By Dennis Read
Dennis Read is an Assistant Editor at Training & Conditioning.
Training & Conditioning, 10.9, December 2000, http://www.momentummedia.com/articles/tc/tc1009/parent.htm
When Arnold Thomas, ATC, LAT, MEd, meets with the parents of his student-athletes, he starts by telling them who he is. Then he explains who he isn’t.
“Here in Texas, many of us are called ‘Doc,’” says Thomas, Head Athletic Trainer at Cy-Fair High School near Houston. “So I tell the parents right off, ‘Ladies and gentlemen, I am not a doctor. This is just a nickname.’ That’s a misconception many of them have, so I have to make sure they understand that I am not a doctor.”
While few athletic trainers outside the Lone Star State have to worry about sharing a nickname with the local physician, dealing with parents is a constant for most athletic trainers. For the high school athletic trainer, rarely a day goes by without some contact with parents. And although collegiate athletic trainers interact with parents less frequently, their contact usually involves weighty events, such as surgery or serious injury.
So, what does it take to ensure smooth relationships with the parents of your student-athletes? And if problems do arise, how are they best handled? Athletic trainers who have enjoyed untroubled dealings with parents agree their good fortune is the result of three things: communication, communication, and communication.
“I think the biggest thing is keeping the parents involved,” says Roger Kalisiak, ATC/L, Athletic Trainer and Physical Education Teacher at Hoffman Estates (Ill.) High School. “Most people don’t like to be surprised, and if they are surprised that can be problematic.”
“I can’t speak for other places, but I think most athletic trainers would agree that if you keep the lines of communication open and explain things to parents, you can avoid a lot of problems,” Thomas adds. “Most parents are really appreciative when you do things for them and their kids, and you explain things to them. Then they feel comfortable knowing you’re going to take care of their kids.”
Of course, that level of comfort doesn’t develop overnight. It takes year-round effort, and some of the most effective and beneficial communication can come before the athletic seasons even begin. Preseason information packets usually offer the first opportunity to make contact with parents. Many athletic trainers make sure introductory letters explaining their role are included along with an explanation of pertinent policies and procedures.
Preseason orientation meetings also provide an ideal opportunity to explain your role to student-athletes and their parents. Don’t assume that parents already understand why you’re there. Even at the college level, many people are not familiar with athletic trainers and what they do, so be prepared to explain.
These types of educational efforts shouldn’t be limited to a formal setting, though. “I think any time you have the opportunity to chat with parents—be it in a group setting or individually, and especially when the topic of injuries comes up—you can talk about the kinds of things you do and your role in their children’s injury care,” says Dale Blair, ATC, CSCS, Sports Medicine Instructor and Head Athletic Trainer at Wenatchee (Wash.) High School. “It’s an ongoing education process. The best time to be chatting with parents is during casual contacts—when they’re picking up their kids or other outside opportunities. When an injury occurs is not the best time to be educating the parents.”
Once parents become familiar with you and your role, it will make communication with them easier when their child is injured. However, the extent of communication needed with parents when a student-athlete is injured will depend on each particular situation. At the high school level, the general consensus is to let the parents know about any injury treatment, no matter how small.
“We tell them whenever something unusual happens,” Kalisiak says. “Sometimes, if it’s a minor thing, we’ll ask the student, ‘Do you want us to call Mom or Dad or do you want to handle it on your own?’ But if we’re sending them home with a wrap or putting something in a splint, we’ll draw the line and say, ‘We’re going to call and let Mom or Dad know what’s going on.’”
At the college level, where most of the athletes are 18 or older, the standards for contacting parents are different. “We won’t usually contact parents routinely,” says Kevin Dermer, ATC, MSEd, Head Athletic Trainer at Creighton University. “But if there’s a necessity for surgery or it’s a complex or serious situation, then we’ll contact them.”
And the athletic trainer won’t always be the one making the call. “I always ask the kids at this level if they’ve told their parents what’s going on,” says Mike O’Shea, MS, ATC, LAT, Head Athletic Trainer at the University of Houston. “Then I’ll ask if they want me to call or the doctor to call. They’re grown people and they know their parents better than anybody. We’ll do it however they want us to do it.”
Athletic trainers with the best parent relationships know that although injuries can raise anxiety, they can also be a valuable opportunity to increase parent trust. This underscores the importance of keeping the lines of communication open after the injury is initially treated. In addition, many parents leave the physician’s office with a jumble of complex medical terminology in their heads. Your interest and willingness to sit with them and break those explanations down into simpler terms not only shows your concern for their child’s case, but also for their peace of mind.
