Communication is the cornerstone of therapeutic relationships between nurses, children, young people and their families. Communication skills are foundational to the work we do in acute care and community settings (Levetown, 2008). As an Australian Registered Nurse, your relationship with children in your care is normally mediated through their family or carers, so the importance of communicating well with all members of the family unit cannot be under-estimated. Good communication develops the foundations for child and family-centred care (Lindly, Zuckerman & Mistry, 2017), a model of care that is deeply embedded in paediatric nursing practice and that is underpinned by the assumption that children, families and health professionals work in partnership, with each party having an equal voice (Shields, 2010). Poor communication generates fear, anxiety and stress, and is a leading cause of dissatisfaction with health services.
A child's way of communicating depends on a range of factors. This includes their chronological age in the first instance, but also achievement of developmental milestones. This development is influenced by their biology, temperament, family and wider environment. Nurses need to have a good understanding of the cognitive and communication stages of childhood development to develop a set of skills that will enable them to communicate effectively with children of all ages, as well as the adults in the family. In this chapter, important considerations for communicating with children will be presented, together with techniques needed to communicate effectively with children of different developmental stages and their families.
The child's voice in healthcare
Within the Australian healthcare system, children, young people and their families can expect to be treated with dignity and respect. The care they receive is family-centred – that is, the family unit is respected for its values and beliefs, including those relating to health and healthcare. Shared decision-making requires a commitment from the family as well as the nurse, and good communication skills are foundational to the success of such a model of care. Communicating with parents about the decisions they make regarding their child's health and healthcare may seem straightforward, but there is another element of family- centred care to which we must pay attention.