"Disappointing experience"

Unfortunately the ENT doctor was running over an hour late - this was not communicated proactively and no apology/explanation was given. He then sent us to the nurse led clinic for ear syringing but didn’t explain follow up plans or what would happen next, and apparently had discharged us without explaining this.

The receptionist said the nurses were ready to see us but the wait was around 20-30 mins. The nurse and support worker were friendly but did not preemptively explain anything to me or my 2 year old about the procedure.

I brought up we’d had a negative experience attempting this procedure before but they didn’t enquire about this or ask how to make things go smoothly this time. When I brought this up afterwards they said I should have discussed all this myself without prompting which seems a lot to expect of a parent.

Even little things like putting on a bib and holding her head were done at the same time as saying -I am going to do xyz- rather than using a tell-show-do approach and pacing. They did not show their equipment or demonstrate the procedure before starting and no risks, benefits or alternatives were explained.

They did not use any play based approaches and only told me they usually have a play therapist available when I specifically requested one (unfortunately they were not available today due to an injury).

I stopped the procedure when I saw my daughter becoming distressed as I believe they were rushing her through the examination without taking things at her pace, discussing nor demonstrating their steps, nor responding to her cues. I explained I didn’t want her to develop an aversion to medical personnel as she had done after the failed attempt last year.

I felt the nurse and support worker became highly defensive in response, explaining that this is their usual way of performing the procedure, and that the blame was on me for not explaining what would work with my daughter before they started - I felt I was not afforded the time or opportunity to do this as they were rushing along. They said they do not like to discuss negative experiences in case it upsets the child but I explained that this could have been framed in a positive way eg -what can we do this time to make things go better?-.

Having worked in procedure based specialties myself, and having attended other departments with my daughter who are fantastic at using play based approaches and taking things at a baby/toddler’s natural pace, I felt that I had an expectation of how a paediatric department would interact with young children that was not met. I would highly suggest the team here maybe shadow other teams to learn more how to optimise their approach for young children.

In the meantime using very basic techniques like tell-show-do, and taking the time to discuss with the child and parent what’s about to happen and discuss what the best way of achieving success is, would make the whole process much smoother. As it is, it feels a little like they saw my daughter as a pair of ears to be cleaned rather than a little person to be understood and helped.