Enquiry

• Enquiry as part of assessment includes addressing physical, social, emotional and spiritual needs of the family as well as young person.  
• Recognising potentially life threatening situations is important. Remember to consider features that may suggest infection or sepsis, flare of disease or safeguarding issues.
• Remember that children who are immunosuppressed may become unwell very quickly or have subtle signs that may mimic mild illnesses.   
• Enquiry includes assessment of Activities of Daily Living (feeding, dressing, bathing, grooming, play, mobility).
• The nurse needs to use appropriate questioning, listening and observational skills to identify actual and potential problems that impact on the health and well-being to ensure safe and effective care. 
• Talking to children and young people is not the same as in adults. Information obtained may be primarily from the parent or carer, and may initially be vague complaints, such as ‘my leg hurts’, ‘my child is not right’, or ‘she has stopped doing x’.  
• It is important to modify history taking style when engaging with children and young people, use appropriate language and tone and be alert to non-verbal clues of discomfort, upset or embarrassment. Talking to adolescents needs specific approaches to address generic health as well as disease related issues. 
• Charts and pictures may help young children describe the site of their pain (see below).
• It is important to know about normal development ('normal milestones') so that you can appreciate what is normal and what is not. 
• Important information is obtained from watching the child as they walk around and play with toys - looking at how they interact with parent(s), carers, siblings or the health care team is useful. There is no better way to learn than to observe experienced nurses engage with children.