just another day at work.....

While doing my practicum last semester for Child Life at my local children's hospital,
I got to do something the average person might think as surprising.

I played monopoly for an entire hour.

Uninterrupted, we played monopoly in the oncology clinic for an hour.

While a patient waited for treatment/to see the doctor/for a procedure, we played monopoly and then moved onto making crafts.
And in that moment of playing a simple board game, I realized, "This could be my job someday! Playing monopoly!"
How cool is that?
Very- if you ask me!
Because in that moment, all the boy needed was someone to play with and something to keep his mind off of what he was waiting to do. And where he was. And that he was sick.

During that hour, I was able to bring a smile to his face,
act goofy and silly,
made sure he wasn't changing the rules (the stinker!),
made up weird words,
sang,
laughed,
and hammed it up!
All for a great cause :)
In those moments, I was able to remember that God didn't give me the gift of being overwhelmingly talented with talking to adults, but with talking with kids.
With that gift, I can inspire, distract, teach, excite, humor, energize, mold,  pretend, be silly, and love on some kids who need it a lot! Thanks for that God! .amen.

and now onto my main reason for typing this here post:


Volunteering/working at a children's hospital means that a normal day can include any of the following:

-playing an adapted form of monopoly (or any other board game)

-making a collage out of teen magazines

-tracing horses straight out of a book

-playing computer games

-playing bingo

-winning awesome bingo prizes

-learning how to play video games

-being totally and completely crushed by a little kid at said video games

-apologizing for being horr.i.ble at said video games

-holding a  t w o   w e e k   o l d  baby (that is just craziness people!)

-walking about 3 miles up and down stairs, over entire units, outside, inside, upside, downside (you get the picture)

-rushed someone back to their room (about a floor, two units, and 15 rooms away). just to pee. ah!

-as an adult, dressing up for Halloween and walking a parade route

-going on a Halloween parade and getting candy from nurses, doctors, and other nice hospital staff

-painting someone's nails

-petting volunteer dogs

-reading countless books

-watching little-kid tv shows/movies

-praying over little babies

-gowning, masking, and gloving up to hold/be with little (& big) ones

-using Purell 52trillionbilliongazillionmamillion times in just.one.hour.

-making paper crafts

-making sugar cookies

-painting

-racing cars

-playing Barbies/Star Wars/Cars/fill-in-the-blank with a popular kids toy/movie/show

-playing candyland

-making towers with Jenga blocks

-passing out toys/blankets/slippers/hats/costumes to kids

-decorated for holidays

-sung songs


-talked about favorites (color/hobby/friend/day/candy/food/pet)

-learned how to make tabouli (from a 5 year-old no less!)

-watched kids grow up


-seen battered/worn down/and wiped out kids, families, visitors, and staff
-witnessed 'accidents'

-witness temper tantrums

-discipline bad behavior (no, it is not okay to say those words in a room filled with kids 4 years younger than you! say darn it- or that makes me mad)

-comfort lonely/sick/frightened/tired/bored/frustrated kids

-loved on kids

-& most importantly:

shared God's love & joy with kids, parents, employees, and visitors

siigh. I love it!

8:34

I can't get over why I keep wanting to cry today.
 I'll be talking to someone about something sad, or something exciting and all of a sudden I want to cry.
My eyes tear up and I have to look away; I can't make eye contact.
I just don't know why though.





Oh, and this morning?
I woke up at 8:34. Exactly four minutes after I was supposed to be at my internship site.
Needless to say, I was a little late.

Then when I went to meet with my boss after being at the hospital, I ended up getting there late too.
Yuck. I hate being late.


You know what?
Throughout the whole day, I never had that feeling that this was just "one of those days."
Nope, not for me!

Emptied the dishwasher, watched a little Army Wives, and working on some fun homework. I know, I know, fun homework?

