How Child Life Specialists Can Help Patients Through an Important Aspect to Pediatric Health Care

Child Life Series: In the last series, we discussed emotional safety within the context of our homes and the ways that we could support the expression of our children’s emotions, validate our children and advocate for them in all settings. This spring series will discuss the pillars of Child Life  – emotional safety, family-centered care, and play - within the hospital environment and how Child Life serves patients and families.

By Ashley Pagenkopf, MS, CCLS, Child Life Specialist at Cook Children's

Every shift in the Emergency Room, I enter rooms of patients and families that have never graced the doors of a hospital, and within a few minutes of meeting them, we will be starting an IV, drawing blood and swabbing their nose and throat most likely. They will have already met upwards of 10 new people. Sometimes, within 10 minutes, I have prepared them for surgery.

I have less than five minutes to build rapport, establish trust and prepare them for this moment, but they are arguably the most critical five minutes for the patient’s emotional safety. Many people have never heard of Child Life before entering the hospital, and many leave without fully understanding what child life can provide. The Association of Child Life Professionals (ACLP) states that our mission is as follows:

We, as child life professionals, strive to reduce the negative impact of stressful or traumatic life events and situations that affect the development, health and well-being of infants, children, youth and families. We embrace the value of play as a healing modality as we work to enhance the optimal growth and development of infants, children and youth through assessment, intervention, prevention, advocacy, and education. 

Child Life exists within the hospital environment to combat the unavoidable stress that accompanies children and families from the moment they enter our doors.  We work alongside the doctors and nurses to build rapport and establish trust with the patients and families.

Medical care is a part of all our lives. However, many adults do not seek adequate medical care due to traumatic experiences as a child. If we can normalize the hospital environment and make it feel more comfortable, then we are able to meet the needs of children while also providing them with the care they need.

The emotional safety of children and families is our top priority, and we help children and families cope with stress. The ACLP defines emotional safety as “an intentional, interdisciplinary practice to promote resiliency, healing and trust for pediatric patients and their families during medical experiences.”

Assessing the patient

First, a Child Life Specialist will assess the patient. We establish how a child relates to and experiences the world. We create a plan to help them cope with their health care experience. Every child is different, and every age group responds differently.

We learn what is helpful for them, what they enjoy, what they fear and how they will respond. We are also assessing the same things in their caregivers and their siblings.

Babies need comfort and the assurance of security. Toddlers and preschoolers need some control as well as comfort. School-age children often need all the information and the opportunity to ask questions. Pre-teens and teens need and desire autonomy and independence.

Preparing for a treatment or procedure

Child Life Specialists prepare patients and families for what they are going to experience. Children respond to their senses, and we know from research that children can respond better when they know what they will see, feel, hear, taste and smell in advance.

The most important part of preparing children is the use of developmentally appropriate language. Child life specialists prepare patients for all procedures including taking their blood pressure (arm hug), inserting an IV (medicine straw), going to surgery, getting stitches (string band-aids), and much more.

When children know what to expect, they can more effectively respond to what they are feeling. Procedures take less time and are accomplished more effectively when a child understands what is happening before it is happening to them.

Supporting patients and families

Next, child life specialists support patients and families through procedures and experiences. Child Life can assist parents and caregivers in comfort positioning. We can also help patients utilize deep breathing and other techniques.

Often, patients cope beautifully with distraction. Typically, distraction works most effective after a child has been prepared and established trust with the medical team. This is where you will see a child life specialist utilize an iPad or other distraction tool.

Child life specialists also support patients and families through traumatic experiences by utilizing debriefing techniques and emotionally supporting patients and families with new diagnoses. We also support patients and their families through trauma, death, and dying experiences.

Child life specialists are educated in grief and bereavement and support families with legacy items and on-going grief support following trauma and tragedy.

Education

Child life specialists also educate patients and families on new diagnoses and other new information.

I often tell kids that we are paid to tell the truth. We believe that children cope better and are more successful with hard procedures by understanding what is happening and why. One moment we educate children about why an IV is the best way to help their bodies, and the next moment we explain what cancer is and how it affects their bodies.

Play

Often the best thing that we can do within a stressful environment is to bring a little bit of normal to the mix. For children, their normal is play. By incorporating play in every aspect of what we are doing at the hospital, we can communicate with the patients more effectively and allow the hospital environment to become much less threatening.

This looks like toys in every area from the ER to the clinics to the inpatient floors. We also provide medical play where children can be in control of the medical procedure and process through their own experiences.

This also looks like decorating rooms and celebrating events even in the hospital from birthdays to holidays to Easter egg hunts. I would argue that our patients and families have some of the most fun of their lives within our walls and this is one of the best parts of being a child life specialist.

Child Life has a unique role and goal within the health care team. Our job is to bridge a gap between very scary health care experiences and children. We want kids to walk away very proud of themselves even after a hard day. They can sit still. They can take deep breaths. They can do the hard one more time, one more day.

We want children to see that they have what it takes to get through hard things, and it’s our job to call it out and help them utilize their internal strengths. Child Life Specialists are available throughout the Cook Children’s system. It is our pleasure to support your children