During my musculo prac there were a couple of occasions when my treatment sessions were interrupted by some of my clients’ family members, including my end of prac evaluation! It was something that was very hard to deal with, particularly when it was the client’s child. For my evaluation, in one of the small Curtin clinic treatment rooms, there was my client, her 12 month old child, her mother, the assessor and myself!!! Having a small child in a room with a plinth (especially when the child was roaming the floor-where the electrical cords for the plinth were) is not a good idea, and having a 4 year old moving the plinth up and down when you are trying to perform a rotation PPIVM is very irritating and could be dangerous.
But what do you say to the mother/caregiver? Do you tell the client to get their child to stop, or do you take matters into your own hands? How long do you wait for the person to stop them before you get fed up?
As someone who doesn’t have a huge amount of experience with young children, and doesn’t have that much patience with them, it was very hard for me to not yell at the 4 year old- his mother had not told him to stop and it was having a big impact on her treatment-and since she had acute LBP it was very important! The child was playing with the up/down button for the plinth during Ax and climbed all over his mother during my attempted Rx. It was a lot easier to deal with the 12 month old because I could just ask the grandmother to take her out of the room for safety reasons and then get on with the evaluation, however when you are dealing with an older child it’s completely different.
When a child is old enough to know better it is more frustrating when they act out, and they are harder to discipline. But it is not up to you, it’s up to the parent, so a polite remark to the parent is far easier and they are more likely to do something. It is not acceptable for you to shout/discipline someone else’s child however it is also not acceptable for them to interrupt the parent’s treatment session, so it is very important that we are assertive enough to take control of the situation. It also helps if you can find something for the child to do, I let the 4 year old move the plinth up and down, but only when I wanted him to, and as soon as he was bored with that he was allowed to draw on one of the magazines. Once I let the child feel involved in the session he stopped being so disruptive and we could get on with his mother’s treatment. You just have to remember to stay calm and get the parent to take care of their child, then you can take care of your client.
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3 comments:
I found the same problem while on my paeds placement, a lot of the kids came in with their brothers and sisters and thus often interrupted the assessment of their sibling. I also found that when you involve them they become less disruptive, but sometimes they just keep being disruptive and you have to ask their play outside
i also found the same problem on my paeds placement and also recently on my musculo placement, when a mum brought her 18 month old child into the treatment session. This child wasn't too badly behaved to begin with, but once she started to feel more comfortable with her surroundings she would walk out of the treatment room and go exploring, luckily my supervisor wasn't too busy and watched her for a little while, however it was still a bit disruptive. But like you said it's not our place to discipline their child and we have to be very polite and patient and if you have the oppurtunity it's sometimes best to get someone else to entertain them for a while.
What a difficult situation to have been in for your assessment! When you are worried about getting a good Ax, perform a good Rx, and demonstrate your skills to your assessor, it's really the last thing you need, huh. But maybe if it was just another Rx session you may have felt more comfortable in the situation?
I think in this situation there is nothing wrong with telling the child to stop, as long as it's in a firm, friendly way and tell them why (you know, your "kid" voice!). Because it could well be that the mum doesn't realise it has such a big impact on your Ax/Rx. Mums and older siblings of disruptive children develop this incredible ability to put that sort of disruption in the background. After growing up with 4 younger sisters, crying children NEVER get on my nerves. Something like, "nooooo honey don't do that, you'll make me hurt your mum!! That's not for playing, ok?" The trick is NOT to sound edgy or like it really bothers you, but to sound relaxed, as if you were asking your patient to stand up for a re-Ax. If that doesn’t work, then I think it’s also fair to tell the mother, “could you pls ask him to stop that, it just affects what I’m doing”.
I think it’s unfortunately something we won’t be able to get away from. It’ll happen sometimes that children etc. are in the room with you. If mum wants to bring children in the room with you, it’s fair that she respects you and doesn’t allow her children to do something that disrupts you, and I think it’s well within our rights to say if something bothers you. But I’d ask the child first…
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