Empowering Pediatric Patients
The following post was written by UCSF Benioff Children’s Hospital’s Certified Child Life Specialist Lauren Meyer, MA.
As a child life specialist in UCSF Benioff Children’s Hospital’s Emergency Department and Department of Radiology, I use child development knowledge to help support children and their families in the hospital setting. By normalizing the hospital environment through play, providing emotional support and information about what to expect, and advocating for children, I help to make a possibly challenging experience a significantly more positive one. Each child and family brings different experiences, strengths, and knowledge, and I take that all into consideration when offering support and helping them through a pediatric imaging exam or procedure in the Emergency Department.
I use medical play as a way to help children understand what they’re going through. –Lauren Meyer, MA
When it comes to expectations, the unknown can cause fear and anxiety in both children and their parents. Part of my role is making the unknown more familiar and predictable. One aspect of this is preparing children in a way they can understand based on their age and past experiences. I emphasize the sensory elements – cold sensation from IV contrast, loud noises during a MRI study, or a tugging feeling during sutures – along with the sequencing of steps.
I use medical play as a way to help children understand what they’re going through. For a child who needs an IV or VCUG, I might use a doll and real medical supplies to demonstrate the steps. Allowing children to explore materials through medical play bolsters their understanding and also helps me to understand what a child might be feeling or thinking. Additionally, it makes unfamiliar items like a tourniquet or anesthesia mask more familiar and thus less threatening, mitigating some fears. In Radiology, we even have a small wooden CT/MRI model along with a Lego MRI model that children can play with and explore. Preparation and knowledge through play helps to not only alleviate fear and anxiety, but also to identify areas that a child might find difficult. For example, a patient might identify getting an IV as the hardest part of an MRI so thinking of ways to help support a child during this part is essential.
I try to build on current coping skills that a child may have to help navigate a procedure. If a patient uses deep breathing in school, I will coach them to do the same during the procedure. The introduction of new coping strategies, like distraction or focused attention, helps kids to better tolerate the experience. When a child is focused on an I Spy book during a procedure or movie goggles during an MRI, they may forget that they are even undergoing the procedure or exam.
By incorporating familiar and “fun” aspects into the hospital setting – for example through our patient-friendly scan suites – the unknown becomes more familiar, which helps to normalize this environment and make it less scary. Playing games with children in the Radiology waiting area, offering familiar items like toy trucks and coloring sheets to children in the Emergency Department, and blowing bubbles with the younger patients helps signal that this is a place where children are welcome and that staff here is trained to work just with kids.
Involving parents in this process is key. Parents are the experts on their children and benefit from being actively involved in their child’s care, possibly reducing some of their own anxiety. Helping a child and family develop a coping plan allows even a challenging event to be more manageable.
The language we choose can also greatly influence a child’s assessment of a situation, so we encourage the use of “softer” language to more positively influence a child’s expectations. Instead of using words like “burn” or “shot,” we use “warm” or “poke.” The goal is to soften language but still be honest with children, and I work to share these softer options with staff, too.
In addition to working with the pediatric patients and their parents, child life specialists also work closely with the pediatric healthcare team. With my knowledge of child development and how development impacts the medical experience, combined with the healthcare team’s medical skills, together we are able to create medical plans that best support each pediatric patient. I act as a liaison between the family and medical team, gathering information from parents about what worked well in the past and then brainstorming with the medical staff about how to incorporate those successful aspects.
Working both in the Emergency and Radiology Departments is helpful, as many pediatric patients in the ED have to visit radiology for x-rays, CT scans, and MRIs. By working in both places, I can better prepare a child for what they will encounter, with the goal of providing a more positive experience for the child.
The most rewarding part of being a child life specialist is seeing kids be successful, make progress, or feel proud about what they were able to accomplish or cope with in the hospital setting. It is heartwarming to see a child come out of an MRI giving high fives and saying, “I did it!” and then sharing what it was that helped him or her accomplish this goal.
I recently did medical play with a 5-year-old patient who needed an IV. The young boy listened and watched intently during the preparation and coped very well. Later, when his aunt asked him about the IV with hesitation, I heard him explain in great detail about the “tiny tube” in his arm for medicine; he exhibited so much pride and mastery in his explanation. Knowledge is power, and we, as child life specialists, hope to empower kids daily as they undergo medical treatment and procedures.
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