Distraction

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During my internship, my supervisors would often challenge me to provide distraction for patients without using an iPad. I’d often shrug it off because, in the rush of getting called for a procedure while they’re already setting up, the patient already crying and tension rising, the iPad 9 times out of 10 would work like magic.

I love iPads for distraction! They’re big so they cover the view of the procedure. They’re interactive which promotes distraction, kids use them at home which promotes normalization, you can easily sanitize them, c’mon! Well, fast forward 1 month after my internship when I began my first job as a CCLS in the emergency department, not only did I not have an iPad, but I wasn’t approved to use an iPad even if I had one!

I spent 10 months working in the ER without an iPad and boy, did I become creative in my distraction interventions! It was during this time that I saw the real magic of child life. You guys, I once distracted a 2-year-old for an IV start with them laying on the bed alone by reading a sound book! Honest! I have witnesses! No one in the room, including the 2-year-old patient, could believe the #childlifemagic that happened that night.

Don’t get me wrong, as soon as I got approval for an iPad I surely put it to good use, but the tricks I learned during those 10 months of being iPad-less in a busy ER gave me confidence. I remember a great CCLS once told me that to be a CCLS you do not need anything but the head on your shoulders; “bubbles, toys, and gadgets help of course, but the only thing you need to be a CCLS is your knowledge and understanding of child life theory and practice.”  In hindsight, I now understand that this is very true! All that work and practice sans iPad gave me the confidence to be a CCLS that is called into a room with nothing but a dry erase marker in her pocket and doesn’t even think twice about going in.

Here’s a list of some of my favorite distraction itemsMusthaveDISTRACTIONitems.jpg

  1. Bubbles – classic
  2. Sound Books – great for toddlers/preschoolers
  3. Buzzy Bee Distraction Cards – I got a pack of these in my welcome bag at the 2017 FACLP conference. I use it all the time – definitely must have!
  4. Melissa & Doug Reusable Stickers – These are puffy too so no need to worry about them ripping
  5. Light Spinner – classic
  6. Find It – one of my forever favorites
  7. I Spy books – love these which you can find for different age groups in TONS of different character themes
  8. Bright Beats – coolest toy in the toy box! Very interactive, colorful, and musical. Great for toddlers

For a full list of my must-have distraction items, follow the link to my Amazon wishlist: http://a.co/6gscxMo

Again, I love using my iPad as a tool for distraction. It’s an incredible resource and has kept my patients calm and coping during difficult procedures. I have tons of go to apps but as for my favorite iPad app right now I’d definitely have to say the Spellbound app!

I was able to get my hands on a couple of augmented reality cards made by Spellbound. I love technology and was a huge fan of Pokémon Go so I was definitely looking forward to using Spellbound with my patients.

First & foremost, cards are made of wipeable material so you can sanitize in between use; YAY! Set up for the app was very easy – just download the app, enter your email, allow camera access, & you’re ready to see into another world.

My demo came with three cards and kept me and my patient completely distracted throughout an entire IV start and a little while afterward. I can definitely see how having a whole deck of these cards can lead to very distracted patients.

For more information on Spellbound AR follow the link to their website: http://spellboundar.com/

 

What are some of your favorite distraction tools?

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Medical Play

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I’m all about cool toys to promote medical play with my patients. I recently found Pandora’s box of playmobile medical play sets and needless to say, I’m obsessed! I got the “Hospital Play Box” which resembles an OR to use on my surgery/ortho unit. They also have a bunch more like an X-ray room, pediatrician, and hospital.

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Want to see other medical play toys I’m using? Check out my Amazon list!

Medical Play
Link: http://a.co/0iAbvOO

Increasing Compliance

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There are many times that I am asked to help a patient to increase compliance with their plan of care. This can be anything from helping a patient take their medicine to helping them walk around the unit post-op to simply helping them breathe after a breathing treatment. These are the times that creativity really kicks in and I need to have more than one trick up my sleeve. Here are some of the tools I use to help increase compliance:

 