When Injury Hits
Of course, parents are most concerned when their child suffers a serious injury. The toughest parents to handle may be the frantic ones who can see only that their child is writhing on the ground in pain. While most parents stay clear and leave plenty of room for you to do your job, a few may insist on coming out on the field. Although few athletic trainers would welcome such an action, it may be easier to let it go than try to stop it.
“You couldn’t keep them away if you tried to,” says Perry Denehy, ATC, MEd, Athletic Trainer and Teacher at Sycamore High School in Cincinnati. “And if you did, there would be a huge confrontation, which is the last thing you need.”
But some athletic trainers have found that it helps to establish a procedure for when a player is injured, and they’ll explain it to the parents well beforehand. “We’re not trying to keep the parent out of the situation, but generally, you want to get the situation controlled first,” says John Donnell, ATC/R, MS, Athletic Trainer and Physical Education Teacher at Lee’s Summit (Mo.) High School. “When we’re down on the field, I prefer that if I need the parents to come down, we’ll motion them on. Generally, the parents who know me know that’s my rule, so they usually won’t come down before that. They know I will find them and talk to them.
“If they’ve seen the play and it’s obvious their son or daughter has been knocked unconscious, most of the time a parent won’t wait,” Donnell continues. “But they will stay back. They’re not going to just push me out of the way so they can talk to their child. It’s the same if a physician is there; they won’t try to push him or her out of the way.”
Other school staff members can also be called upon to assist with parents in these situations. Coaches and administrators can often help explain what’s going on while you tend to the injured player.
“A lot of times our athletic director doesn’t want anything to do with the blood, but he makes a good public information officer,” Denehy says. “He’ll go and talk with the parents and explain who is out there. He can indicate ‘Those are two orthopedic doctors and our two athletic trainers, and they’re out there working on your child.’ Then, as soon as we can, we give them an update. And I’m very cognizant of asking the doctor if he or she can talk to Mom and Dad.”
“Whenever a young man or young lady is hurt, we’ll invite the parents down and tell them what’s going on,” Kalisiak says. “Even if it’s rather minor, I’ll make sure that the athlete identifies his or her parents and while he or she goes to the halftime talk, I’ll try to get over to Mom and Dad and let them know what’s going on and why their son or daughter isn’t playing.”
Parents can even lend a hand to an athletic trainer who needs to return his or her attention to the continuing action after the initial injury has stabilized. “Sometimes, we’ll even ask the parents to come down and help out,” says Rochelle Rittgers, ATC/L, Head Athletic Trainer at Augustana (Ill.) College. “Say, during a game situation where we have to keep an eye on things, we’ll ask them to come down and stay with their child.”
Although it can be difficult dealing with upset parents who have seen their child suffer an injury, collegiate athletic trainers often face the on-going challenge of dealing with parents who may be thousands of miles away. When their child has suffered a serious injury, and particularly when surgery is required, parents unsure about coming to campus turn to the athletic trainer for guidance.
“I feel bad for some parents because I know they’d like to be there for the surgery,” O’Shea says. “They’ll say, ‘Johnny doesn’t want me to come, but I really want to.’ My advice is, ‘If it’s at all possible and you feel you should come, then you ought to come.’ Sometimes kids want to be on their own and they don’t want their parents to come, and that’s between them. But it’s usually good to have the parents by their side.”
Of course, the distance factor can also work against the athletic trainer instead of the parent. Especially at smaller schools, parents might prefer to have things handled by their family physician. While the parents’ reasoning is understandable, the distance poses challenges to the athletic trainer—challenges they must work out, since the parents ultimately call the shots.
“We tend to give the parents the choice of utilizing their own physicians or ours,” Rittgers says. “Certainly, if they choose to use their own physicians, we have even more follow-up work, but we try not to take the responsibility of doctoring out of the parents’ hands.”
The Skeptical Parent
Some of the most difficult situations arise when dealing with parents who are wary of the healthcare system. Whether the result of a bad experience in the past or a general distrust of doctors, some parents are reluctant to take their children to a physician.
“Sometimes all we can do is make our suggestions, because it is ultimately up to the parents,” Thomas says. “If we’ve got an athlete backboarded and it’s a serious injury, or a knee injury and we know the ligaments are torn up, it’s pretty much open and shut—we just say they have to see the physician on this. But if it’s questionable and you’re not sure there’s a fracture or not and the parents say ‘We’re just going to wait a day or two and see if it’s really necessary,’ there’s nothing we can do, because the parents ultimately have the final say.”
“We do have some parents who refuse to take their child to a doctor,” Kalisiak says. “In those cases, we take a very conservative role with their children and document everything.”
In these situations, though, the difference between effective treatment for the athlete and a slow recovery may depend on how willing you are to engage the parents in discussion and alleviate their concerns. “If they’ve had a problem in the past with a physician or other healthcare professional, my guess is there was a breakdown in communication,” Blair says. “Then it becomes a matter of good communication and helping them understand the process of healthcare and of treating that specific injury.”