Week 8: March 22-27

   Once again, I experienced many new things at my site this week. On Wednesday I was in the oncology clinic again and was able to observe a few procedures with a Child Life Specialist (CLS). Every procedure is different, depending on the emotional state of the patient and their family. Some children are very quiet and calm, quiet and scared, or loudly scared, or loudly happy. One girl was very calm and excited to blow bubbles before she received her 'sleepy medicine'. Her dad held her while she became sedated, which seemed to make her and her parents more comfortable. The next patient was quiet and blew bubbles quickly as her mother talked for a long time with me. I think the mother may have needed someone to talk to calm herself down because she just kept talking without needing me to respond very often. Once again, the CLS I was observing told me that if we can calm patients (and their families) before a procedure, then they will wake up calmly and be more calm during procedures in the future. We talked again about a possible project and then I worked on some puzzles with some children. I also attended a long staff meeting on Wednesday. At this meeting, I simply observed and learned many new things. I learned some new things about how a Child Life program works together as a team, each fulfilling certain duties. I talked with my supervisor about my project and she gave me more direction for what I could work on. I hope to start working on my project soon both at my site and at home.
   On Friday, I observed a different CLS in a unit I had only been in a few times before. She explained that she only works with patients who she receives referrals for. Apparently, getting referrals from nurses (& etc.) can be a big problem for specialists. Another thing she pointed out was a referral requesting toys to be brought for a patient. She explained that it is frustrating to receive that request because any professional in the hospital can take toys to a child. However, a CLS uses play and toys in various ways to address a range of problems or questions a patient may have and a more specific referral is more helpful.
   I was also able to talk with this CLS about her background and education in CL. She explained that she attended a prestigious CL program for her master's degree and that she would be willing to talk more about further education goals with me. She encouraged me to become more educated in CL and to really start pursuing an internship position. Another exciting thing was when she offered to talk to the CL supervisor about possibly offering me a summer internship position. I wasn't even thinking I could do a CL internship without a degree (I'm graduating in the fall) so I found this news very exciting. I know at this point that I want to at least volunteer at the hospital once I complete my hours. Hours of volunteering are often required for internships but more than that, I really enjoy being with children at the hospital. And it wouldn't hurt to keep in contact with the CL program! In addition, I was very excited to hear that CL practicums are hard to find in California so my time at the hospital for my school internship will definitely help my resume! She also explained that I need to be more open to relocate for a position in CL because larger programs offer more training venues and larger cities typically employ more CLS at children's hospitals. I already knew some of the information she shared with me but I learned so much more. I'm excited to work with her again next week so I can continue learning about CL education, various CL programs, and becoming closer to completing some of my career objectives.

Week 7: March 15-20

  One thing I have realized lately is how much I am learning. Every day is another new and entirely different day. CL specialists have to be flexible and work with a very tentative schedule. This week I observed in the oncology clinic again which is where cancer patients receive outpatient care. On Wednesday I was able to observe three LP procedures. During a lumbar procedure, the patient is sedated while spinal fluid is drawn (a chemo treatment is usually given too). For the two younger patients, the CLS used distraction and breathing tools to help calm the patients before their procedure. The CLS simply talked quietly to the older patient and held her hands. At first it was hard to watch such little children having this procedure, but I quickly saw the necessity of the CLS for each patient. She kept telling me that if a child is calm before a procedure, then they are able to stay calm during the procedure and then wake up calmly.

  The ever-changing schedule in the oncology clinic allowed me to do many different things this week. She has also shown me different places in the hospital, telling me about the purpose of each area. We went to a tumor board where doctors discussed the history and diagnosis of a patient with germ cell tumors. It was really interesting to hear the medical process of treating patients. Also, I helped out in the playroom, working on puzzles with a patient. Another thing I enjoyed doing at the oncology clinic was making crafts with patients. We colored, cut, glued, and glittered. It is neat to be able to engage patients of different developmental stages in fun activities. The pace of the clinic is definitely different from a regular unit and we were able to talk a lot while waiting for patients. She explained the requirements and certification process CLS now have to go through to work in established hospitals. I'm really excited to hear how other established specialists got their start in the field of CL and was glad when the CLS shared her experience with me. We also talked about the role volunteers have at the hospital, helping patients when the CLS and medical staff cannot. Also, after talking to her about the clinic, I think that I may have a project to work on too! I'm excited to go back next week and put some longer hours in. Hopefully I can talk to my supervisor about visiting and observing in different areas of the hospital soon as well.

*To answer Lauren's question, I became interested in CL a few years ago. I met my current site supervisor through a mutual friend and talked her ear off about CL. I quickly realized that I wanted to go into CL instead of my original goal of nursing because my background and schooling fits the CL career far better than nursing. Although I sometimes wish I knew how to help patients medically, I know now that the role of the CLS is extremely helpful for patients. There are so many things children deal with at the hospital that can affect their physical situation that must be addressed too. Oops, I'm stepping off my CL soapbox now, but feel free to ask more questions!

