You are in the middle of a movie theater, at the most important part of the movie. The theater is dead silent. Suddenly, you hear your child make that gurgly noise that you know means he will desat in one minute without suctioning. What do you do? What is proper suctioning etiquette?
Rule 1: Saving a Life Always Wins
The first rule of suctioning etiquette is that your child’s life is always way more important than etiquette. If your child needs suctioning immediately, or is severely distressed, go ahead and suction anywhere and any time.
Yes, you might get some stares, rude remarks, or grumpy looks, but your child’s health and safety always trumps another person’s need for a quiet, undisturbed space. And if anybody comments or criticizes, simply say it was a matter of life and death–which it was.
Rule 2: Minimize Disruptions
There is no doubt about it–suction machines are noisy. But there are things you can do to minimize the noise, and you should most certainly try your best to cut down on the noise as much as possible. First of all, ask your home health company for one of the newer style suction machines. While they are by no means quiet, they are a little quieter than older models. Keeping your suction machine in its case or bag also can reduce the noise. Even throwing a towel over the machine or padding the sides with blankets helps a little bit.
In addition, make sure you have everything out and ready before you start, so you can be in and out as quickly as possible. Most parents are suction ninjas, and can get the job done in seconds.
Rule 3: Try to Be Courteous
If it is not a matter of life and death, try your best to be as courteous as possible to those around you, of course within reason. This may mean you choose to step out of a library, church sanctuary, or theater for a moment to suction in private.
You always need to balance your child’s need (and right) to participate in an event with the amount of disturbance that will inevitably be caused by suctioning. We all know that suctioning is loud and a little gross no matter how cute your child is, and may be frightening to some children. While I am all for being an advocate of suction awareness, one should not intentionally disturb others for the sole sake of advocacy.
The middle of a piano recital? Step out if possible. The middle of a rock concert? Go ahead and suction.
Rule 4: Take the Child’s Feelings into Account
While many kids who need suctioning may be too young to care, some children are able to make their preferences about suctioning known. Some may be perfectly comfortable suctioning in public; others may prefer going to a separate space. Some may want you to explain to their class or group before suctioning the first time; others may not even want the other children to know they get suctioned.
Ask your child his or her preferences regarding privacy, or if your child has difficulty communicating, observe his or her reactions to being suctioned in various places. It is just as much your child’s right to be suctioned privately as it is to be suctioned publicly.
Rule 5: Pick a Safe and Sanitary Location
Do not ever bend to someone’s insistence that you must “do THAT in the bathroom.” Suctioning must be done safely and in a sanitary location, and bathrooms just aren’t sanitary. While there really aren’t any universal laws on performing medical procedures in public, no one has the right to deny a person with a disability access to a public place because the medical needs of the individual may be a little noisy or may make others uncomfortable.
Similarly, try to avoid suctioning in food preparation areas, unless it is an emergency.
Safe and sanitary suctioning at school can also be rather challenging. Some school districts or school nurses have strict guidelines on where and when suctioning can be performed–and some school districts have even gone to court on this very issue. In general, there is no specific educational law that guarantees your child can be suctioned in the location of her (or your) choice. The law leaves it up to the school nurse, who must determine what location is the safest for the child.
If your child attends a special needs school or class, you are unlikely to run into too many problems. In these settings, most children are suctioned in the classroom unless personal preference or safety requires otherwise. Children who are partially or fully included in regular classes may have a more difficult time being suctioned in their preferred location. In many cases, a simple explanation to the students and teachers goes a long way. Soon enough, they probably won’t even notice the sound of the suction machine anymore.
Some teachers or staff members, however, may be very resistant to suctioning in the classroom, stating it is disruptive to the class. Once again, you must balance your child’s need to learn with the level of potential disruption. If your child requires suctioning every 10 minutes, removal from the classroom each time will severely interrupt her education. On the other hand, if suctioning is rare and unusual, it may be best for all involved to try to suction in the hallway if it is safe and easy to do so.
The Moral of the Story
Health and safety comes first. Beyond that, try to be as minimally disruptive and courteous as possible, both to your child and those around you.