Choices: Are you giving the right ones?
Sarah Davis, MS, CCLS
Child Life Specialist II, Practicum Coordinator
The Children’s Hospital of San Antonio
San Antonio, TX

When working with children and adolescents, it’s very important to be aware of the role that choice plays in providing patient care. Allowing a patient choices offers at least a little control in a situation where others are making all the decisions. A child who is given the opportunity to make choices is a participant in his or her care, boosts feelings of validation and respect, and can actually help increase compliance. But before you become concerned that allowing a three year-old to choose between sedation and no sedation is what I’m suggesting, I would like to put your fears to rest. Choices should always be both age-appropriate, and truly a choice.
 
The first rule when giving choices is don’t give a choice if there isn’t really a choice. One of the most common questions I see staff members ask is “Can I listen to you?”. In this example, it appears to the child that you are giving him or her a choice when you actually are not. You have probably had a two or three year-old tell you “no” when you asked to use your stethoscope. In that instance, there was probably some laughter and then you listened to the child with your stethoscope anyways. While this may seem like no big deal, when you don’t follow through with a choice, it begins to crack the trust that you have built with the patient. If there are enough instances of insincere choices being provided, the patient may display distrust, disputes with staff and/or family, and possibly become noncompliant. In order to create the best experience possible for patients, families, and staff, it is critical to recognize the significance of appropriate choices.
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