A wide range of patients with a wide range of health problem walk through the doors of your hospital or clinic every day, and of that wide range of health problems, it’s amazing how many may be traced back to stress. High amounts of stress have been found to cause heart issues, digestive issues, breathing problems, headaches, immune system deficiencies, and other health problems. In other words, we know that stress in our adult patients is far from healthy… but how bad is stress for child patients?
“Very bad”, according to the Center for Youth Wellness (CYW) in San Francisco. And the long-term effects can range from asthma to heart disease and even to cancer. Simply put, heavy amounts of stress on a young life can lead to that life being cut short.
“It can tip a child’s developmental trajectory and affect physiology,” explains Dr. Nadine Burke Harris, a pediatrician and founder of the CYW. It can trigger chronic inflammation and hormonal changes that can last a lifetime. It can alter the way DNA is read and how cells replicate, and it can dramatically increase the risk for heart disease, stroke, cancer, diabetes — even Alzheimer’s.”
Dr. Harris goes on to explain that childhood stressors such as divorce, abuse, or death of a loved one “literally gets under our skin, changing people in ways that can endure in their bodies for decades.”
Stress by itself can actually be a good thing for both children and adults… if it occurs in small doses. Stress can help keep us awake, focused, and activates the “fight-or-flight” response when we encounter a dangerous situation. But in order to accomplish these things, stress activates so many of our bodies’ systems simultaneously (immune, hormonal, respiratory, cardiovascular, muscular, and more)—and keeping all those systems perpetually revved up and ready for action eventually starts to wear the body down.
And just imagine what that kind of wear-and-tear does to a body that’s still developing.
But unlike many of the health problems that can be caused by stress, stress itself can be dealt with before it becomes a life-threatening issue… if caught in time. Dr. Harris shares the story of one patient, a 3-year-old girl, who scored a seven on the Adverse Childhood Experiences Study, a very high score for a patient so young. The patient simply wasn’t growing (“itty bitty”, in the words of Dr. Harris). But after identifying stress as a contributing cause and prescribing child-parent stress therapy, her patient was back to a healthy place on the growth curve within six months.
As a nurse, you also have the unique opportunity to help temporarily reduce stress in your young patients. A trip to the clinic, doctor’s office, dentist’s office, or hospital is almost never without an element of fear for most children, but there are a few simple tips you can use to help make the experience a positive one.
- Positive Reinforcement – Pay attention to what’s going well and use praise to reinforce that behavior. Are they doing a good job of listening or holding still? Let them know!
- Take a Deep Breath – Or more accurately, take several deep breaths. Show your patient some relaxation techniques such as deep breathing or progressive muscle relaxation to help calm their nerves.
- Explain Everything – Dr. Greg Psaltis (a pediatric dentist) suggests providing “a running commentary to the child so that nothing comes as a surprise. By telling the patients (in simple, understandable words) what is happening, they can anticipate the next instrument, sensation, or procedure with minimal anxiety.”
- Don’t Forget The Parents – Very little upsets a child faster than seeing their parents upset, so be sure to share some of your focus with the adults in the room. Keeping them calm will in turn help keep their children calm.
Of course, these tips and tricks work primarily for the medical or dental visit itself—they aren’t designed to deal with the bigger psychological stressors that may be a factor at home. But it’s always possible that stress-management techniques learned in one place (your workplace) can be applied in others (their home or school). And as always, if you believe stress may be impacting the health of your young patients, address the possibility with your supervisor first.
“This is a public health crisis,” says Dr. Harris. “So guess what? Schools, you need help! Doctors’ offices, you’re part of the solution! If you’re in early childhood, you’re part of the solution. If you’re in juvenile justice, you’re part of the solution. We all need to be part of the solution. If we each take off our little piece, it’s nuts how far we’ll be able to go, together as a society, in terms of solving this problem.”