Approaches to Childcare


04. 01. 2018

While professionally, health care in the Czech Republic is truly on a very high level, the approach towards patients still lacks in comparison. Sometimes, these drawbacks may appear relatively insignificant, but in the end, an improvement would benefit both the patient and the doctor. The approach towards children is a good example of this.

Imagine that you arrive to your scheduled examination at a hospital. You are a little bit afraid and you are not entirely sure what department and where you should go to. Your worries are immediately relieved when a young man approaches you and helps you find the way. In addition to this, the young man talks to you and you almost forget you were actually afraid of something.

This is exactly how it works at one of London's leading hospitals, the Great Ormond Street Hospital which I visited recently. These people are probably students hired on a part-time basis and carry a yellow T-shirt with the text “I Can Help You.” They are there so that you can turn to them for help at any time in case you need to. Parents are not left wandering around the hospital and young patients are not stressed by the uncertainty of their parents. Their worries are not the only difficulty. A scared child deals with the examination with more difficulty, all takes longer and sometimes, it is not even possible to carry out the examination at all. There are many other similar approaches that can be observed at this hospital and our health care system should seek inspiration from such examples.

Czech patients do not ask, doctors do not explain

Unfortunately, the conditions under which Czech medical staff have to provide their services  are often not ideal. This is usually also reflected in the subsequent approach of the medical staff in question. In addition to this, Czech culture as well as what the Czechs consider to be the norm all play a role – people are not used to asking and the doctors and nurses are not used to explaining everything, often not paying much attention to the patient's feelings including fear or worries of the unknown.

The situation is further complicated by the actual construction and economic capabilities of medical facilities. When we for example take a look at pediatric care in particular, we often find that the facilities here have larger rooms which were made to cater for numerous children at once. It is not always possible for the parents to be there with their children and often, there aren't enough funds for better equipment and decoration. However, that said, there are many new places available now where that is no longer the case. When comparing the situation with western countries, there is still much progress to be made.

Parents are always in the room, even during examinations

In western countries, single-bed or two-bed rooms are considered the norm while treating children. In addition to this, it is usually expected that one of the parents will be there with the child as well. Further, parents are there with the child during all medical procedures with the exception of surgical procedures in the operating room. The doctors reach our and form a relationship with the patients and the parents as well.

At Great Ormond Street Hospital, this particular approach is visible at all times. The naming of the various medical departments carrying animal names is a perfect example of this. The child does not find himself/herself in something referred to as the neurology department, but rather at the Bear or Squirrel department. This is naturally much more appealing and pleasant for small children.

There are already some game entertainment staff members at medical facilities in the Czech Republic playing with children. However, in the UK, these individuals are already present at the waiting rooms regardless of whether it is a common examination, blood sampling or an ultrasound examination. Their goal is to capture the child's attention and to divert the children's worries through play and interaction. These individuals are called play specialists and their presence eases the situation the parents, personnel as well as parents find themselves in. They are in constant contact with the children and are present there along with the parents during the necessary procedures. Doctors there are so used to this that it has become an integral part of their profession.

Medical staff in the UK do not wear white coats but instead dress in plain clothes. The only limitation is that men are not allowed to wear ties for reasons of hygiene and must have their sleeves rolled up. Great attention is paid to hygiene. For example, door handles are sanitized and each entrance is equipped with a sanitizing mat. Visitors are therefore not required to wear any special shoes or covers as is common in many Czech hospitals. Despite it not being widespread, these new approaches are finding their way to an increasing number of hospitals.

Why is it important to work with the whole family?

This unique and desirable approach is not only available in the UK but also for example in Germany. I had a very positive experience at a specialized clinic focusing on the long-term treatment of children with rheumatic diseases in Garmisch-Partenkirchen. The Kinderklinik there cares for children anywhere from two weeks at a time to much longer. Patients come here from across Germany and from abroad. The care is paid for by the insurance companies.

Entire families can be accommodated including siblings, who will then attend the available school or kindergarten. Children have special bobies available to push themselves around so that they can freely navigate the entire clinic or visit their friends at different departments etc. The boby not only serves as a means of getting around but it also fulfills the function of aiding rehabilitation by helping relieve pressure on the hip joints while moving around. Older children have the options of taking walks and to visit the city of Garmisch-Partenkirchen.

The children and their families are cared for outside of the healing procedures by medical staff members who believe that rheumatic illnesses do not only affect the patients themselves but that they have an impact on the life of the entire family. This is why they aim to also work with the families. Few would challenge the belief that this is definitely a desirable and appropriate approach.

Barbara Taušová – pediatrician, founder, executive head and director of private family medical center Canadian Medical in Pragueowner of a private pediatric office in Prague.


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