Learning to suture and more!

I have wanted to learn how to suture for the longest time, and was able to finally practice at a workshop hosted by NAPNAP recently! Yay for sharp needles and fake skin! I went a little overboard on the stapling, but it was so cool. I have been a student member of NAPNAP ever since I’ve wanted to be a pediatric nurse practitioner, and I love going to their workshops, but THIS one was my favorite. Do any of you know how to suture (people, animals, couches…)? If so, I’d love to hear your pointers!

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Bonus: my toilet training presentation of a sampling of professional vs. lay literature for my child development and behavior class.

Here are a compilation of tips for any parents who are interested in toilet training (and probably already know way more than me!). These are based off of The American Academy of Pediatrics and Dr. Brazelton’s method.

Toilet Training Practice Pearls for Pediatric Providers & Parents

1. Introduce potty scenarios and language starting at or before the 1st birthday

  • Decide on terminology, e.g. “pee-pee” vs. urinate
  • Comment on diaper contents when changing your child
  • Allow your child to observe you using the bathroom

2. Watch for developmental milestones suggesting readiness for training (18-24 mos)

  • Physical: walking, stays dry for 2+ hours, removes own clothing
  • Mental: recognizes urge, able to imitate behavior
  • Psychological: willingness to please, curiosity, impatience with soiled pants

3. Prepare yourself first

  • Plan around stressful events, e.g. trips, family changes, moves
  • Purchase at least one potty, training pants, easy-off bottoms
  • Plan a routine for others who watch your child, e.g. grandparents, childcare

4. Take action

  • Have your child pick special underwear that is a size too big (easy removal)
  • Practice sitting on the potty fully clothed for a few minutes at a time for 1-2 weeks
  • Teach complete hand hygiene to the ABC song
  • Empty dirty diapers into the potty with your child
  • Place your bare-bottomed child on the toilet for 5-8 minutes every 2 hours or 45 minutes after liquids
  • Maintain a low-pressure environment with praise and stories
  • Avoid battles by keeping expectations low and allowing accidents to happen
  • Do NOT create power struggles (parent back down first), child has to learn autonomy vs. shame & doubt on their own
  • Take a 1 to 3 month break if the child is not having successes, rebuild trust and communication
  • Motivate your child with praise for the big and small successes
  • Rewards are optional (e.g. stickers, charts, trinkets, pants-free time..yipeee!)

5. Looking forward to nighttime dryness

  • Place a potty and nightlight in the bedroom and/or bathroom
  • Avoid pressuring for nocturnal dryness
  • Usually achieved by 4-5 years, is genetic; boys > girls nocturnal enuresis
  • 5% of ten year olds still have nocturnal enuresis
  • If your child is > 6 years old and still having nocturnal enuresis go see your pediatric provider

References

  1. The ABCs of Potty Training. http://www.babycenter.com/0_the-abcs-of-potty-training_4399.bc. Updated July 2014. Accessed February 9, 2015.
  2. Bookout K, Williams K. The Everything Guide to Potty Training. Avon, MA: Adams Media; 2010.
  3. Choby BA, George S. Toilet training. American Family Physicians. 2008; 78(9): 10591064. http://www.aafp.org.offcampus.lib.washington.edu/afp/2008/1101/p1059.pdf. Accessed February 9, 2015.
  4. Faull J, Neville HF. Mommy! I Have to Go Potty! A Parent’s Guide to Toilet Training. 2nd ed. Bonney Lake, WA: Raefield-Roberts; 2009.
  5. Frankel A. Once Upon a Potty: boy. Buffalo, NY: Firefly Books; 2013.
  6. Frankel A. Once Upon a Potty: girl. Buffalo, NY: Firefly Books; 2013.
  7. Hockenberry MJ, Wilson D. Wong’s Nursing Care of Infants and Children. 8th ed. St. Louis, MO: Mosby Elsevier; 2007.
  8. Port DR. Step-by-Step Guide to Potty Training. http://www.parents.com/toddlers-preschoolers/potty-training/basics/step-by-step-guide-to-potty-training/. 2013. Accessed February 9, 2015.
  9. Toilet training guidelines: parents-the role of the parents in toilet training. Pediatrics. 1999; 103(6): 1362-1362. http://pediatrics.aappublications.org.offcampus.lib.washington.edu/content/103/Supplement_3/1362.full.pdf+html. Accessed February 9, 2015.
  10. Vermandel A, Kampen VM, Gorp CV, Wyndaele J. How to toilet train healthy children? A review of the literature. Neurology and Urodynamics. 2008;27(3): 162-166.http://onlinelibrary.wiley.com.offcampus.lib.washington.edu/store/10.1002/nau.20490/asset/20490_ftp.pdf?v=1&t=i5yqcxjd&s=d0e9a4bc4724a61c97ea0aa3b77c7b068a3b30af. Accessed February 9, 2015.
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