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IU Health North Child Life Department Presentation

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Child Life Department

on 19 August 2013

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Transcript of IU Health North Child Life Department Presentation

Helping Children Cope
with Healthcare Experiences

Child Life:
Why should Child Life be consulted/paged?
If your patient:
will be having surgery
will be admitted to an inpatient unit
will be having a procedure/test or painful/stressful exam, especially when attempting a procedure without sedation
is experiencing unmanageable pain and/or anxiety
What are Child Life Specialists?
A Certified Child Life Specialist (CCLS) is a member of the health care team who focuses on the psychosocial, emotional, and developmental needs of infants, children, and adolescents in the healthcare setting
Procedure preparation

Reduce the stress and anxiety associated with the healthcare experience. Reduce anxiety & increase/maximize coping skills.
A Child Life Specialist utilizes:
A Child Life Specialist seeks to:
What is the Education/Preparation for being a Child Life Specialist?
Bachelors or Masters degrees in Child Life, Child Development, Psychology, Education or related field
Many hours of hands-on clinical training
Full-time 4-month internship
Passing a national exam to become a Certified Child Life Specialist (CCLS)
Maintain their certification through professional development hours.
What services can Child Life provide in the ED?
Bereavement support
Family/Sibling support
Ease patient anxiety
Utilize developmentally appropriate methods for helping children decrease anxiety and increase coping skills. Assist with relaxation/coping techniques, comfort positioning, and the creation of a soothing environment
Provide children with developmentally appropriate materials in order to promote normalization
Distraction for procedures
When should Child Life be consulted?
Child Life is available at IU Health North M-F, days
Child Life Cisco #’s: 688-4390 & 688-4389

Please let the Child Life Specialist know why you need Child Life Consult Child Life as soon as possible.

The more warning, the better the CCLS can assess the situation and prepare the pt.
Tips for Communicating with Children
See handout “Caring for Kids”
When you first enter a pt’s room – introduce yourself and what you are there for
Use the pt.’s name/nickname (ask what they like to be called)
Communicate in a natural, friendly, and relaxed tone
Get down to the pt’s eye level by kneeling, sitting, etc.
Give pt. a choice ONLY when an actual choice exists.

BE HONEST and PREPARE children - explain what you are going to do and describe how it will feel (using sensory information). Each time you talk honestly, children learn to trust you.
Tips for Communicating with Children
Use simple phrases; avoid technical jargon and abbreviations
Children have magical thinking and often interpret the meanings of words literally
Avoid teasing, sarcasm, and euphemisms. They are difficult for children to interpret, especially preschoolers who think concretely not abstractly
“Little ones have big ears”
When consulting with colleagues regarding patient’s plan of care, please discuss information outside of the pt.’s room to avoid misinterpretation by children and families.
Try to refrain from personal discussions with colleagues in the presence of children and families.
Preparing Children for Procedures
Information on the roles and responsibilities of Child Life Specialists & tips
for working with children and families
Why should Child Life be consulted/paged?
If your patient:
is newly diagnosed with a illness/condition
has experienced a recent trauma, death in the family, or other major life event or has other major psychosocial concerns
has siblings/parents/family that would benefit from support and/or education
is noncompliant/uncooperative with staff
Encourage caregiver/family presence during preparation and procedure to provide emotional support to pt., as well as to give some control back to the family

Use appropriate and timely medication and/or topical analgesics to decrease pain sensation/anxiety
Describe what you are going to do and how it will feel (use language to describe how it may feel, smell, taste, sound etc.)

Relay the most threatening information last (so they hear everything else)

Give developmentally appropriate explanations using sensory information and visual aids when possible - (i.e.: let the child feel the tourniquet; show the child there is not a needle on the end of the syringe before pushing meds through the IV, etc)
Preparing a Child for Procedures
Preparing Children for Procedures
Be honest about pain, but acknowledge variation of pain tolerance to avoid self-fulfilling prophecy (i.e.: “some kids say it feels like a pinch and other kids say it didn’t hurt as bad as they thought it would”)

Avoid pain analogies (i.e.: “this will hurt like a bee sting” - a sting may have been very traumatic and painful for the pt and a bee sting lasts longer than most needle sticks)
Give children a job and allow for expression of feelings (i.e.: “its okay to say ouch, but it is important for you to be as still as you can”)

Preparation materials are available through Child Life (i.e.: CT/MRI and OR/surgery photo books, etc.)
Preparing Children For Procedures
Comfort Holds & Positioning for Procedures
*See Positioning for Comfort Poster

What is a comfort hold?
A holding technique that enables the parent/caregiver to provide comfort through a hugging hold during a procedure.

