Understand | diagnose | change

Whether you are looking to learn more about paediatric musculoskeletal problems, or are involved in the care of children, then PMM and PMM-Nursing will help you change your clinical practice for the better.


The psychologist can provide valuable support to families and young people who may be struggling with aspects of their diagnosis or treatment. Access to psychology can be challenging but early intervention can reduce issues including needle phobia, taking pills, anticipatory nausea and anxiety. 

Practical tips for procedural anxiety which can be used by nurses:

  • While it may not be possible for the child or young person to have a choice about whether they have the procedure or not, it can help them to have some choice about how this happens.
  • As much as possible, give the young person choice about aspects such as where they sit, who is in the room, if they have cream or spray. This helps them to feel more in control of the situation.
  • Make a plan in collaboration with the young person beforehand which clearly states how they would like things to happen. Write this down, print it out and give it to the young person and those involved in their care.
  • Distraction works better than reassurance, instead of saying “it’ll be ok” or “don’t worry”, talk about something else that the young person is interested in.
  • Agree beforehand how the young person would like to be distracted – use the TV, a tablet, music, books, depending on the young person’s interests.
  • Try and encourage the young person to practice relaxation and deep breathing techniques at home and then remind the young person to take deep breaths during the procedure.
  • Acknowledge the young person’s feelings; say “I know this is hard” “I know you don’t want to have this done”.
  • Agree beforehand who is going to talk to the young person. It is best if this is only one person as otherwise it becomes overwhelming.
  • If a young person is anxious, make sure they don’t have to wait. It is best that they are seen as soon as they arrive and by someone that they know and trust.
  • If a child becomes distressed, decide if they can take a break or come back another day.
  • Use rewards appropriate for the child’s age.

Practical tips for pill swallowing which can be used by nurses 

  • Try the lazy toad swallow! 'Did you know that toads catch the insects they eat with the tip of their tongue and then schlurp! and gulp them down. Try the lazy toad swallow by placing your tablet on the very tip of your tongue. Take a sip of drink, tilt your head back as far as you can and then swallow hard'
  • Try the alien slimy swallow! 'Did you know that aliens like slimy, oozy, squishy things to swallow? It helps make their throats even more slippery. Practice the alien slimy swallow by taking your tablet with a teaspoon of slippery food, such as yogurt, chocolate mousse or caramel pudding'
  • Try the pampered puppy swallow! 'Pretend you are a puppy being tickled under the chin when you swallow. Place your tablet on your tongue and fill your mouth with your favourite drink. Now close your mouth and do the pampered puppy swallow by tipping your head back and tickling yourself under your chin and on your throat as you swallow'
  • Try the slippery fish swallow! 'Pretend you love to drink water like a fish. Place the tablet inside your mouth and drink as much water as you can, holding the water in your cheeks. Now do a slippery fish swallow and swallow until all the water in your mouth is gone along with the tablet'

These practical tips are available as Top Tips

Procedural Anxiety - Top Tips 

Pill Swallowing - Top Tips