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Fear, Children and ER Nursing

I watched him pace the back wall of the emergency room, cry, kick and scream while he watched my every move. “What is behind your back?” he half screamed and asked. The left side of his flushed face was swollen, more swollen than it was 2 days ago. This was our second encounter and the thought of him thinking I was going to hurt him ripped my heart apart.

When I saw his fear, and heard the question…“What is behind your back,”

I was transported to a time when I was a small child, in the hospital and I asked a nurse that same question…she lied to me and said nothing…then she pushed me over and jabbed a needle in my derriere. I have NEVER done that to a child and I never will; I quickly showed him my empty hands and I slowly sat on the stool.

Photo credit: Contact Ben Earwicker, @BenEarwicker or

A dental extraction that ended up infected brought this amazing little boy to me. Our first encounter was 2 days prior…he was a week out of an extraction and his face was swollen and he was in pain. I started his IV with minimal fanfare and he received pain med, antibiotics and fluid. I gave him a hand massage for 10 min and he fell asleep—mom was happy. He was discharged with a plan…all went well.
This encounter was after another visit to the oral surgeon, a second extraction and debridement and 2 nights of no sleep, minimal oral intake and a now terrified little man.

Mom asked for me and I was so happy that I was on. She hugged me, he screamed and ran to the back wall…I didn’t take it personally, of course, but it broke my heart; the fear in his eyes was intense. Again, this brought me back to when my then 6 year old son was acting like a caged animal prior to his second ear surgery…I remembered the fear he had and how awful it was for him and me!!!

I can proudly say that our ER team did a fabulous job orally medicating him with some Versed and Lorab—effectively bringing his anxiety and pain levels WAY down…and then the IV was inserted and antibiotics, pain med and fluids were given and he then was admitted. Mom was happy. I felt relieved and pleased. Little man was back to talking to me and letting me near him without fear.

Part of my job as a nurse is to calm and reassure my patient and their family; reassure them of my ability and my concern. Children create a special challenge as we all know.

I was so happy to head home the night after caring for this little man and know that I did my best job with him and his mom. My experience came into play and my heart was open to them. I connected with them and it felt good. I was happy that I was there for them. I pray he is 100% better now!!

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