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Making a child’s (hospital) life a little easier

Dialysis patient Lexi Tursi performs a surgical procedure on her stuffed animal with friend Taylor (r) and Child Life specialist Toni Crowell.

leven-year-old Lexi Tursi, with stuffed animal and new Maroon 5 CD in hand, arrived with her friend Taylor for the post-Valentine’s Day pajama and pizza party. She happily greeted her friends in the bright, cheerfully decorated room and started to prepare for the day’s events.

Not exactly what you might expect in the dialysis unit of a hospital, or how you might picture a young girl about to undergo a long, uncomfortable procedure. But Lexi, like many Children’s patients, is fortunate to have a Child Life specialist to help her through her hospital experience.

Lexi has known Child Life specialist Toni Crowell, MS, CCLS, for three years, and the two have developed a close relationship. “She helps me have fun,” Lexi says. “It’s never boring around here.”

The two play games, work on projects such as making fashion books, simulate medical procedures with stuffed animals and props, and practice deep breathing relaxation techniques. Coming in for treatment three times a week can make it difficult for patients like Lexi to lead a typical life, but Crowell helps create a routine that is both normalized and fun. Unlike most adult wards, there is often a sense of community as children going through similar treatments rely on each other—and the frequent pizza or dance parties—for social support.

Crowell is one of 18 unit-based Child Life specialists at Children’s, who work as liaisons between doctors, nurses and patients. They help patients and families cope with the fear and anxiety associated with difficult procedures and hospitalizations, and provide developmental play experiences at the bedside and in the activity rooms.

“Child Life specialists provide the environment and opportunity to counteract the stresses inherent in most hospital experiences,” says Myra Fox, director of Child Life Services. “We incorporate the child’s perspective into treatment plans. The staff contribute greatly to our understanding of the whole child.”

The Child Life profession evolved out of research in the early part of the 20th century showing that the high rate of infant deaths in hospitals was related to sensory deprivation and a lack of human contact. Play helpers and teachers were hired by hospitals to ease young patients’ boredom, loneliness and anxieties.

In the 1970s, the profession and its educational requirements became better defined. Since then, the number of Child Life programs at hospitals with pediatric programs has grown, and today colleges and universities offer academic programs specializing in Child Life.

Child Life specialists have undergraduate or graduate degrees in Child Life, Child Development or Education. They can become certified through the Child Life Council, a professional organization recognized by the American Academy of Pediatrics. Child Life specialists often develop specific areas of expertise such as infants, oncology patients, or terminally ill children.

Angela Franceschi, MS, CCLS, a seven-year Children’s veteran, employs coping techniques tailored to the needs of her patients. In the hospital, children often feel that they have little control over what is happening to them, so Franceschi gives her patients some choices, such as a “time-out” coupon to be used during procedures. “We try to help normalize the whole hospital experience,” Franceschi says. “It’s not just medicine that helps them get better.”

Child Life specialists work side by side with nurses, but perform a unique role that assists both the nurse and the patient with the emotional aspects of care, while the nurse concentrates on the medical aspects.

“When we’re performing a painful procedure, it’s a huge help to have someone there who has a rapport with the patient to help with techniques of distraction or refocusing, so we can do what we have to do,” says Janice Farren, RN, Renal Dialysis Unit. “Having the Child Life specialists here allows us to do a better job. I can’t imagine working here without them.”

Children’s will celebrate Child Life Month with a week-long series of events beginning March 30. Children are invited to bring a stuffed animal to the Puppy Pre-op Program in the Patient Entertainment Center for a simulation of typical pre-operation procedures, such as getting x-rays, drawing blood, or getting a cast. On Thursday, April 1, from 1 to 2 p.m. in the Gamble Reading Room in the hospital library, the Child Life and Nursing departments will present an exemplar for Children’s staff of a true story of collaboration between a Child Life specialist and nurse as they helped a patient through an especially difficult situation.

“Child Life specialists make an enormous contribution to the care of our patients and their families by allowing our patients to be children first and foremost,” says Susan Shaw, RN, MS, director of Clinical Operations. “They are essential members of the health care team.” —NT