Choice and Control
Little ones seek independence. This desire is met with making decisions for themselves. Allowing children to choose instills a sense of control over their life and body. This is important inside the home as well as inside the hospital.
The key is to determine what their choices can be.
Choices at home
At home, asking a kid, “What do you want for dinner?” leaves an open door to many unreasonable requests. “Do you want macaroni and cheese or pizza for dinner?” is more conducive to an appropriate wish.
My daughter does not enjoy learning her vocabulary words. This is non-negotiable. I inquire, “Do you prefer to write your words with chalk or marker?” I do not ask her, “Do you want to practice your spelling words?” That gives her the opportunity to say no. Once she denies it, there is no wiggle room on the subject. Instead, with the chalk or marker option, she knows she must do some writing, but she gets to choose the manner. Inside or outside? Crayon or pencil? On the couch or in the kitchen? There are ways to change the selections while obtaining the same result. She exercises her fingers and puts some letters together.
Another option for kids is to ask which choice they want to start with. “Do you want to shower or read a book first?” This variety is helpful when both tasks need to be done Phrasing the question this way makes it clear that it is not an either-or decision. It places power in the hands of the little one to indicate what their preferences are.
Choices in medicine
In a medical setting, many situations are not fun for children. Clinics, white coats, and equipment can be scary. Practices such as shots, blood pressure measurements, allergy testing, lab draws, and invasive procedures cause pain. Children also remember trauma from previous engagements. They associate doctors with needles and injections, but also can recall positive prizes or actions.
Obtaining a blood pressure reading requires an arm squeeze. Some kids do not like this. Asking them which arm they want it on is a reasonable preference.
Blood draws and shots are painful. There are many times during this procedure that a nurse can give a kid control. Before starting, ask if they want to watch or not. Do they want to hold someone’s hand or a stuffed animal? “Do you want me to count?” is a favorite of mine. Afterward, let them select a bandage color. Picking out a prize or a sticker is a positive diversion.
In the hospital, patients are on the hospital timeline. They must eat at set times, perform therapies, take medications, get vitals taken, and complete tests. In these situations, allowing the patient as much autonomy as possible is even more paramount.
Every patient must get a daily bath while in the ICU because of infection risk. The patient can choose if they want a morning or afternoon wash. Getting up for meals is important. The patient can opt for a chair facing the window or hallway. Preferences, such as door open or close, curtain open, half, or close, create an environment where those who are ill have power over something.
Choose to empower
It may not seem life-changing, but it is for kids. They are developing a sense of self, learning who they are and what they are capable of. We can empower them by providing them with a safe environment where they can make choices while still completing the task.
Editor: Claudia Cramer