The hospital can be a scary place for a child patient. They may be in an unfamiliar setting, hooked up to an array of machines and not told what is going on. Doctors may come in with the dreaded syringes and needles, and patients could be away from their friends for an indefinite amount of time. These things can lead to an early fear of the hospital, which can manifest into distrust of doctors later in life. Fortunately, the Child Life program at Prisma Health Children's Hospital understands how easily this fear can develop and tries to combat it through various activities and opportunities directed towards young patients.
“The Child Life Program meets families and children where they are and makes sure that [the hospital] provides an emotionally and medically safe environment,” said Christy Fink, manager of child life and special programs. “Our job is to meet patients, help them feel comfortable in the hospital, help understand their treatment and diagnosis and allow them to feel in control of their treatment.”
Certified Child Life specialists work in tandem to communicate with children across the development spectrum. Fink's team, however, also consists of other individuals who are diverse in their respective roles and titles. Music therapists can aid patients in writing lyrics and exploring instruments in the hospital's music room, while child life assistants help develop a comfortable atmosphere for children by incorporating playtime. More so, playroom attendants play a role in keeping the children's hospital's playroom organized. An injury program specialist further interfaces with the community by analyzing causes for a rise in certain conditions and injuries and providing information to the local community on how to avoid such injuries.
Fink explains that a very important aspect of the Child Life program’s mission is to allow children to feel like they have control over themselves and at least some aspects of their hospital stay, especially when a diagnosis can provide little choice in a child's treatment. Child Life aims to do this by providing an array of opportunities and activities to patients. These include normative play so children have a chance to express themselves, playing in the playroom and answering questions about treatments in a developmentally appropriate way so children understand what is happening to them.
Fink also talked about the importance of medical play as part of the Child Life program, and how it can help children feel more comfortable with the equipment in their room. “[As specialists,] we don’t direct this type of play. Rather, we allow the child to lead and follow behind them,” Fink said.
Allowing children to “play doctor” can reveal misconceptions about medical conditions and diseases. If a young child tells a stuffed animal they are getting medicine because they “didn’t listen to what mom said,” child life specialists can later help the child understand that it is never anyone’s fault for being in the hospital or having a condition. Even regular play can help children process their emotions in a safe space. Playing UNO with a teenage patient can allow them to feel more comfortable sharing their concerns, such as lack of privacy. This can help Child Life specialists better collaborate with the medical team to provide solutions to these issues, such as giving the patient time when they are not disturbed by anyone.
The Child Life Program holds many activities throughout the year to spread cheer and help kids feel involved in something larger. These can include holiday celebrations, like Santa Claus visits, holiday parades and markets during the winter holidays, reverse trick-or-treating during Halloween, where dressed-up hospital staff delivers candy to dressed-up patients, to Valentine’s Day cards, where community members can drop off cards to children’s “mailboxes” during Valentine’s Day. During March, which is Child Life month, the Child Life Program celebrates its team and increases awareness of child life through spirit weeks, encouraging patients and the medical staff to celebrate. The Child Life Program has also coordinated with the UofSC Basketball team to allow children to spend time with athletes through activities such as cornhole, hula hooping and mini basketball.
When asked about whether she has seen a difference in child care and child health with the implementation of the Child Life program, Fink shared an experience she had as a specialist that has always stuck with her. When Fink was a specialist in the pediatric intensive care unit, she remembered one time when she heard one of her patients, a 7-year-old boy, screaming because he needed an IV. Fink quickly walked in to help. She noticed his SpongeBob shirt, and the two began talking about SpongeBob. When the child had calmed down, they started talking about him needing an IV. Fink lowered herself to his level and gave him some information about the IV, such as how it directly provides medicine in his body and that they can give him numbing medicine so he will not feel any pain. She then gave him some choices about whether he wanted to be distracted while the IV was being put in, such as playing I Spy, or watching the procedure occur with Fink explaining everything that is going on, step-by-step. She even told him that he could keep screaming if he wanted; he just had to make sure to stay still.
The IV procedure went smoothly and Fink continued to stay with the child anytime he needed a new IV. This continued for a year until the patient was given infusions as an outpatient procedure. Fink continued to be with the patient for the first three or four times, then for the fifth could not be present as she was taking a vacation. Fink had prepared the patient for this so that he would be able to do this infusion on his own. When she later received a call from the hospital, the patient was on the phone, proudly exclaiming, “I did it! I did it!"
“It was just so rewarding to see that turnaround,” Fink said. “Everyone on our team has a story like that with at least one patient, where you put in so much work with them and they turn out really proud of themselves. When I meet with new members, I always tell them that we do a lot of work in wanting to keep patients comfortable. Sure, you could perform a procedure in two minutes if you just hold the child down and get it done, but you would give so much more trauma that the patient would not recover from in two minutes.”
The Child Life program has significantly helped numerous parents and children feel more comfortable while in the hospital. Michelle Spigner, a local high school teacher, shared some of her experiences with the Child Life program both when her daughter was admitted to the hospital and later when her son needed a minor surgery.
“As soon as we got in [during my daughter’s hospital stay], a Child Life specialist came into the room and talked to [my daughter] about being in the hospital, what it was going to be like and talking about the IV process. They showed her what everything was going to look like, which I thought was good, because the more kids know what to expect the more it helps them allay their fears. [My daughter] was just so scared, but [the specialist] helped her so much. As soon as [the specialist] came, [my daughter] was more comfortable. I wanted to hug them and tell them how much I appreciated them for everything. When my son had surgery, he also had a specialist. My son was older, so he asked them so many questions, and [the specialist] was really good at answering all of them.”
“One thing I appreciated is that the specialists … were there for the kids. They didn’t ignore the kid and focus on the parent.” Spigner said. “The best part is the Child Life specialist was always there right away to help [my children] feel more comfortable and explain what is happening. They are so good at telling kids what is going on in a way they can understand, especially for 6 to 10 year-olds. They are so calm and comforting, and the extra [toys] they have really help."
Spigner’s experiences with the Child Life program have prompted her to organize donations to the program at her high school. She and her students work to donate items such as toys, coloring books, essential clothing and more.
Spigner sees the program as an essential aspect of the children’s hospital. “Most kids don’t have any experience going to the hospital. The Child Life specialists are there to support the child and help them feel more comfortable and make everything less scary.”
“Going to the doctor and having needles stick you is a part of life,” Spigner said. “Not being scared of a doctor your whole life is important because self-care is important. Having positive experiences as a child is important in continuing to feel comfortable in going to the doctor and knowing that it’s not the end of the world."