Appropriate Adult Interaction with Child Volunteers

Appropriate Touch

Touching children appropriately is an important part of personal safety training for children. It is a foundation in helping children express their feelings about touch and about their choices of what or who touches them and how. It is especially important in a hospital where children may have fewer choices about being touched for procedures and treatments. Appropriate touch also protects volunteers from misunderstandings about their interactions with children.

Young children may come in contact with adults who don’t make good decisions about touching children. Touch is confusing to children:

When the child is not used to the touch When the child is not sure about the intent of the giver When there are double messages about the touch When the touch is equated with sex When the touch feels good but there is something “secret” or not safe about it.

Volunteers can support the child’s sense of power over his/her body by asking the child if s/he wants to be picked up or hugged. Younger children will reach for you and even smile in their efforts to get attention from you. It is OK to hug or hold the child as long as s/he continues to give you signs that s/he is comfortable with the physical contact. Know the difference between focused attention (listening, eye contact) and physical affection – patients may be looking for focused attention more than affection.

Protect the Patient, Protect Yourself

For the safety of patients and volunteers, we want to provide volunteers with information and tools to:

Recognize and prevent situations that could lead to potential conflict or complaints. Properly report situations that do arise

The easiest way to avoid a potentially confusing situation is to prevent one from occurring:

Conduct yourself in a professional manner (e.g. DCH volunteers have a fairly casual dress code, but modesty in personal appearance is important). Let the patient know who you are and what your role is It is not appropriate for a patient to treat you disrespectfully. If a patient does make a comment that is disrespectful: Remain calm Let her/him know it’s not acceptable Graciously excuse yourself from the area if necessary Report to Child Life or Volunteer Services (some of our patients will have been exposed to inappropriate behaviors and it will be important for Child Life to know this)

Recognize potentially high-risk situations:

Patient asking questions that feel too personal Patient displays hesitancy or avoidance verbally or through body language Patient groggy when waking up from sleep or on sedation Privacy issues such as patient using bathroom, changing, etc. (volunteers do not assist) Being aware of perceptions when alone with a child (sensitivity to anything that might appear inappropriate)

Additionally, it is never acceptable for volunteers to:

Touch areas that are normally covered by swimming suits. When hugging, it may be more appropriate to hug from the side over the shoulders, not from the front Make sexual jokes, comments of a sexual nature, give massage, etc. Reveal personal information about one’s sex life Use physical contact in a coercive way – grabbing, pushing, etc.

If a concern is reported:

Avoid confusion by reporting any issue around appropriate boundaries or physical contact to Child Life or volunteer services immediately If a patient reports a concern about a volunteer, Clinical Risk Management may need to conduct a full investigation (details in the online Respect at the University training) The volunteer may be placed on leave during an investigation

Sources: Appropriate Touch, Volunteer Services, Children’s Hospital and Regional Medical Center, Seattle, WA. Protect the Patient, Protect Yourself, Legacy Health System, Portland, OR.