Chapter 3 | Family Dynamics and Communicating With Children and Families 49
Communicating With Infants The infant period, from birth to 12 months, is a time of rapid physical and developmental growth. Body systems mature, and skill development occurs. Social development is influenced by the infant’s environment and the attachment with parents and caregivers. When caring for an infant, the pediatric nurse should be aware of the communication characteristics of this age group: ● Infants are unable to verbalize needs, concerns, and discomforts. ● Nonverbal behaviors, such as smiling, promote socialization. ● Infants cry when they are hungry, when their diapers need to be changed, when feeling pain or discomfort, and when feel- ing lonely or wanting to be held. ● Infants coo when they are content or happy. ● Infants are often quiet, observing the environment around them. ● Infants respond to the nonverbal behaviors of adults: touch, sound, and tone of voice. ● If the child has attained understanding of object permanence, he or she will know when a parent is missing (see Chapter 7). ● Observing parent and caregiver interactions with the infant can provide information about: ● Separation anxiety ● Fear of strangers ● Temperament and disposition Nursing Interventions for Infants ● Communicate primarily with parents and/or caregivers. ● Learn the infant’s routines—feeding, changing, sleeping schedule—and incorporate them into nursing care. ● Use gentle touch when handling the infant to provide a sense of security and comfort. ● Allow the infant to suck on the pacifier to promote stress relief and relaxation. ● Talk to the infant when providing care to console him or her. ● Use music and sounds to assist in soothing the infant. ● Quickly respond to the infant’s crying by feeding, diaper- ing, or picking up the infant, all the while talking to the child about what you think he or she is communicating (Fig. 3–15). ● Use sing-song approaches to communication—singing and music can quickly gain the infant’s attention, as does wide- eyed, high-pitched communication (Traub, 2016). ● Incorporate visual, auditory, tactile, and kinesthetic stimula- tion into nursing care. ● Include interaction with child life specialists, if available at your facility. ● Incorporate continuance of care so that the same nurses are providing care as much as possible. The infant will become familiar with the nursing staff. ● Incorporate consistency in nursing care and contact to allow the infant to develop trust. ● Consistent nursing staff will allow the nurse to better interpret the nonverbal communication patterns of the infant.
FIGURE 315 Quickly respond to the infant’s crying by feeding, diapering, or picking up the infant.
● To decrease problems with temperament and disposition, in- corporate as much of the infant’s normal routine as possible in care provision.
Communicating With Toddlers and Preschoolers
The period between ages 1 and 5 is a time of intense exploration of the child’s environment. The speech of a 5-year-old should be understood by anyone listening. The young child learns more about the environment while also exhibiting some negative be- haviors, including tantrums. Children of this age are typically egocentric, or unable to think from another person’s point of view. Although this time can be overwhelming and challenging for parents and caregivers, substantial cognitive, social, psycho- social, and biological growth and development are occurring. When communicating with a child in this age group, the nurse should be aware of the following: ● Use statements such as “good job” instead of “good boy/ girl.” ● The child cannot separate his or her actions from the origin of pain experienced. ● Exploring objects through touch helps children gain knowl- edge of and experiment with unknown environments (Fig. 3–16). ● Medical play may be useful in demonstrating how a procedure will take place. ● The child may practice or pretend that a doll is having a procedure done. ● If appropriate, allow the child to handle a stethoscope, pulse oximeter, and blood pressure cuff and explore these items in a nonthreatening environment.
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