1. Stiekema, Jennifer L. CPNP-BC, MS, RN

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In the second week of my pediatric rotation on a general medical-surgical floor, I was assigned to a 2-year-old girl, we'll call her "Chloe," who was admitted to our floor after a colostomy creation procedure the night before. As I rounded the corner into her room for the first time, I was greeted by the sound of the Despicable Me minions giggling and two big brown eyes peeking out at me from over the top of an iPad.


"Good morning, my name is Jenny, and I am on your team of nurses and doctors today. Can you tell me your name?", I asked as I approached her bedside.


Immediately, her eyes widened and darted to her Mom, who was sitting on the couch across the room. "Go ahead, sweetie, what's your name?"


Her eyes darted back at me and then back at mom. "Can you tell Miss Jenny your name?"


One more fearful glance at me, and then she hid her face behind the iPad.


I responded, "That's okay, we can try talking a little more later. I'm just going to check your bracelet to make sure I'm with my friend Chloe, okay?"


She nodded her head yes, but as I reached for the ID bracelet around her ankle, she immediately whimpered, "no, no, no, no, no," to which Mom said, "Chloe, it's okay, no booboos, no booboos."


I repeated, "No booboos, I just want to see your name on your bracelet."


To my surprise, "no booboos" worked! Chloe was immediately consoled and allowed me to continue. "Wow, what a powerful phrase," I thought.


I then moved to place the blood pressure cuff on her leg, as her nurse alerted me to a difficulty obtaining her blood pressure, and I was again met with a "no, no, no, no, no." Applying my newfound wisdom, I replied "No booboos, I just need to give your leg a nice little hug with little machine, okay?" Chloe's big brown eyes again darted from me to mom and then back at me, at which point she responded with a slow, unsure nod, permitting me to proceed.


As I was finishing with her vitals, her nurse came in to give Chloe her morning medications, and as expected, she was greeted with the same "no, no, no, no." This time, a chorus of "no booboos" from her mom and me filled the room, followed by lighthearted giggling from all-even Chloe.


Once she was consoled, Chloe took her liquid Tylenol from the nurse. After the first taste, her eyes widened and she let out a big "YUM." Chloe quickly finished the medication and then said to the nurse, "and Beary too?" while pointing to her purple teddy bear sitting next to her on the bed. The nurse replied that of course Beary needed his medicine, too. As the nurse approached Beary, Chloe said, "It's ok, Beary, no booboos."


My time with Chloe over the next day was met with fewer "no, no, no's" as I developed more of a rapport with her. After each assessment, she would "read" me a few pages from her book about Mickey Mouse and his afternoon picnic with his friends or about Curious George getting stuck in a cage with bunnies at the street fair.


By the end of her time at the hospital, Chloe became very trusting of me and allowed me to assess her without a single "no." Although, if I went anywhere near the colostomy bag, the "no, no's" made a swift return as she was aware that site was initially a new "booboo." However, I made an effort to explain that soon that will be a "no booboo" site and she should not feel any pain or discomfort there. If she does, she needs to tell Mommy so that she can help her. Chloe gave one clap of her hands and shouted, "No more booboos!"


This specific experience taught me an important lesson that I believe is unique to pediatrics. I realized how easy it is to forget that, although children in the hospital are generally sick, they themselves do not always recognize that-especially at Chloe's age. Moreover, the hospital can be a scary place for kids, as there are beeps, buzzes, and hums that they have never heard before and an army of nurses, doctors, Nurse Practitioners, and Physician Assistants everywhere they look. I learned that taking the time to read stories, especially ones that normalize a child's "booboos" like the book Why Buttercup Wears a Bag! The Adventures of Buttercup and Elliott (to be reviewed in a forthcoming issue), can help to momentarily distract them from all this unfamiliarity and may be one of the most important things I will do all day. I also realized the importance of my phrasing and the vocabulary I choose to use with children. A little bit of "no booboos" and blood pressure cuff "hugs" can go a long way.