Opening Schedule to Pediatrics

To have your schedule opened to pediatric patients, you will need to complete Nourish's pediatrics training and review our policies around treating minors. Please read through and study the course below to prepare yourself to see pediatric patients.

Once complete, reach out to support@usenourish.com confirming that you have completed the course, along with the minimum patient age you would like to see and we'll enable your scheduling!

When working with children (anyone under 18), it’s important to spend time individually with the patient and also talk privately with their parent(s) to make sure everyone is on the same page.  Parent(s) must be given updates after each session with the child.

You should structure the 55 minute session to include time with the parent(s) and child separately. Communicating with parents is key to providing excellent care to the patient — and is required by law. If you find that you aren’t able to fit all that into one session, feel free to schedule an additional session with the parent(s)! Just set it up the same way you would your normal appointment, and communicate to their parent(s) that you would only like to speak with them during that time.

When determining whether to see the parents during the session with the child, consider the following:

• Is the parent available and able to have private time with you that will not be overheard by the patient during the patient’s session time?

• How much time do you expect to need with the parents for educating, updating, etc.?

• How talkative is the patient? Will they fill an hour session or provide brief answers that could fit into a shorter time?

Expectations for how to communicate outside of session should also be addressed during the initial session. Note that you do not need to send an additional update to the parent.

• Email is usually best for brief and straightforward information. This could be used if the parent is not in the session and just needs basic information in the update.

• If the parent or patient asks questions over email that require a longer response or anything that may need follow-up questions, consider responding by letting them know you will discuss that in depth at the next session. Remember that things often get lost in translation in emails. Waiting to answer the question in the next session avoids confusion and a lot of back and forth questions.

• Remember that things often feel urgent to the parent or to you, but can actually wait until the next session to be addressed. Urgent matters are those that put the child into immediate risk. They are new since the last session and waiting to address them could cause harm to the patient.

• If a brief phone call will not be sufficient to address an urgent concern, schedule an extra session specifically to address their question.

Establishing regular and clear communication with parents is a key component to working with children. Learning about the patient and parent(s) will help you determine the most effective way to set up sessions. Regardless of how you set up sessions, there will still be some communication outside of session. Setting expectations and maintaining boundaries with communication outside of session will help to provide effective and clear information to the parent and help you manage your time.

Seeing both your patient and your patient’s parent(s) during a scheduled 55 minute session is the most efficient and effective way to manage your session. Seeing the patient and the parent(s) separately and privately is sometimes challenging in the telehealth setting. Expectations for this structure and and the ability to meet privately are explained in the Welcome Email sent out prior to the first session. Seed below for examples of how to structure the initial session.

1. 5 - 10  minutes - meet with both kids and parent(s) to introduce yourself and explain the plan for how the session will run for the day.

   • Today we will start with me meeting with (patient name) then at (time) we will flip flop and I will meet with parent(s) and then at (time) we will all come back in to discuss plan and next steps. How does that sound to everyone?

   • What brings everyone in today?

   • Begin to ask some of the basic interview questions to gather the basic information you usually gather during a first session. Focus on the types of questions your patient may have a harder time answering such as medical history, medications, etc.

2. 30 minutes - meet privately with patient and begin rapport building and continue to gather information.

   • What brings you in today other that what your parent shared?

   • What do you like to do? Time with friends? Social media? Playing sports?

   • Diet Recall

3. 10 - 15 minutes - Meet privately with parent(s) to follow-up on any high-priority information

   • What is your biggest concern?

   • Planning for meal, feeding, shopping, snack prep, etc.

   • Set expectations for session frequency and how those sessions will be structured. Also set expectations for outside of session communication

4. Last 10 minutes - Patient and parent(s) come together to make sure everyone is on the same page.

   • Who’s responsible for what - packing lunch, etc. You may choose to use the Weekly Guidance Form to make sure this is very clear.

   • Set up follow-up sessions

   • Review expectations of communications

1. 5 - 10 minutes - check in with everyone to see how it has been going between sessions and check in on goals.

   • Today’s session I’m going to chat with (kid) and then parent hope in at (time) and then we will all meet back up at (time).

2. 35 - 45 minutes with child to talk through any changes since last session and action items for the future

3. 5-10 minutes with the parent to discuss any changes that they have noticed in the primary patient.

4. 5 - 10 minutes with parent and child to make sure everyone is on the same page, especially with to dos for the week

Taking steps to keep our pediatric patients safe when we learn about dangerous situations can feel daunting. These types of situations don’t happen often, but when they do you often need to act fast. This lesson will provide details on how the process works in Texas specifically. More generally:

• If you feel there is an issue report it — the government agency will determine if it needs to be investigated not you. Trust your gut!

• Ask a CQM if you have a question and they will help you walk through reporting your the first time.

• Reporting can be sad and scary and it can saves lives.

• You will be anonymous.

• Check out the PDF documents attached for further detail, and if there’s specific states you are curious about, all information here is publicly available.

Now that you have completed the pediatrics course, email support@usenourish.com to confirm that you have completed the course and are ready to see pediatric patients. Please include the minimum age of patients you wish to see and we'll enable scheduling!