What are the benefits of a comfort hold?
It provides close physical contact with caregiver (i.e.: parent, grandparent) - which helps children feel safer, less anxious, and consequently calmer and more cooperative
Comfort Holds & Positioning for Procedures
What are the benefits of comfort holds?

It provides a sense of control for the child - Lying flat on one’s back can be a very intimidating and vulnerable position for children (especially for young children who just learned to sit-up) and can often be the most upsetting part of the procedure.

It provides a positive way in which the caregiver can participate. The holder is able to give hugs and reassurance through positive assistance-rather than negative restraining or passive on looking.
What do you do when using a comfort hold?
Utilize staff holder for the extremity (i.e.: have a staff member hold the child’s arm for IV placement)

BEFORE the procedure, explain the job/role of the caregiver & it is helpful to give the child/pt. a job role (such as, “Your job is to hold as still as you can and breathe in through your nose and out through your mouth and/or wiggle your toes or help us count backwards from 10 etc.”) and plan some distraction/activity to use during the procedure.
Developmentally Appropriate Comfort Strategies
Sensory :
Sucking (Pacifier)
Cognitive or Behavioral:
Holding a toy or stuffed animal
Bubble blowing by adults
Use objects that change shapes or colors
*See all for Infant

Cognitive or Behavioral:
Pop-up books & I Spy books
Bubble blowing
Singing songs
Nursery rhymes
Pat-a-cake and other finger-play songs

Story telling
Speaking to child using puppet or a doll
Squeezing play-doh
Pretend situations
Pretend roles
Cognitive or Behavioral:
Pop-up books
Bubble blowing
Counting/Alphabet song etc
.Singing songs/Nursery Rhymes
VideosI-touch Apps
School-aged Children
Squeezing Play-Doh
Cognitive or Behavioral:
Bubble blowing
Counting/Alphabet song
Magic Wand
I-Spy books
I-Touch Apps
Videos/Video gamesBreathing exercises
Pretend roles
Pain switch
Visual fixation
Pretend story
I Touch Apps
Squeezing Play-Doh
Cognitive or Behavioral:
Bubble blowing
Video/Video games
Guided Imagery
Visual fixation
Pain switch
Self relaxation
Watch your language…
Therapeutic language to use with kids
Use language to create the expectancy that they are capable and that they can do this!
i.e., “ When you are ready, you can…” (vs. Not “you can try…”), & “I wonder when you will…” (vs. Not “I wonder if you might be able to…”)
Use language that is future oriented. Shift child’s mindset to future and out of the moment we are in…
“When you are done with this…”
“After you do so well…”
“When you are fully into your special place…”
Use language to communicate a sense of confidence in their capabilities
“I wonder how quickly you can allow yourself to…”
“You may be surprised to discover…”

Use language to encourage dissociation from negative experience
“It doesn’t seem like you are having fun paying attention to this. I wonder what you’d like to pay attention to…?”

Use language to help reframe their experience
“ How great will it be to tell this story to your friends…”
Therapeutic Language to use with Kids
Try to avoid
these words:
Try These:
Instead of…
“Take this medicine for your pain”
“This will help you feel more comfortable”

Instead of...
“That’s really bleeding a lot”
“That healthy red blood is washing away all the germs”
“I wonder which cut will stop bleeding first.”
Language Continued
Instead of…
“I know this is going to hurt, but…”
“I wonder if you are going to let it bother you a lot, bother you just a little or not bother you at all…

”Instead of…
“Get ready for the ouch on the count of three…”
“You can notice the poke if you want, or you can just ignore it altogether…either way, it doesn’t need to bother you…”
Language Continued
Child Life Council handouts
Caring For Kids
What is Child Life?
Full transcript