Journal of Professional Nursing

Pre-school children frequently seen but seldom heard in nursing care

Paul Watson, RN, PhD, Senior Lecturer, School of Nursing and Human Services, Christchurch Polytechnic Institute of Technology

Reference:  Watson, P. B. (2008). Pre-school children frequently seen but seldom heard in nursing care. Nursing Praxis in New Zealand, 24(3), 41-48.


A significant number of users of nursing services are pre-school children, and have a right to be heard in matters affecting their health. Despite nurses’ duty to seek and take seriously the views of children in matters concerning children’s health, children are rarely directly consulted as consumers of health care. Thus, children’s voices are largely unheard in nursing practice. Furthermore, research about children’s experience of illness generally excludes preschool children. Therefore, preschool children’s voices are also mostly unheard in nursing research about the experience of being ill. Consequently, there is little evidence from nursing practice or research to show the potential benefits of ensuring these voices are heard. This line of reasoning forms the basis of recommending the need for research that seeks to understand how preschool children experience being ill and how they communicate those experiences to others.  

Preschool children, children’s voices, paediatric nursing

The importance of hearing children’s voices in health care is evident in the following example from my experience as a registered nurse caring for a primary school aged child admitted for elective surgery. While completing a routine preoperative checklist with a child (approximately 8-years-old) and his mother, I asked the mother whether the child was allergic to anything. The mother said “no”, but the child interrupted saying something like “what about at the party when I was blowing up the balloon?” The mother shrugged off the child’s comment as not important. However, I asked the child to tell me more, and he mentioned having tingly lips after blowing up a balloon. I explained to the mother and the child the possible significance of the tingly lips as a sign of an allergy to latex. The anaesthetist was informed; precautions against exposure to latex were taken during the operation and the remainder of the child’s stay in hospital. Subsequent testing confirmed the child had a latex allergy. This incident highlights the potential benefits of ensuring children’s voices are heard and given due weight in their health care.  Preschool children (being those less than five years of age), rather than school aged children, are the group of children seen the most by nurses in primary, secondary, and tertiary health care settings (Ministry of Health, 2008). Despite this fact …….cont.

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