When is it appropriate to ask a parent to leave when examining a pediatric patient? Do you have any advice on how to do this diplomatically? — Tamara Aguilar, FNP, Chico, Calif.
The answer to this question largely depends on the age and development of the child and the extent of the intended physical exam.
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Generally speaking, both parents and prepubertal children are comfortable remaining in the room together during the physical exam. However, this can change as children enter puberty and begin to develop a sense of privacy. There is also the consideration of when a practitioner should begin providing confidential services to adolescents and what the reason for the exam is.
Finally, you must remember that examination of reproductive organs requires a chaperone for the safety of the patient and the clinician. In more than 20 years of experience, I have only had one parent refuse to allow me some private time with a patient, as long as a chaperone was present when the purpose was explained. The American Academy of Pediatrics has published a wonderful resource for providing quality care for adolescents. — Julee B. Waldrop, DNP (186-2)
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