Week 6: March 8-13

  A big thing my supervisor has been showing me is having to help patients who are emotionally reactive. When a child doesn't speak the same language, if they are delayed, or if they are fearful of adults then being at the hospital may be a scary experience. While it is easy for anyone to dismiss another person's fears by calling them "irrational," I feel that it is inappropriate to do so for children. In scary situations, children need to be allowed to express their fears. In tough situations, children need to be told that crying, screaming, and being afraid are natural and 'okay.'

 Another thing that I have had to deal with personally are my own hesitations I have while at the hospital. Sometimes being in a hospital can be a scary thing because of the various codes given over the intercom, language barriers, and the seriousness of medical problems all bring their own amounts of anxiety. Working in the medical field involves everything from life to death. Patients die, parents grieve, and their nurses and medical caregivers must cope with such losses. One example of a moment of anxiety occurred this week while I was walking down to a lower floor to meet up with the specialist I was observing. Before I reached the stairwell, I heard noises and lights going off in one unit. A 'code blue' was quickly called and as I continued to walk down the stairs, numerous doctors, specialists, and nurses ran up the stairs towards the patients' room. Sometimes it is hard to hear codes because it usually means that a patient has stopped breathing or has other life-threatening problems.

 Other things include seeing an 8-month old child in the oncology clinic receiving a weekly chemotherapy treatment. One little 9-month old had SMA (small muscle atrophy) and the CL (Child Life) specialists were amazed he was still alive. Apparently SMA and CF (cystic fibrosis) patients usually die very young. Also, in DNR (do not resuscitate) meetings, parents must decide whether or not to keep their children on life support even after they code. I can't imagine having to decide whether or not to keep your loved one alive even after they cannot live without the support of machines. Seeing kids so young that are so sick or dying is sad and somewhat depressing. However, I really enjoy being involved in the emotional part of their healing process. I knew it might happen at one time and just last week, I heard a little girl tell her mom in a quiet voice that her friend was going home. Her mom commented, "Isn't that nice for him?" The girl replied, "but I want to go home! It would be more fun if it was me going home- not just him." I was glad that she had her mom to help her deal with her emotions, but sometimes it is the job of the CL specialist to help patients and families cope with overwhelming emotions. Sometimes parents become overwhelmed by the severity of their childs' situation and are not able to help their children adequately.

  Therefore, at the same time that all of these things make me hesitant to enter into such an intense environment as a profession, they have fueled my desire to enter into the field of Child Life. If everyone felt anxious, overwhelmed, and scared by this intense profession, then children and their families will suffer. Sometimes I have to remind myself that while few things strongly scare me in a hospital, those same things, and many others scare children, which have harmful benefits in their healing process. I feel that I have a fitting personality and life experience to aid children and their families in their process of being hospital patients, some with light or serious health problems.

  For instance, I am minoring in communicative disorders (deaf studies) so I know American Sign Language. A deaf patient was admitted a few weeks ago but not many people in the CL department know how to sign. (Actually only my supervisor and myself know ASL.)  My supervisor had me talk with the patient and get to know her. When I went back a few days later, I was able to talk with her again, and I hung out with her a lot yesterday. Nurses and doctors are somewhat impatient with children sometimes (even without language barriers) so I was glad I could explain to her what was going on. Then on Friday, I was able to interpret for some CL workers, explaining the games we were playing and allowing them to carry on a conversation. At first I was really frustrated because I kept making mistakes, but then I slowly warmed up and started remembering things. She kept laughing at my mistakes so it was fun to joke with her and relate to her. When grown adults approached our signing as a strange thing, I began to realize how isolated she was. (It was a little strange when other patients became curious and stared at us signing though!) At times I felt badly for her because she was so isolated in a profoundly hearing environment, but then we became closer as we played games together. I was pleasantly surprised to have such a unique skill to share as a CL student, and I hope to see her next week and continue our friendship if she is still there. In the end, I have definitely learned that I cannot allow children to be treated passively so I am constantly feeling stronger about becoming an ally for them and becoming a Child Life specialist.

