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?

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.

 

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/

& my adventure continues…

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LOT has happened these last two months in my adventure in child life. I am so happy and excited to let you all know that I have started a new job as a child life specialist at a new hospital! Here’s a list of the crazy changes this new job brings:

  • Children’s hospital within an adult hospital –> Stand alone children’s hospital
  • Independent child life program –> Well established child life team of 12+ specialists
  • Out patient setting (Emergency Room) –> In patient setting (Respiratory Unit)
  • Working 3pm-11pm –> Working 9am-5pm (This is huge! As a morning person, this is something I’ve missed – big time!)
  • Very limited resources to provide for patients/families –> A WORLD of resources to provide for patients/families
  • Short length of stay for the patients –> Long length of stay for the patients
  • Very fast paced interventions –> Slower paced interventions

I am so excited about all of the changes and what this means for my professional growth. I am eager to learn about the new population of kids I will be working with and to be a part of such a big and supportive Child Life team. Having done my practicum and internship at stand-alone children’s hospitals, being a part of a big Child Life team is something I’ve always missed.  Support from other CCLS’s is an invaluable aspect of succeeding in the Child Life world in my opinion, and I am so happy to have that again.

However, I want to take the time to state how incredibly blessed I feel to have been able to spend my first two years as a CCLS working in an emergency department. I wouldn’t trade the time I spent there for anything in the world and I feel that it served as an incredible base for my career. Here’s what I learned:

  • Confidence; In the ER you’re not always called upon to provide services for patients. Things happen very quickly, there is a lot of stress in the air, everyone seems to always be rushing. Being in the ER taught me how to throw myself into situations that I wasn’t necessarily invited into.
  • Prioritization; Being the only CCLS on staff in the ER, it was up to me to cover the 24 beds and be aware of where my services were most needed. Being in the ER taught me how to figure out how to prioritize my census list.
  • Thicker Skin; The nature of the emergency room is usually very fast-paced and stressful with a wide variety of medical staff. Being in the ER taught me how to work with people in high stress environments and how to work with difficult personalities (to all of the Grey’s Anatomy fans, think…working in a place with many Christina Yangs).
  • Empathy; The ER is also filled with highly anxious patients and parents waiting for answers about recent changes in their child’s health. Working in the ER has taught me how to listen and really understand and address the fears and concerns of the patients and families we see.
  • Teamwork; There is something unique about working so closely with your co-workers in an environment like the ER. I quickly became very close to many of my co-workers which not only made work more fun, but made us “the dream team” when providing support for our patients and their families. I consider many of my co-workers some of the best friends I’ve ever had! Working in the ER taught me how crucial it is to be a team player.
  • Knowledge; The ER is the front line. We get everything, the kids with asthma, the kids with lacerations, the kids with appendicitis, kids with the flu, new chronic illness diagnosis, kids with broken bones, the list goes on and on. Working in the ER has given me knowledge of a wide range of symptoms, diagnosis, and treatments, which is sure to help me along my adventure in child life.

Again, I’ll always cherish the two years I worked in that ER; the families I met, the laughs, the tears, my beautiful work family I became so close to, and most importantly, all of those times I saw the true magic of what Child Life is all about.