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Child life specialists: Making hospitals less scary for kids

  • Eagle correspondent
  • Published Tuesday, March 19, 2013, at 7:07 a.m.

Helping children with medical procedures

Via Christi child life specialists Angie Long and Catherine Coakley offer the following tips parents can use with their children:

Getting kids to take medicine

• Explain the importance of the medication in kid-friendly terms.

• Offer choices when appropriate. Let the child choose the way the medication is offered (syringe, spoon, dropper) or what they get to drink after taking the medication.

• If appropriate, have the child take the medication with their favorite food or a special drink.

• Create a reward or sticker chart for children who take medications on a repeat basis.

• Have the child role play by giving pretend medications to a parent or a favorite toy or doll.

• If your child has difficulty swallowing large pills, check with a pharmacist to see if medications can be crushed or dissolved. Pharmacists can add special flavoring to some medications.

• Praise the child when they successfully take the medication.

Calming kids before shots

• Be honest. There are ways to explain what the child will experience without scaring them.

• Explain the need for the shot: “This will help keep you healthy.”

• Give the child options to involve them in the process such as letting the child pick in which arm or leg the shot will be given.

• Compare the procedure with something they know: “It will feel like a little pinch, squeezing or poking.”

• Give them permission to cry — making the child hold in emotions can often make things worse.

• For infants or toddlers, try comfort holds during the shots. Hold the child on your lap or hug them during the shot. For an infant, try the Five S’s — swaddle the infant tightly in a blanket, lay the baby sideways or on his or her stomach while awake, make a shushing noise close to the little one’s ear, swing baby back and forth, allow the baby to suck on something such as a pacifier — which is a calming method developed by a pediatrician.

• The Centers for Disease and Control Prevention suggest the following comfort holds for infants and toddlers: Hold the child on your lap, place one of the child’s arms under one of your arms and the child’s other arm around your back, and apply gentle pressure for a secure, hug-like hold. Use your free arm and hand to hold the child’s other arm gently but securely, and anchor the child’s feet firmly between your thighs. For older children, the CDC recommends you hold the child on the lap in a similar fashion or have the child stand in front of you and anchor the child’s feet firmly between your thighs.

Whenever 6-year old Malea Borden is hospitalized, Via Christi staff members Angie Long and Catherine Coakley know it’s time to bring out the art supplies.

Malea is a frequent patient at Via Christi’s ChildLife Center, where she gets treatment for the cystic fibrosis she was diagnosed with at age 1. Being in isolation during those two-week stays means Malea has lots of time to get bored and frustrated with her hospitalization.

That’s where child life specialists Long and Coakley come in.

With degrees in family studies and child life, respectively, Long and Coakley help hospitalized kids be kids and comfort them during their hospital stay — by bringing toys and projects to kids in isolation, explaining the medical care and procedures in kid-friendly terms, or even helping parents and siblings understand an illness and express their feelings.

During Malea’s most recent stay, Long and Coakley suggested that Malea and her family transform a large ceiling tile into a work of art that will be displayed in a hallway ceiling. Malea’s sister, mom and dad helped her paint peace signs and hearts onto an orange background. She and her sister also left painted handprints on their artwork. Art projects are among Malea’s favorite activities.

“We have to be creative with Malea because she’s done a lot of the things we have to offer,” Coakley said.

There are more than 4,000 child life specialists across the country. Every pediatric hospital in the country has a child life program, according to the Children’s Hospital Association, as do many general hospitals with large pediatric units.

In Wichita, Via Christi Health employs two. Wesley Medical Center employs six.

Wesley’s child life specialists are assigned to specific units, with two working in the emergency room, and others working in pediatric surgery, pediatric intensive care, pediatric sedation and dialysis, and in the pediatric unit.

Via Christi’s Long and Coakley are assigned to its pediatric unit but will also help in other units, such as the burn center, where children are hospitalized.

While they work in a medical setting, specialists don’t have medical degrees because they’re not involved in direct medical care. They usually have degrees in child development, psychology and similar fields. They also must complete an internship in a medical setting of at least 12 weeks or 480 hours. Pay tends to be on par with a teacher’s salary.

The field is very competitive, with the number of people seeking certification outpacing the number of available jobs, said Dennis Reynolds, executive director of the Child Life Council, a professional organization for the specialists.

Melissa Ramirez, who demystifies surgical procedures for kids as a child life specialist at Wesley, knows all too well how competitive the field is.

When she and her husband moved to the Wichita area in 2006, she spent a year trying to get into a child life program. She finally was hired as a child life assistant at Wesley in 2007, while concurrently completing an internship at Via Christi. It’s not unusual for a specialist to start as an assistant if they don’t have the necessary internship or if they want to get into the hospital setting.

In 2009, Ramirez was hired as a specialist at Wesley.

“There are plenty of other things that I could have done in child development, but I really wanted child life,” Ramirez said. “Kids are so vulnerable, and this can be such a scary setting. But what people don’t realize is that if you sit down and discuss with them the hows and whys, they’ll understand.”

When Ramirez prepares a child for surgery, she visits with them about why they are there, what is going to happen and why, how it will feel and what they will need to do.

She lets the kids decorate and even scent their anesthesia mask with extracts or oils to make it more fun and pleasant to wear. For young kids, she’ll tell them some sleepy gas will come through the mask and help them go to sleep for their procedure.

Using play helps kids cope with what can be scary procedures and situations, agreed Ramirez, Long and Coakley.

Letting a child use a syringe to squirt paint onto some paper, for example, makes it a less threatening tool, Coakley said.

Sometimes Coakley and Long use “shadow buddies,” which are muslin dolls with different medical conditions. The diabetic shadow buddy, for instance, comes with an insulin syringe and snacks to help control blood sugar.

A child life specialist also can help children cope with their emotions about being hospitalized or sick.

“We provide them with a safe place to express their emotions,” said Coakley.

Long recalled helping one angry child express his frustration by throwing wadded toilet paper at a bulls-eye target. Before taking aim, he’d written down his feelings about his disease onto the target.

But child life specialists don’t just help hospitalized kids. They can visit a school to help a child’s classmate and teachers understand a condition, or how to be a good friend to someone with an illness, Long said.

They can help parents and siblings cope with a child’s condition, too.

“A child’s anxiety can be directly related to a family’s anxiety,” Ramirez explained. “We’re here to be advocates for the family and for the child.”

Contributing: Jenny Gold, Kaiser Health News

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