‘Children’s fear in hospital can be eased with small actions – even at busy times’

“If a child is relaxed during a blood test, they will be less scared if they need another”

When I was newly qualified, I was looking after a patient with a condition unknown to myself; her mother told me my patient had ‘white coat syndrome’. I had met plenty of anxious or nervous patients, but had not heard a parent use this phrase before. It took a moment for me to realise that, instead of explaining her daughter’s medical history to me, she was simply saying her daughter was afraid. According to Blood Pressure UK, ‘white coat syndrome’ is when a person’s blood pressure is increased due to the presence of a health professional or being in a clinic.

I believe the mother was generalising, referring not just to her daughter’s blood pressure, but to her overall fear of medical professionals and interventions. This scenario is not unusual and I imagine all paediatric nurses can recall similar experiences. I remember being frightened of blood tests myself as a child, so I try to be as patient and reassuring as I can. This, however, is not always enough.

There is broad agreement that using toys and play therapy can help to improve hospital experiences for children. Just take a look at some of the colourful artwork in many children’s departments, and the numerous play workers and specialists who work with children in hospitals worldwide.

The Care Quality Commission’s Children and Young People’s Survey 2020 found that, of 27,374 participants surveyed and admitted to NHS hospitals between November 2020 and January 2021, 44% reported there being enough things for them to do in hospital – this was a statistically significant drop from findings in 2018 (50%) and in 2016 (51%).

It also found that 41% of 8-to-11-year-olds said staff “did not play or do activities with them” and only 43% of parents or carers of 0-to-7-year-olds said their child “definitely” had enough to do – a large statistically significant decline from 2018 data (61%).

It is likely that infection control measures introduced during the Covid-19 pandemic had a negative effect on staff’s actions and the availability of toys in hospitals – this is something from which we can learn. We may not always have enough time to play with patients and be able to take extra time with procedures such as blood tests, but there are things we can do to help.

We can call on play specialists to help us, and even ask someone present who is not a doctor or nurse to help put the child at ease. We can also try to be even more patient and explain what we are doing, using age-appropriate language and terminology.

If a child is relaxed and distracted during a blood test, it should go smoothly and they will likely be less scared if they need to have another one. These may seem like simple things, but they can easily be forgotten or overlooked during a busy shift. Childhood phobias of hospitals and health professionals are not always preventable, particularly during emergencies. We all know the phrase ‘prevention is better than cure’; we would do well to remember this and apply it, when possible, to calm children’s fears of hospitals.

Holly Veness is staff nurse, The Portland Hospital

2022-10-06