Week 5: March 1-5

. In my second full week at my internship, I am finding my confidence and my knowledge of Child Life growing in leaps and bounds. As I may have explained before, although I am completing the internship requirement for State, I am only considered a student at the hospital, and not an actual CL intern. At first I was a little frustrated that this limits what I am able to do at the hospital, but now I know that I am in the right position. After slowing becoming acclimated to the many aspects of the hospital and CL, I realize that having the position of a student who may only observe and may not get as "hands on" is okay. There is definitely a lot to learn and a lot to know about the profession. By asking more questions and keeping my ears open, I have finally learned the meaning of some crucial terms such as patients with NPO, RSV, contact/droplet (many patients have that), and 'appy's (appendicitis). Although I was a little overwhelmed at first, I am learning as I go and becoming more confident and comfortable.

. Another large part of building my confidence depended on becoming familiar with the medical staff. It seems like every time I am at the hospital I meet someone new! As the nurses and various other medical professionals are becoming more familiar with my face, I have found it easier to work alongside my supervisor. A few times this week a few nurses even talked directly to me which may seem weird to mention, but because of the hierarchy of a hospital (surgeons, doctors, np's, nurses, specialists, and eventually CL specialists & etc.), it is very encouraging to me. I knew from job shadowing that dealing with attitudes from this hierarchy is a somewhat frustrating part of a CL specialists job, but each positive experience I have alleviates my doubts. Although some people obviously do not like the CL workers, one nurse initiated a conversation with me without even questioning my status as a student or waiting for my supervisor to join me. Patients and their parents also appreciate the work of the CL department and I am now very willing to be an advocate for CL programs and their many benefits.

. Over time, as my supervisor notices my growing confidence and knowledge, she allows me to do more things and initiate more activities. This week I read more literature about CL, retrieved necessary toys and distraction tools, and was able to sit in on a procedural teaching lesson. Each new day brings more opportunities and drastically different experiences. On Wednesday I helped out in the classroom for a few hours, working on reading, math, and logic with some patients (yes, they do still have to go to school! -especially if they are at the hospital for an extended period). I have escorted patients to their rooms, ran to retrieve items from other departments, and have gone on rounds in other floors.

. Also, each day I am asked to interact more with patients which is exciting because I get to develop my skills as a student and also because merely observing can be a little mundane. Next week I am going to be working with a different specialist and I am excited about the new opportunities. However, I do not know exactly what to expect because I will be in the oncology clinic, a department I have never visited. Needless to say, next week will definitely be interesting!

Week 4: Feb. 22-27

This was (finally) my first full week at my site. After arriving on Wednesday, I attended my first daily staff meeting. During these meetings, the Child Life specialists note which of their patients needs a volunteer and who can go to the playroom or the classroom. This is an important part of keeping each person in the CL department updated on all of the many patients that are at the hospital. The meeting moved quickly and I was easily confused by all of the medical and specific terms the women used. After the meeting, I was able to ask my supervisor questions about what happened and then we started rounds on her floors.

Just like I was last Friday, I was a little unsure about entering patients' rooms. My supervisor works so confidently and quickly, that I find myself easily confused by the terms and events that occur. After holding my questions for awhile, I slowly started asking about confusing aspects of the job. By asking questions and speaking up when something strange or confusing happened, I am quickly learning a lot of new things about Child Life and the hospital.

Also, like I mentioned in class yesterday, I have been doing a lot of walking! It may seem like a silly thing to note, but after two full days at my site, I realized that I need to get some better shoes! In order to cover all of the patients that are under her care, my supervisor has to walk over two floors and is constantly on the go. Because of this, I keep getting confused about where rooms are and where patients that we have visited are located! My supervisor is really understanding and helpful with this.

Sometimes I think I look a little lost because she'll smile and start explaining what just happened or where a certain room is. Because of our improving communication, I have been learning many new things, and my confidence has been growing. At the beginning of the week, I was overwhelmed and was questioning my intentions of going into CL but now I am excited and I am slowly building up my confidence. Also, because I am not considered an official intern in CL at the hospital, I am only supposed to observe. However, each time my supervisor asks me to do something small, my confidence builds and I get more excited!

Week 3: Feb. 15 - 20

Yesterday I attended my facility orientation where we reviewed hospital rules, HIPPA laws, and the codes that are used at the hospital. This part was somewhat boring because I already knew about confidentiality. Some of the codes they use at the hospital are very serious and life threatening (health alarms, bomb threats, etc.) which definitely reminded me that being in the hospital environment can be a very serious thing. However, the orientation speaker said that a code pink (child abduction or kidnapping) usually doesn't even refer to patients. She said that most of the time, little (toddler) brother or sisters of a patient will become distracted by something and walk away from their parents who will then need help finding them. This reminded me that although children can be cute with their endless curiosity, sometimes they can be frustrating!

