How Me first enhanced TB clinics for CYP

“All London TB Extended Contact Tracing Team (LTBEx) nurses attended the Me first children and young people centred communication training and it opened our eyes to as to how we could improve our communication with the children that we saw. In our work we would see children and young people of all ages, we would generally only get 10-15 mins with a child in which we had to build a rapport and ask them questions about their health, travel, and clinical and social risk factors. This would be followed by a skin test. We realised from the training that we were asking a lot from the children and our way of communicating was quite rigid in that we sat there with the questionnaires and directly asked them a list of questions expecting them to answered honestly.

We thought about our experiences and looked at how we could encourage the children to feel more comfortable to answer our questions and to use the questionnaire process as not only an assessment tool but as an opportunity to build a rapport with them and help them reduce their anxieties over the skin test, as this was what most were most concerned about. In order to make it a less rigid process and one which would enable them to feel more open about communicating we sourced cartoon illustrations of symptoms from a TB charity and put them on a laminated sheet which on the reverse also had a list of the risk factors we were concerned about. So instead of saying out-loud they could point to anything that affected them avoiding any embarrassment with the nurse and eliminating the fear of their peers hearing.  You can look at our poster on the Me first resource hub.

The training also highlighted to us that we did not give the child and young person any feeling of control in the situation that would help them cope better with what was happening. As the whole process is relatively simple we looked at how we could make a small adjustment to the process of the skin test by giving the individuals a choice. We decided to let the individuals choose what arm they wanted the skin test on. These two very simple adjustments to our practice gave the individuals a chance to be more open about their situation and a chance to have control over it.”

Trish Costello

Contact Tracing Nurse

London TB Extended Contact Tracing Team (LTBEx)