“You just have to get to know the parents themselves,” Donnell says. “If you don’t get to know them, then you won’t know their situation—maybe they had a bad experience themselves when they were in school and they’re carrying some excess baggage. So you have to feel your way through to determine what the situation is. I can’t speak for all situations, but normally when you do that with them, a large percentage will go to bat and work with you.”
And those who won’t? “We tell them, ‘If this is the way you want to do it, fine,’” Donnell explains. “‘But understand that your son or daughter is not going to play. And that’s unfortunate. Because if they want to play and they could be able to play, they should be playing.’”
In other instances, parents may have a different way of treating their child’s injury. It may involve some home-made remedy or treatment that goes counter to accepted norms of athletic injury care.
“We put ice on many injuries and there are some cultures that don’t believe in putting ice on it; they add heat to it,” Kalisiak says. “It actually makes their case a little worse. And even though you’ve tried to explain that to them, because they’re from another culture and they haven’t had the background, they’re going to do it their way. You just have to try to understand those things and be sensitive to them. Because it is their child.”
Situations like these can really put athletic trainers in a tough position, stuck between a parent’s wishes and enduring a coach’s pressure to get the student-athlete back in the lineup. Though the middle is a tough location to be in, most ATCs feel it’s more important to protect the family’s interests than circumvent those to meet a coach’s demands.
“If I know I could have an athlete back sooner if the parents would follow my suggestions, I’ve learned from past experience not to tell the coach my frustration,” Denehy says. “Typically, the coach is going to take it out on the kid or label him or her with one of those coach’s phrases that really won’t benefit anyone. Although I think open communication is important, if I run into problems with the parents, then I need to be somewhat selective in what I reveal. I just tell the coach, ‘Here’s the plan,’ and I don’t admit that I don’t think it’s the best plan.
“Eventually, I may have to answer to why I told the coach what I told him or her,” Denehy continues. “But I have to look after the best interest of the student, and also realize the parent has the ultimate responsibility and control. So if I’m going to offend someone, I would rather offend a fellow teacher or adult in the building than offend the parent, because the consequences are going to be more severe should I upset the parent. I work for both, but I actually feel a higher allegiance to the parents.”
Thankfully, those parents who deny physician care for their children and concoct home remedies are in the minority. A more frequent area of conflict between athletic trainers and parents are return-to-play decisions. In some cases, parents view the athletic trainer as an obstacle to their child’s return to the lineup and go from physician to physician looking for one who will clear their child for play.
“There have been some difficult situations where parents have doctor-shopped a little bit,” Kalisiak says. “And we’ve had some situations where parents have had to sign waivers before their child could be returned to play.”
Sometimes, problems with parents are completely unrelated to medical treatment. Although state laws vary, athletic trainers can find themselves caught in the middle of such things as custody battles or dealing with parents who may not be in a condition to take their child anywhere.
“We have to be careful that when we release a child to the parent that that parent is OK to take that child home,” says Roger Kalisiak, ATC/L, Athletic Trainer and Physical Education Teacher at Hoffman Estates (Ill.) High School. “There have been a couple of times where parents have come under the influence of alcohol that we have not let the child go with them. That has caused a little bit of tension, but nobody has gotten abusive. We also have a number of children who live with one parent and they’re not to have contact with the other. So we have to be careful about those things, too. But those are few and far between.”
Although these are rare occurrences, there may not be enough time to decide what to do about them on the spot. So it’s best to establish policies and procedures in advance, and share them with all parents. Your school may already have some policies in place that will address many of these situations, but you will also have to see if there are any possible situations that have not been addressed.
Part of the Job
For some athletic trainers, dealing with parents simply comes naturally. For others, it’s a side of the job they have to work at. “Some people are better communicators than others,” Donnell says. “And some of the younger athletic trainers have a tendency to distrust parents. I’ve always felt that parents are my best supporting group, but you have to communicate with them and educate them. Once they understand the process, most of the time they’re very supportive.”
“Young athletic trainers, when they first come out of college and take a head position, sometimes can be intimidated by an overpowering coach or parent,” Thomas says. “But if they just take a step back, relax, and explain things, they can get on the right track from day one.”
Finally, while not all athletic trainers can share the experience of being the parent of an injured student-athlete, O’Shea feels that’s the best guide for an athletic trainer to follow. “The basic thing, at any level, is you have to put yourself in their shoes,” O’Shea says. “It helps you answer a lot of questions appropriately. It’s a matter of understanding and seeing where they’re coming from, and if you do that, it makes it a lot easier.”