After attending my orientation, I met with my supervisor. She explained to me again that because the CL department in is a time of transition, I will need to be very flexible and patient. Next we went to the PICU and checked on a few of the children there without any parents or visitors. One boy had to get an x-ray taken. After my supervisor asked a nurse if he would need her, she said that 'no, he seems fine.' I noticed quickly that my supervisor was very persistent in her questions, continuing to ask different questions and in different ways.* I hope that I can be persistent and assertive regarding the care of my patients if I do go into this profession in the future. I know that I am not always as vocal as I should be in standing up for myself, so I hope I can learn this skill.* Even after talking to the nurse, my supervisor went to check on him and talk to his mom. He became very upset once the x-ray machine arrived. Because there wasn't much time, my supervisor could not calm the boy down enough to lay still so she had to hold him down so they could take it. Once we left the room, she explained to me that sometimes if there isn't time, her last resort is to help restrain a child instead of having the parent do it. She explained that the parent is already the 'bad guy' at home and she didn't want a parent to be in that situation while the patient was at the hospital. This resonated with me and definitely got me thinking about the parent-child relationship.

After that, we walked down to a room where a baby was barely waking up. My supervisor said that he didn't have many visitors and that he could really benefit from being held. After putting on the protective scrub smock, mask, and gloves, I sat down to hold him. It was a little tricky at first because he was hooked up to oxygen tubes and blood pressure wires, but then he settled down. It was funny because he didn't like the wires so he kept moving them, but then after awhile he fell asleep. Although it was a little alarming to have to wear so many things to protect myself from whatever he was sick with, it was fun to just hold him and talk to him for a few hours. He seemed like such a sweet little baby and it was sad for me to realize that his nurse was probably his only visitor. I fed him and then held him until he fell asleep.

Before I left my supervisor kept thanking me for being with the baby for such a long time. She told me that if she has spare time, it is one of the most rewarding things for her to just sit and hold a baby who needs to be loved on which I readily agreed with. I know that most days will not be as quiet and easy as yesterday was, but I'm ready and willing to keep learn and observing!

Week 2: Feb. 7 - 13

Blog from week 2:

After getting all of my required information turned in, I am finally going to be able to attend my clinical orientation class this upcoming Friday. After some initial frustration, I am excited to jump in and learn a lot about Child Life (CL) at my site: Children's Hospital Central California (located in Madera).

This week, I was able to talk to my site supervisor about my learning objectives and I am excited to get to work! Previously I job shadowed a Child Life specialist who is actually now my site supervisor. While discussing my learning objectives, I realized that I will now be involved in many areas of the hospital that I have never visited before when I shadowed the CL specialist previously. This is exciting to me because I will be experiencing and learning so many new things.

Also, I learned what I will actually be doing while at my site. By doing some reading and research, I will be learning about Child Life, what the profession is, and what it entails in a children's hospital. I will also be learning about developmental stages of children and how they are present in the hospital. I'm excited about this because I will be able to apply some things I have learned in previous classes in a clinical setting. Also, I'm excited to begin my internship while I'm taking my theories class. I hope that I will be able to learn firsthand how each one of the 'grand theories' are evident in children. In addition, I will be observing and learning about what procedural teaching is and how to implement it in a hospital. I'm excited about explaining to children what IV's, Pic lines, and other things that may seem scary in a hospital are used for.

I will also be learning about play, distraction, and other tools to help children learn about and cope with their hospital experience. By observing other CL specialists, I hope to learn what tools to implement in similar situations in the future. After being able to help a CL specialist with implementing these strategies in my previous visits while job shadowing, I am excited to learn even more by observing from a clinical perspective.

One of the other things I will be doing is observing and implementing information I will be learning in the classroom and playroom. I am really excited about this because I was not able to visit these areas the previous times I was at the hospital. After talking to my supervisor, I think that this is probably where I will be doing the bulk of my work on a project for my site. I think that I might be working on developing play plans (a sort of schedule of lessons) for children of all ages and developmental stages. This should be an exciting and interesting process of integrating the concepts I will be learning in tangible ways.

After taking my orientation class next Friday, I hope to have new information to share about my experiences at the hospital. Although the orientation will mainly focus on hospital facility and employee standards, I am excited to get started and learn the basics about being a hospital employee so that I can jump into the field of Child Life.