Worth it: 003

 

 

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I found this hidden in my drafts & thought it would be great to post for today’s throwback Thursday! This was written about a year ago when I was still working in the pediatric emergency room. I love this post because stories like these happen all of the time thanks to child life specialists!

(The patient’s name has been changed for privacy.)

When I walked into 6-year-old Bettys room to do an IV teaching, she was nowhere in sight. I asked mom if she was in the bathroom when Betty started to scream from under the sink.  (Side note: Can you imagine being so scared that you hide under a sink?! )”No!” “I don’t want the needle!” “You’re not going to pinch me!” I then crouched down and sat in front of Betty to introduce myself; “Hi, Betty – my name is Diane and I’m a Child Life Specialist. I don’t have any needles with me, but I did bring my bubbles. Do you like blowing bubbles?” Betty nodded. We started to blow bubbles and Betty hesitantly popped them from under the sink. After a little, I said “why don’t you come out from under the sink so that you can pop them better… I’ll make a big one for you!” “Okay!” Betty said & came right out from under the sink.

As we continued to pop bubbles, I started to ask Betty about her  hospital experience. It was her first time, she felt very sick, and she was very worried they might give her a shot.  I validated her feelings and then began to talk to Betty about the different ways we were going to help her feel better while she was in the hospital. I told her about the urine test she did, the flu test she did, the strep test she did, and about her upcoming IV. Betty was now aware that the IV meant that there was going to be a “pinch” involved and that the most important rule for getting her IV was that she could not move her arm because her veins (aka, blue tunnels) are very slippery. Betty also made the decision to play on the iPad while they started her IV so that she didn’t have to watch, and she wanted her nurse to count to 3 before the pinch.

Our plan was in place. I told Betty I would go let her nurse know that she was ready and she nodded & hopped up on the bed. Betty did GREAT with her IV, you would have never thought she was hiding under the sink screaming just 10 minutes before. I was so proud of her and how brave she was with getting her IV!

 

Worth it: 002

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Earlier this week we had a little 5-year-old, let’s call her Emily, visit the ER for constipation. After 2 unsuccessful enemas, the doctors and nurses decided it would be best to just have her drink a medicine that would help do the job of the enema. Little Emily would drink a sip, cry about how bad it tasted, and then spend the time between sips bargaining with her mom for alternatives to avoid taking another sip. During this chaos, one of the ed techs called for me. I went in and introduced myself. Emily was shy and serious upon meeting me, but as soon as I brought out my bubble wand she was all smiles! Leaping up to catch the bubbles, giggling, and smiling from ear to ear. Once all the bubbles popped, she looked at me to blow more – I told her that in order for me to blow more, she needed to take a sip. Immediately she grabbed the cup from mom’s hand, took a sip, and I blew more bubbles. When the bubbles popped and the giggles stopped, she said she didn’t want anymore sips. I encouraged her to take another this and then I would blow a BIG BIG bubble. She smiled again and took another sip. I then blew a big big bubble. This went on for a few minutes while she drank the rest of her medicine. In the end, I congratulated her for being brave and drinking her medicine even though it didn’t taste good and since she was so brave, I gave her her own bubble wand to take home with her. The parent’s were relieved that their visit to the ER didn’t end with their little Emily crying all the way home.

Worth it: 001

  Often times when people learn about what I do I get sympathetic responses and gasps with comments like “that is so sad”, “I could never do that”, “how are you able to emotionally handle such a sad job”. And while yes, sometimes situations can be VERY sad, there are always more good days that bad days! Just to prove that, I’ve decided to share some stories of the good days that make it all worth it! 

IMG_6241             Earlier this week, I was helping a 7 year old girl with an IV start (I work in the ER) which she’s had many times before so she immediately started crying and screaming when the doctor told her she was going to need one. I heard the commotion from the nurses station so I quickly grabbed my “bag of tricks” and went right into her room. We talked for a little bit while the nurse was setting up; about school, things she likes to do for fun, favorite foods, her family, and Halloween plans. Once I noticed that she had become more comfortable, I brought up the IV. We came up with a plan all based on her choices of how she would like things to happen…

  • She and I would play on the iPad while they did it
  • The iPad would block the view because she did not want to see
  • The nurse would first look on her left arm rather than her right arm
  • The nurse would count to three and poke AFTER three
  • She would follow the 1 rule which is: do not move your arm.


