The consent of a three year old – A parent’s view 

The experience I am about to detail is that of me as a Dad rather than something I experienced in any of my different early years roles, I do however accept that I am likely to have viewed the situation through the lens of an early years educator and it is a combination of those two differing perspectives which has made me decide to share it and raise this important topic for wider discussion. 

The background 

On Saturday morning over Easter weekend my daughter (who is currently three and turns four at the end of April) collapsed shortly after getting up in the morning, the finer details around this I would prefer to keep private out of respect for her privacy as well as my own. However, the result was a 999 call, and trip to accident and emergency with the paramedics. I will add here that I have nothing but praise and admiration for the incredible job of the paramedics, their response was quite quick, and the way they interacted with all of us, including my daughter was absolutely fantastic and faultless. We all felt at ease and they made what was a deeply traumatic situation a little more bearable and as calm as it could be.

Unfortunately due to the blur of the whole situation I am unable to remember their names but should I ever come across them again I will be sure to thank them publicly. 

After being triaged for a period we were transferred to the paediatric emergency assessment unit for a decision to be taken on the next steps, whether to admit my daughter or not etc. 

The incident 

The beginning of the next stage of our experience was okay, not amazing but okay. My daughter was subjected to a range of tests by a student nurse in the department including an ECG, this was explained to her in a very brief way so at least she knew where the stickers were going and that they would be taken off when it was done, even though the purpose of the ECG could’ve been explained. 

However, I was soon to realise that this was actually a million times better than what came next. 

The paediatric staff nurse who was on shift came in, (whose name I absolutely remember but out of respect to her – despite her showing zero respect to my daughter, I will refrain from naming and shaming her), she explained to us that she needed to take bloods for further testing, which naturally we were happy to consent too. She then proceeded to tell my daughters’ Mum to cuddle my daughter and to place one of my daughters arms over her shoulder and tuck the other arm of my daughter under her arm and rest her head on her chest. ‘Like a koala’ she described it. Then, with no warning to us or my daughter she told the other nurse present to ‘hold her arm’ and proceeded to put a needle into the back of her hand (there had previously been numbing cream on both of her hands and forearms.) She then squeezed blood, drop by drop into small two bottles that she was holding. Naturally, my daughter burst into tears, she couldn’t see what was going on and had absolutely no idea what was causing the pain or what was happening or why. It was a shock to us too.

The nurses’ response was ‘there is no long needle’, like that makes what she was doing acceptable. This was the hardest part for me, at that point I clearly did not want to demand that she immediately removed the needle. I did not want to start the argument at that point as this would’ve added to my daughters distress, so instead I had to focus on trying to reassure my daughter and calm her down, whilst asking the nurse what the hell was going on. She assured me ’it isn’t staying in’ and ‘it won’t take long.’ She was incredibly dismissive of my concern and seemed to suggest, by the needle comment, that my daughters reaction was unwarranted, and the fact that she was crying because she had her arm pinned by a stranger and her hand stabbed with no fore warning and all done completely hidden from her view. 

The process was not short either, I am not a medical doctor but I struggle to believe the most efficient way to extract so much blood from a child is quite literally one drop at a time over a five minute period, whilst the child is screaming the whole time and being pinned down by two total strangers behind her back. 

I think at this point it is important I remind you, my daughter is three years old. So as I am sure most people reading this will recognise, no, she is not old enough to provide informed consent, but she IS old enough to understand what is going on and why. Throughout the majority of the other medical experiences prior to that moment, she had been shown the equipment that was going to be used and had the process explained to her in as child-friendly a manner as possible. 

Now, I hope that everyone reading this will understand that the above is completely unacceptable. You would not just grab an adults arm and stab them, or at least I hope you wouldn’t so why do people think this is an acceptable way to treat a child? More worryingly, why does a paediatric staff nurse see this as an acceptable way to treat a child? 

This is how people develop fears and anxieties of hospitals and needles and the like.  

I am not saying my daughter should be asked to agree, because unfortunately, whether we are comfortable with it or not, sometimes we, as adults, are forced to make decisions that are in the best interests of the child because they are unable to fully understand the pros and cons and make an informed decision themselves. 

I am however saying, out of respect for, and awareness of, the understanding and the feelings of the child, everything that is happening to the child and their bodies should be explained to them, in as much detail as they can understand, they should be shown all of the tools that will be required, told what will happen and most importantly WHY it will happen.

I do not think this is too much to ask or is too complicated. 

I do not think this requires years of training or an extensive background in early years or education or experience of children, even though as a paediatric staff nurse she should have a good understanding of children or so you’d think. 

I do however, think this is a matter of respect. 

Respect for the child. 

Respect for the individual. 

Respect for them and their bodies. 

Respect for us as her family. 

I feel we were disrespected that day. 

I feel my daughter was mistreated that day. 

This blog post is not where it will end.