Yoga + Child Life – Part I

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You may remember at the end of last year I enrolled in the Rainbow Kids Yoga teacher training ( see post here ).  Let me start off by saying I am by no means an expert Yogi! I enrolled in this course not to deepen my practice or ditch child life to become a yoga teacher but rather to use the theory of yoga in my day to day as a CCLS. Fast forward 7 months after the Rainbow Kids Yoga training: it’s worth it!

I use the skills I learned with Rainbow Kids Yoga almost on a daily basis with my patients. So, what did I learn and how am I applying it to child life? For starters, it’s important to realize that yoga is more than just poses and flexibility. In fact, I don’t use yoga poses at all with my patients. What I do use is deep breathing exercises, guided imagery, and mindfulness practices.

I have so much information and resources to share on this topic that I’ve decided to break up this post into 3 parts so stay tuned for more!

As a lover of free resources, I have set up a google drive where I’ve uploaded tons of freebies from teacherspayteachers.com on this subject. Click the link below to view:

https://drive.google.com/drive/folders/0B7up2fwr6___OXJ4MUlJRnNoNjg?usp=sharing

Part I:

Deep Breathing

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Any wise 7-year-old will be quick to tell you that breathing is important – we have to do it to stay alive! And while this is quite true, our breath also has a big impact on our mind and how we cope with experiences.  image-4722.jpgSee this picture example of how our breath changes as we become stressed. This is where yoga comes into action! By teaching children different breathing exercises during times of stress/anxiety, they will be able to slow their breathing thus helping them cope, remain calm, and feel a sense of control.

There are TONS of kids breathing exercises you can find with a quick google search. For example one of my favorites is Snake Breath – take a big breath in and as you exhale make a “Sssss” sound as long as you can. Another favorite of mine is Lion Breath – take a big breath in and as you exhale stick out your tongue and make sure to make your meanest lion roar face. Find inspiration online or make up your own! I made up Bubble Breath – inhale and pretend you’re blowing one really really big bubble as you exhale // inhale and pretend you’re blowing out millions of really little bubbles as you exhale. For some little ones the concept of “inhale” and “exhale” may not be appropriate so change up your terminology to something like “smell the flowers, blow the leaves” or “smell the birthday cake, blow out the candles”.

In an effort provide a visual for the patients and to help me remember so many different breathing techniques, I created a laminated breathing cards with different clip art depicting the type of breath.  Shout out to Gretchen Blackmer for the inspiration for these breathing cards http://www.everydaywarrioryoga.com/ 

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Another great tool to use to show patients the effects of breath is to use a  Hoberman Sphere.This is one of my favorite resources to help kids really understand how lungs open and close with each breath. Plus it’s an overall really cool toy and instant rapport builder in my opinion. I’ll guide my patients in doing the different breathing exercises with the Hoberman sphere so they can see the full effect.

Another great tool I’ve used to support my breathing exercises is the book “Breathe, Chill: A Handy Book of Games and Techniques Introduced Breathing, Meditation, and Relaxation to Kids and Teens” by Lisa Roberts. This book breaks down various types of breath and how/when/why to use them. After I purchased this book I read the testimonials on the back and saw one of them was written by a CCLS! Just goes to show how beneficial yoga practice can be in the field of Child Life. You can find this book here on Amazon. 51NfLPIAGjL._SX346_BO1,204,203,200_.jpg

I’ve had many kiddos that really enjoy doing these deep breathing practices before/during/after procedures. I even had a patient choose my breathing cards over my iPad for distraction during her first IV! Not only do these skills help them cope with the present situation, but they walk away with a new coping technique in their pocket for future use & that’s what child life is all about!

 

 

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Asthma Education

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Asthma is a pretty common diagnosis, not just on the respiratory unit where I work, but everywhere! I had asthma as a kid and I know lots of other kids around me had it too. It was something pretty “normal” to me growing up and I never really thought twice about what it was, why I had it, and I loved that it came with the perk of not having to run the mile in P.E. Even while working in the ER, a chief complaint of asthma was not a high priority compared to everything else coming into the department  (unless the patient had a very bad asthma attack).

Seeing more and more asthmatics come onto my unit now in the “winter” months down here in Miami, I began doing lots of research on different asthma education resources. I found tons of resources just by typing in “asthma education for children” in Google.

Here are just a few I found:

The list goes on and on and on, however, after a couple of asthma teachings using these resources, I felt like something was missing. I wanted to my patients to reach specific goals I had for them which were not always all covered by the resources I found.

My goals for my asthma lesson plan are:

  • What part of the body is affected by asthma (lungs)
  • How many lungs they have (you’ll be surprised how many older school aged kids have told me 1!)
  • What happens when you have an asthma attack (bronchial tubes become tighter)
  • What can cause an asthma attack (identifying triggers)
  • How can you help lungs/airways feel better if you have asthma (long-term medicine/quick relief medicine)
  • and what are the symptoms you might feel when you are in the green, yellow, or red zone (self-awareness)

I mixed some pages from various resources I found online and also created some pages myself to help me get my message across the way I feel is best for my patients. While creating my new asthma education packet, I still felt like I was missing an effective concrete example demonstrating the difference between healthy lungs and lungs experiencing an asthma attack. That’s when I created the activity below!