          The time came for the IV start and she did AMAZING! She did so great that mom started crying saying that in 7 years, this was the first time that she hasn’t had to be held down while she kicked and screamed. Not only was everyone in the room extremely proud of her, she was SO proud of herself! You could see it in her face how HAPPY she was that she didn’t need to have help to hold still. The mother thanked me for everything I had done but really, it was all her daughter! By giving her choices when she felt there weren’t any, she regained control over the situation and chose what she felt would be best for her. 

Papoose Prep

While not very Child Life friendly, it is sometimes necessary to use a papoose with younger patients in the ER for procedures such as facial lacerations. Up until now, when prepping these little ones for their procedure I’ve told them about being wrapped up like a cocoon but it usually didn’t matter what I told them as soon as the papoose was brought into the room. So, I decided to make a doll-sized papoose so that I can show these little ones about their upcoming cocoon and they can practice putting a doll in & out of it and using the velcro straps! Materials UsedHaving made the papoose out of a mailer and duct tape, it’s easy to wipe down in between patients. The Velcro is also an awesome detail to show them since the real Papoose has tons of it. The Papoose in our ER is blue so to make it as realistic as possible, I used blue duct tape. The metallic pink is from the mailer I used (its actually an ipsy mailer!) This was a nice touch because being pink & blue it can be used with boys and girls without getting annoyed looks from pre-schoolers for having brought the “wrong” color.

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Papoose’s are never fun but are sometimes necessary to keep both the patient and the physician safe when doing delicate work with sharp tools. Hopefully my papoose prep can help ease the fear and anxiety little ones feel when needing to get into their own little cocoon. One more thing, before I’m shunned for having a Barbie that cannot be easily cleaned in the papoose, let me assure that she was just modeling the papoose for Adventuresinchildlife!  I still need to find an appropriate toy to use with patients. 

Tea Time with Activated Charcoal

Earlier this week I had a 2-year-old girl, let’s call her Lily, come into the ER because she had gotten into her grandmothers blood pressure medication. I was able to successfully distract her during her IV, being hooked up to a monitor, etc. After all of this, however, came the hard part… getting her to drink all of the activated charcoal on her own to avoid an NG tube.

Luckily, Lily was thirsty from the moment she arrived to the ER so when she got a bottle with a “black milkshake” in her hands, she quickly latched on and chugged a good amount! After a few gulps, her mouth and chin were covered with black goop and a small drop splattered onto her hand. She stopped drinking and asked me to clean her hand for her (such a girly girl)! However, this was the end of her willingly drinking the “black milkshake” and there was still about a quarter left.

The nurse told mom that Lily needed to drink the entire amount given because this was being given as an exact dosage. At this point mom started to get a little nervous begging Lily to drink it, bribing her with toys, trips to Disney world, ice cream, you name it. But Lily was not budging – she would quickly turn her head the other way and scrunch her forehead.

This is when my “Child Life Lightbulb” turned on! I rushed out of the room and grabbed my tea set (shout out to my Child Life Assistants for always keeping my toys clean for situations like these!) I set up the tea set for Lily, mom, the nurse, and I to have some fun. We pretended to pour tea into our cups, cheers, put “air sugar cubes” in our tea, sing, etc. Lily still wasn’t too happy to be drinking out of her bottle since everyone else had tea cups so, the nurse poured Lily’s drink into a medicine cup which she seemed to be satisfied with. And just like that, Lily drank the last bit of her black milkshake! Thanks to such a pro-child life nurse & a calm & supportive mother, we were all able to work together to help little Lily drink her activated charcoal, avoiding another procedure. This is definitely a Child Life win in my book!