  • Incentive charts – there are tons you can find online like this one that I found on Amazon. Lots of times a sticker chart alone is enough to help a patient increase compliance with their plan of care. Never underestimate the power of stickers, people!71KFeBlCzQL._SL1000_
  • Increase ambulation – this one is always tricky and requires a lot of back up plans. Depending on the age, there are various floor toys that require kids to walk, stand, or move around to engage in play. Again this will all depend on the specific patient and his/her likes, interests, and pain level when needing to walk. Think outside of the box when selecting toys; for example, I once had a teen soccer player who was reluctant to walk after his surgery. I brought out a soccer ball during one of his laps aro614sLwN22hL._SX355_und the unit and he lit up with excitement to be able to lightly kick the ball down the hallway. Another example was a 5-year-old patient that didn’t want to walk after having her appendix removed. I was called in to help after the nurse had tried for over 30 minutes to convince her to walk. As soon as I came into the room the patient exclaimed: “I’M NOT GOING TO WALK!” I validated her feelings and told her I wasn’t going to make her walk. However, I noticed her Rapunzel doll looked a little hungry so I asked the patient if she wanted me to bring in a play kitchen so she could make her some food. The patient eagerly accepted and spent over an hour walking, sitting, standing, and moving around her room as she played preparing food for her doll.
  • Increase PO intake – when it comes to food one must always be empathetic. I would never want to ruin a child’s relationship with food so I always use caution with these interventions. Depending on the age, fun plates/cups/utensils of their favorite characters will do the trick. Other times an incentive chart will help. I’v71PGEs0JBGL._SY355_e had a lot of success with simply changing the subject; stop talking about food and do something else. Leave the food around, engage in play, and the eating will often start organically. I mean, who doesn’t like to munch on some waffles while setting up Lego’s. It’s definitely a syrupy mess but hey, he ate! Providing play food and letting them freely play and feed their toys can also be helpful.
  • Incentive spirometer – many patients are required to use an incentive spirometer after certain breathing treatments. The ones at my hospital have fun designs on them that make them look like a game. However, I get consults to help with these patients all the time! Kids hate using them! So, leave it to me with my bag of tricks to get kids to breathe. Check out my previous post on yoga and deep breathing as this is always my first go to. I also like to give kids choices so I have kazoo’s, bubbles, string pipe toy, and other fun 61n+WVdutdL._SY355_breathing toys to get them to take those deep breaths. Even toddlers get in on the breathing fun by blowing out the candles on my birthday cake. There’s nothing toddlers love more than songs, repetition, and a cause and effect toy!

 

 

 

 

For a full list of resources to increase compliance, check out my Amazon list here:

Increasing Compliance
Link: http://a.co/1sKYUcg

Child Life Market

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All week long I’ve shared with you my NICU tips and tricks. Today I want to share my NICU shopping lists with you!

Must-Have Items for NICU Siblings
Link: http://a.co/hVPChxj

Must-Have Items for Bereavements
Link: http://a.co/gh3Fq3w

Must-Have Items for NICU
Link: http://a.co/9x22vgR

What are your NICU must-have items?

NICU Bereavements

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While it is an honor to be able to be a part of this difficult time in a family’s life, bereavements are always difficult in a pediatric setting. They’re of course difficult for the grieving family, they’re difficult for the staff, and they’re difficult for me. No matter what anyone says/does, this is the worst day in this family’s life. Our role as child life specialists is to provide support to the grieving family. This may be by simply sitting with the patient’s mother and listening to her vent, this may be by helping the family create a memory box for the patient, or even just providing tissues and tea. Every bereavement is different as are the needs of each family. During my time in NICU I have found some incredible resources to offer grieving families.

Angel Gowns  NICU Helping Hands’ Angel Gown® Program began in 2013 because we recognized there was an overwhelming need for better support for families who lost a baby. Our Angel Gown® Program provides comfort for bereaved families through the gift of a beautiful custom-made gown for final photos and for burial services.

I was touched when I received my shipment of Angel Gowns by seeing how much detail was put into the gowns. They’re made from donated wedding dresses and come in a wide range of sizes. The smallest being an “Angel Wrap” for those angels that are too small to clothe, up to extra-large size for infants. The gowns come in individual boxes with a flyer from NICU Helping Hands of various support services they offer grieving families. The gowns are also open in the back with the option to tie, much like a hospital gown.

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Angel Gown for a girl

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Angel Gown for a boy

Angel Wrap for a girl

Teeny Tears Teeny Tears is a service organization that provides tiny flannel diapers at no charge to hospitals and bereavement support organizations for families that have suffered the loss of a preemie or micropreemie child through stillbirth or NICU loss. 

Teeny Tears are another great resource which offer cloth diapers/hats and blanket for the loss of preemies/micropreemies. What I love most about Teeny Tears is that each bundle comes with two diapers and two hats; one for the baby to keep and one for the family to keep.

I have also created an Amazon list of other items I’ve used for bereavements. Click here: http://a.co/iwUT1Zt

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 and guided imagery practices.

I have so much information and resources to share on this topic that I’ve decided to break up this post into 2 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!

 

 

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/