Jack (4 years old) needed an injection. He was scared.
I explained to him the different places on his body that the injection could go so that he could choose.
He chose his arm. Despite being given a choice about the location, he remained nervous. I noticed a tear trickle down his face.
I prepared the needle and arrived back at his bedside. I spoke gently with him, acknowledging his fear while helping him into a comfort position.
As I injected the needle, I distracted him by asking him to wriggle his toes. The sting hit him hard. He let out a cry but remained still so I could finish the procedure.
I finished by thanking him for staying still for me even though I could see it really hurt him.
As I was about to leave, his Mum spoke up and said to him, ‘Jack. Say thank you to the nurse!’
Through his sadness, he sobbed a barely audible, ‘Thank you.’
I encounter this scenario often and it always makes me uncomfortable. I just hurt the child. Granted, it was a necessary ‘hurt’ for a greater gain but to the child this greater good is not always obvious or clear.
I. just. hurt. them.
Instead I would rather the parent thank me if they feel some gratitude needs to be expressed. This way, the parent’s need for thanks to be given has been met and confusion & resentment in the child has hopefully been avoided. When a person is asked to say ‘thank you’ when they are not feeling very grateful, resentment forms.
My standard light-hearted response to families in this situation is…
- The child needs to be acknowledged. Feelings of hurt, both physical and emotional, that are acknowledged carry less emotional baggage. It builds connection and trust between myself and my patient.
- I repeat: A forced thank you can potentially build resentment, not connection. I want my patients to feel comfortable coming back to me for future healthcare needs so I feel it is incredibly important to build that rapport and trust.
When healthcare providers thank their paediatric patients for their co-operation, it creates a stronger relationship with them because it shows the child that you understand their difficult situation.
So parents, please reconsider how important your child’s manners are in these situations. I am ok with not being thanked and I will never think your child (or you) is rude.
Healthcare professionals, try thanking your paediatric patients and see if it makes a difference in your relationships with them. I’d love to hear how it goes for you.
Until next time…
Also, if you are interested in knowing more about teaching (or not teaching) your child manners, here are a few links to some articles giving a very different approach to manners.