In Babies, that can provide you information and talking points with your own baby’s pediatrician and health care team. They provide tips for you to help support your baby and also get the reassurance you need.
Information on using numbing cream for painful procedures.
Information on reducing the pain and anxiety of needles.
Chris Johnson says
Thanks for this essay. Failure to recognize and treat pain in children, especially preverbal children, is a huge concern of mine. I practice pediatric critical care and also do a lot of procedural sedation, so I use a lot of pain killing medications in my daily work. It still astonishes me that medical people do things to children without adequate pain treatment, things that we would never think of doing to anybody old enough to tell us about it.
A big issue for many years was (and still is to some extent) that doctors are not familiar enough with using pain-killers in children — they are afraid of them. Their fear is appropriate if they are inexperienced because, in unskilled hands, powerful pain-killers cause problems. But the answer for parents is, as you point out, to speak up: if the doctor is uncomfortable using these agents, ask for somebody who is.
Parents also can do a lot to reduce pain, and especially anxiety, by simply being present with their child when uncomfortable and painful procedures are needed. Our own service also makes extensive use of child life specialists, who can make a huge positive contribution.
We can always relieve pain and anxiety.
Chris Johnson says
One thing I forgot to mention: pain slows healing. There are good studies to show this. And it makes sense: pain activates the stress hormone response, and stress hormones inhibit healing. This includes mental stress.
Karen says
AND…it is okay to give your child Tylenol or ibuprofen for pain (or fever) when coming in for a visit to either Urgent Care or the Emergency Department. So many times we hear “I didn’t want to mask anything” but how the child responded to pain medication is an important thing for us to hear as Providers. Conversely, when we offer pain medicine, don’t say “no need” when your child is saying they have pain.
Ever line ogeke says
I remember bringing my baby to emergency room and they will rub her round with bed sheets so she wouldn’t move while they put in an Iv line, that experience haunts me todate thanks for publishing, hope it brings a change.
Colette Hernandez says
Thank you for writing this blog! My 11 year old son is a 3 year cancer survivor so he knows a thing or two about pain. Due to his chemo treatments one of the side effects is nerve damage in both of his legs. Tylenol or Advil isn’t helping reduce the pain. We recently got a new doctor who knew all about my son’s medical history and was willing to take him as a patient. Now 3 months into seeing him, the doctor has decided he isn’t comfortable prescribing pain medications including non-narcotic meds and migraine meds. I have debated back and forth about finding a new doctor and after reading this I have decided to find a new doctor tomorrow. My son has already been thru a lifetime of pain and having a doctor who won’t even discuss pain management is incredibly frustrating! I learned very quickly how to advocate for my son’s well-being and treatment and now I need to ensure pain management is a priority. Thank you again!!
Chrissy says
I am an RN and often struggle with this for vaccinations. I agree with all of the above re: interventions for pain management. I also loved how this mom communicated with her children before an injection: “tears are okay, screaming is not.” All the kids were able to express the pain, but they got some parameters that didn’t include, “Oh come on, it’s just a little prick.”