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  • While going over our asthma education packet, the patient and I cut out lungs from the packet (the best  printable version of lungs I found were from this website: http://learncreatelove.com/printable-lungs-craft/ ).
  • Then the patient and I will glue the lungs onto paper lunch bags. In an effort to save paper/materials, we make 1 lung with asthma and 1 lung without asthma vs 2 lungs with asthma and 2 lungs without asthma.
  • After we glue the lungs onto the paper bag, we tape a smoothie straw into one lung and a cocktail straw into the other lung. I have the patient then blow into the healthy lung and suck the air out a few times. Then I have the patient blow into the lung with asthma and such the air out a few times as well. This way, the patient can clearly experience the difference in breathing and how it is much more difficult to breathe during an asthma attack than when lungs are healthy. *Check with the patient’s nurse before doing this activity to make sure the patient is clinically stable enough to do breathing exercises. You wouldn’t want to exacerbate them!*
  • After this activity the patient and I then continue with the education packet (triggers, medicines, etc.)

There are TONS of resources on asthma out there – asthma books, asthma camps, asthma videos, asthma games…look on the child life forum too! As a reinforcer, I also created an asthma memory game to make patients more aware of common terminology usually associated with asthma (albuterol, pulmonologist, inhaler, spacer, etc.). I also encourage them to download (with their parent’s permission) an app called “Widzy pets” which centers around asthma education in a fun way.

What are some ways you help your patients learn about asthma?

Grape medicine cups 

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Taking medicine isn’t always easy – especially when it needs to be taken every day for an extended period of time. Non-compliance with taking medicine can also cause a great deal of stress for parents, especially when it’s the one thing keeping the patient from being discharged. One of my patients was having a hard time with this task so to make things a bit more tolerable, we decorated her medicine cups. This patient really wanted it to be grape flavor however we couldn’t give her that option for this particular medication. To try and fix her grape craving, we stuck with the grape theme for her medicine cups. The medicine is still unpleasant, but creating these cups & giving her choices made the whole process a little more tolerable. What are some ways you help patients be compliant with taking their meds?

Shield of Bravery!

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One of my younger patients was a little shy and nervous to be back in the hospital setting so we made a shield with tips to help him be brave. We had a lot of fun making this shield and of course, I learned so much more about him during the activity. I learned about his past hospital experiences, different ways he copes during procedures, and which procedures he has a difficult time with. He proudly hung up the shield on his bedroom wall and now had a visual reminder of his own tips on how to be brave.

His tips to himself were:

  • Take medicine to help you feel better
  • Look away
  • If you get bored, call volunteers to come and play with you
  • Count down
  • If you don’t want to take your medicine, just take it fast and get it over with (this one was my personal favorite)

Helping non-verbal patients have a voice

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I recently had a patient that was unable to speak after a surgical procedure. She was developmentally appropriate and had no prior history of hospitalization so all of this was new and very frustrating for her. Her nurses came to me asking for help because she was having a very hard time communicating with them.

Here’s what I knew: she enjoyed playing on the iPad but did not have the strength to hold it up to type, she didn’t have the fine motor skills she once had to be able to use a marker/paper to write, and she had no family at his bedside to speak for her. I began to think of what she can do rather than what she can’t…. that’s when my creativity light bulb lit up! I created  a communication chart for her.

One thing that she could do is move her arm/hand around and point. That was perfect! I found a chart with a couple of key phrases and emotions on it via google images by searching “communication chart”. I also created an empty template for her and her nurses to include more personalized phrases. I put both sheets into a sheet protector with a piece of cardboard in between so that it was sturdy and ta-dah!

My patient and the medical team working with her loved this communication chart and it truly helped her have a voice again.

 

Favorite find of the month

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As any child life specialist knows, finding a doll with plastic hair is like finding a hidden gem! Due to infection control precautions, cloth dolls or dolls with hair (barbie) should not be used in between patients because they are not able to be properly cleaned/sanitized. I was so excited when I found this Aladdin for 2 reasons:

1. his plastic hair making him easy to clean and maintain

2. Aladdin is a boy making him more relatable and engaging for my boy patient’s

I placed a PICC line on him for now but who knows, maybe in the future, he’ll need an IV or help me demonstrate an OR prep or a breathing treatment. I am so excited to have him by my side!

You can find your own Aladdin doll on  Amazon !

Cystic fibrosis teaching

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Recently I had a school-aged boy diagnosed with cystic fibrosis (CF) admitted to my unit for a “tune up”. He told me he was in the hospital because he had CF and when I asked him what CF was he said: “I don’t know what it is but I know that I have it…”. I asked him if he wanted to learn a little about what CF was and he agreed! Right away I went to grab a Huxi book, some crayons, and coincidentally I found a panda stuffed animal in our prize closet. We read through the book and talked a lot about mucus and the parts that it effects in a person’s (or panda’s) body with CF.

