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.
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.
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
Coming to our medical center, whether for a stay, day surgery or ongoing treatment at one of our specialty clinics can feel overwhelming and even scary to our young patients. Children and teens of all ages can feel stressed or worried during their visit. The unfamiliar environment, loss of control, fear of pain and lack of routine are among the most common anxieties young patients feel during a health care encounter. The Child Life specialists at Cook Children's are here to help.
Child Life specialists work with kids and families to make their visit to the medical center easier and more comfortable. We offer your child and your family an opportunity to express and work through any fears and concerns you may have. We'll also provide an explanation about what's going to happen during your visit and work with parents, brothers and sisters and other family members who may be involved in your child's daily care.
As a part of our commitment to family-centered care, Child Life specialists work with your child's health care team to advocate for and ensure your child's and your family's needs are addressed in the most nurturing atmosphere possible.
The Child Life program at Cook Children's offers a variety of services, all designed to make your experience at Cook Children's the best it can be. Our services include educating, preparing and supporting your child through tests and procedures, as well as coping with any life challenges you and your child may face.
Our Child Life specialists and activity coordinators also provide meaningful play and recreational opportunities for patients and siblings visiting the hospital to promote growth, development and some much needed fun. Best of all, the services are available for free. Child Life services include, but aren't limited to:
- Activities and toys for families to engage in while they are in their hospital room
- Developmentally appropriate teaching about diagnosis, treatments and life changes
- Opportunities to desensitize and explore real medical equipment through play (medical play)
- Preparation for medical exams, procedures and surgeries
- Assistance with coping strategies, distraction and/or support during stressful events
- Support to siblings and other family members visiting a patient
- Celebration of birthdays, milestones, holidays and essential life experiences
- A visit to a child's school after life-altering injury or chronic illness to help classmates understand and make it easier for the patient when returning to classes
- Developmental assessments and referrals to community resources
- End-of-life support to patient and family as well as bereavement support for family members
- Child Life Zone is a treatment-free fun zone where kids, teens and family members can go for games, art, music, reading and relaxing
- CARPE (Creative Artist in Residence Programme) connects patients to the art of healing through creative expression
- Provide information about hospital amenities
About Cook Children's
Cook Children’s is more than a health care system: we strive to be an extension of your family, growing with your child from their first steps to adulthood. By collaborating to deliver on our Promise—to improve the well-being of every child in our care and our communities, we connect the dots for our patients. Between primary and specialty. Between home and medical home. Between short-term care and long-term health.
Based in Fort Worth, Texas, we’re 8,000+ dedicated team members strong, passionately caring for over 1.5 million patient encounters each year. Our integrated, not-for-profit organization spans two medical centers (including our new, state-of-the-art location in Prosper), two surgery centers, a physician network, home health services and a health plan. It also includes Child Study Center at Cook Children's, Cook Children's Health Services Inc., and Cook Children's Health Foundation.
And our impact extends beyond the borders of Texas. We proudly treat children from virtually every state in the nation and 32 countries. By seeing the world through the eyes of children and their families from all backgrounds, we’re able to shape health care suited to them: connected by kindness, imagination and respect — with an extra dose of magical wonder.