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Image Source: http://www.amazon.com/Fisher-Price-Laugh-Learn-Say-Please/dp/B0083IXKXK/ref=sr_1_3?ie=UTF8&qid=1412110554&sr=8-3&keywords=tea+set+toy

Favorite find of the month

A common problem as a child life specialist is having your toys “walk away”. Being that I’m still fairly new, I haven’t found a grand source for toy donations so the toys that I do have to lend out to patients, I take extremely good care of.
One of my more popular toys is my “little people playsets” – you know, a plastic castle, home, or scene that comes with little characters to play in. Since the playsets themselves are fairly large and have “pediatrics” “please return to child life” “Peds ER” written in sharpie all over them, they rarely* walk away. The “little people” however disappear before they even come out of the box! I’ve been wanting to find a good solution to this that didn’t include spending millions on a lifetime supply of “little people” nor stopping use of the playsets all together.
Earlier this week I made a trip to Target where I found these cute Mystical Ponies! Each pack contains 20 and costs $1 (LOVE TARGET’S DOLLAR SECTION!) For boys, I have dinosaurs/ toy soldiers (not pictured) which also came in packs of 20 for $1. I stocked up on these little figurines & now if they’re taken, I have backup!

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Don’t forget the teens

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During my practicum I always struggled when interacting with teens. Being that I was 21 years old when I was doing my practicum, it seemed awkward for me to provide child life services to someone who was so close in age. During my internship I went out of my comfort zone and really made an effort to connect with my adolescent population. Thus began my new found love for providing child life services to teens (as much as I would for any other age.) Now that I’m working as a child life specialist, I’m always looking for ways to keep our teen population included when it comes to giveaways/things to do while in the ER because while yes, teens do love being on their phones, phones run out of battery and there is only so many times you can refresh your twitter newsfeed before you go crazy. Here’s a list of what I have (so far):

  • A variety of “teen movies” for them to choose from to watch in their rooms
  • Age appropriate board games (apples to apples, connect 4, uno, regular cards, etc)
  • An x-box on wheels with age appropriate games (need for speed, nba 2k13, etc)
  • And, my latest option to hand out: Mandala art!

Mandala art is supposed to be therapeutic to color if you’re coloring from the inside out {https://spiritualityhealth.com/articles/mandala-art-drawing-your-way-wholeness} . I hand out a few sheets and some coloring pencils to my teens who are interested and it’s been a hit! I’m so glad that I’m able to provide my teen population with things that they enjoy & are age appropriate.

Child life month – first timer

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As you all may know, this is my first year celebrating Child Life Month as a Child Life Specialist! Very exciting!! However, I am the only CLS in my department so it’s really up to me how I decide to celebrate Child Life month (no pressure, right?!). Being that I started working in January, I am still too shy to go all out and make shirts, organize a flash mob, create games with prizes, call the news stations, etc. So, here’s what I’ve done!

– A banner (Mara Mi tablecloth target- on sale!) which I hung above a main intersection in our unit. *Warning* the paint bleeds through the tablecloth & paper placed between floor & tablecloth will stick to the tablecloth when dry. #RookieMistake
– We have a bulletin board in our staff bathroom which needed a little tlc so I (with the help of some fabulous nurses that are very excited for Child Life month) fixed up the bulletin board & added a fun little Child Life info sheet which I’ll change weekly for the month of March. The info sheet includes: child life tip, did you know…?, get to know your child life specialist (2 truths & 1 lie about me), & a favorite child life quote.
– I was also able to gain custody (for this month at least) of a bulletin board in a high-traffic area in our unit! I dressed it up with “Lucky to have Child Life” (idea inspired by a post on the Child Life Council blog) & a “who, what, when, where, & why” about child life (info from the Child Life Council as well).
– I wanted to do a little more so I met with my boss to see what she could help me with to celebrate Child Life month & I was able to write a post for the monthly newsletter and have food ordered for the staff on a date of my choice.

Not too shabby for a first timer, if I do say so myself! The staff in my ER is great and really supporting my role as a CLS. From doctors and nurses giving me excellent referrals, to staff members asking if they can help me bag crayons or clean toys, to even brainstorming child life month activities! I may be the only cls in my department but I’m definitely not alone :).