After we talked about mucus, then things got really fun… we made slime (aka, mucus)! There’s nothing school-aged boys love more than making gross, icky, gooey, slimy mucus. I wanted to make slime with him so that he could have a concrete example of how sticky and gooey mucus can be. While we were squishing the slime around in our hands he began to ask questions like “how do we get rid of mucus?”. I answered his question by asking him about things he does at home – breathing treatments, enzymes, wearing his vest, etc. We also talked about other ways he can help his body get rid of mucus like eating healthy and being active.

I am so glad I had the opportunity to teach my little patient about CF & that we both had so much fun!

 

Let’s talk about camp!

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Back in March, I mentioned I was working at one of my hospital’s week long camps for patients with special healthcare needs. Now that I have some more free time having finished with school, I’m ready to let you all in on the magic I witnessed during my week at camp.

Our camp is a (free) week-long spring break camp for children that need a little extra help breathing from the use of a ventilator and their families. This includes children with tracheostomies – needing a ventilator, C-PAP, Bi-PAP, or oxygen to help them breathe. The campers come from all over the world to spend their spring break doing fun activities such as going to the beach, going to the pool, going on a yacht around  Biscayne bay, and having a dance party at the hard rock cafe!

This may sound nice to anyone, but this camp has a profound positive impact on the lives of its campers. Due to their medical condition(s), many of these campers are not able to do the activities they do at camp when they’re home. Our camp is fully staffed with volunteer nurses, doctors, respiratory therapists, nurse practitioners, high school volunteers, nursing school volunteers, and a child life specialist (guess who!). It is thanks to so many medical professionals volunteering that these campers have the opportunity to bathe in the ocean or in a pool. For many of the campers, our camp is the only time of the year when they are submerged under water.

Our camp also gives the campers, their siblings, and their parents an opportunity to realize that other children go through similar medical experiences – just like them! With this tone of equality and normalization set within the first day of camp, it allows the campers and their families to relax, let their guard down, and just have fun!

Needless to say, I was blown away by the immensely positive impact this camp has on the lives of its campers, their families, and the dozens of volunteers that spend their spring break vacation dedicated to this organization.

To all child life students: this is a perfect example of how to stand out in the child life world. Not only would it look impressive on a resume, it will also help you with your personal professional development and medical knowledge. I’m not going to lie, I know that for my hospital’s camp there is a big commitment for those volunteering (in the end totaling 90+ hours). But, in my opinion, it’s worth it! There are camps like the one my hospital hosts all over the country and for various medical specialty populations. Had I known about this camp earlier on in my adventure in child life, I would have totally volunteered!

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You can’t have a rainbow without a little rain

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It’s been almost 5 months that I’ve been working at my new job as an inpatient child life specialist. Having been an outpatient child life specialist for 2 years, I am loving the change. Some of the things I love the most about my new role is having ample time to build rapport with my patients, having time to provide more in depth diagnosis teachings, and my new favorite thing: engaging my patients in therapeutic activities! Therapeutic activities is something I’ve always tried to incorporate into my child life practice however due to the nature of the fast paced emergency room, I rarely got the chance to. Here is one activity I facilitated during my first couple of weeks in my new role.


At first, I was a bit nervous because I was not sure that I’d be able to know which one of my patients would really benefit from a therapeutic activity. However upon meeting one of my teenage patients who’s frequently hospitalized for extended periods of time due to her condition, it was clear to see this was the perfect opportunity. I presented the activity to my patient with the theme of “you can’t have rainbows without a little rain”. In the clouds, she wrote things that make her feel sad about having to be hospitalized and in the rainbow she wrote benefits of being treated at the hospital. This way she has a nice reminder of the “pro’s” of being in the hospital when she needs a pick-me-up.

She and I both had so much fun putting together her poster board and I was able to learn so much about her.  As for the materials I used, I put together supplies last minute after coming up with the theme. In fact, all I had with me was a poster board and cloud cut outs! I had the patient choose between markers, crayons, paint, glitter, magazine cut outs, etc. and just followed her lead with how she wanted to create her art. Not too shabby for our first time, eh?!

Cystic fibrosis resources! 

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Working on a respiratory unit I often have patients that have been diagnosed with Cystic Fibrosis (CF). This is a population I never worked with at my previous position in the pediatric emergency room so I had a lot of learning to do coming into my new position. May is CF awareness month so I thought I’d share some of the amazing resources I have found to help educate and support our CF patients.

With a quick google search, I was able to find (free!) resources via the cystic fibrosis foundation web page. I requested a couple of items, one of which is my ultimate favorite: a coloring/story book about a little panda with CF name Huxi! I was also sent booklets for parents/caregivers, booklets for teens, and a big “ultimate guide to CF” binder, stress balls, and luggage tags. I am so thankful for all of these resources and how they will help my patients (and myself) learn more about CF.

To see where I found these resources, follow the link below:

http://www.foundcare.com/fc-patients/resources/