Since March is National Child Life Month, I thought I would take this opportunity to brag a little bit about my job and give you a day in the life of working in a large inner-city Emergency Department. I never thought that the ED environment would be right for me until I had the opportunity to spend some time working in a smaller unit during a graduate level internship. After the first few days, I was hooked! I love the fast-paced environment, the chance to see a variety of different patients, and the challenge. I think working in this environment actually helps me to disconnect from my job when I need to go home at the end of the day and remember that most children are healthy and uninjured. While I certainly get attached to certain patients, because I only see them for several hours, rather than spending several weeks with them, I have the ability to leave work at work, although that is sometimes easier said than done! I also think that is helpful in my current line of work that I don't have children. Finally, one perk of being single! It allows me to a bit more objective and fully support families. When I do become a parent, I have a feeling that I will either be the most informed or most neurotic mother after having witnessed so many injuries and illnesses. So, what exactly does a Child Life Specialist do?
In simple terms, my number one and most important job is to help support patients and families while they navigate the unfamiliar and often frightening experience of coming into the Emergency Department. I provide developmentally appropriate play materials and opportunities to help patients pass the time during an extended wait, distraction for a variety of exams and medical procedures, teaching and education for any number of injuries, illnesses, treatments, and procedures, support for siblings, parents, and extended family members, referrals to hospital and community support services, as well as information related to being admitted to the hospital and the medical and support services that are available. I am a part of a trauma response team, and help a patient to understand what is happening when they are brought into our trauma bay due to the fact that they have a serious and sometimes life-threatening injury. Because I work at night at the hospital, I am also considered an on-call resource for any patient or family in the hospital who may have an urgent coping or procedural support need. Finally, I provide end-of-life support to families both in the Emergency Department and throughout the hospital that includes the creation of legacy items, sibling teaching and support, and providing family members with a variety of resources for grief and coping. Whew! I can without a doubt say that this job at this particular institution is the most challenging, rewarding, heartbreaking, but ultimately worthwhile position I have ever had the privilege of obtaining. Perhaps that's what makes my current situation with chronic illness so difficult in terms of my abilities to work a physically and emotionally demanding job!
At the end of every shift, when I think to myself that I have "seen it all," I need only to walk back through the Emergency Room doors the next day. It is not uncommon for me in the course of a single shift to work with the family of a three day old infant in helping them to prepare the patient's sibling for an extended hospital stay, and then to spend time with a 26-year old oncology patient who continues to be treated for cancer at a children's hospital due to the fact that her prognosis is much better when she remains on a pediatric research protocol. However, I would say that the majority of my patients tend to be between the age of four and twelve years old. In any given night, I am responsible for a specific pod of patients, usually encompassing twelve to fifteen rooms, although our entire ED houses 80 pediatric beds. Within those fifteen rooms, I have seen extremely rare genetic diseases, life-threatening injuries, many cancer diagnoses, patients who have just arrived to the United States from halfway around the world to receive specialized treatment, horrific acts of violence against children, and run of the mill fevers, coughs, and colds. I have experienced families who welcome me into the hospital room with open arms and eager to assist their child in coping with this experience, as well as those who banish me from the room with shouting and cursing. I do not always feel appreciated, respected, or valued. However, at the end of the day, I always believe that I what I do has meaning and is as necessary to patients as IV medications, bloodwork, medical evaluations, and CT scans.
To give you an inkling of what a typical day is like, here's an example of one hour of patient care last week. I provided support and distraction to a three-year-old boy who had swallowed his mother's wedding ring at home and was transferred from an another hospital for further evaluation. His impish grin and delight in throwing toys across the room entertained the physician who spoke with his mother and assured her that the ring would likely "pass" in the next several days. My next stop was the room of a fifteen-year-old boy who would be spending his first night in the hospital in our Cardiac Intensive Care Unit due to a life-threatening abnormality of his heart rhythm. He taught me about hockey, while I taught him about a procedure called a cardiac cath and asked his nurse to print out his EKG rhythm strip while we compared it to a photo of what a typical heart rate should look like. Two rooms down, I modeled positions of comfort to a frustrated mother of an infant who was having difficulty tolerating the oxygen mask needed to improve his breathing and soothe his croupy cough. When that same infant need an IV placed, I used a pacifier and a solution of sugar water to keep him calm, then allowed his mother to swaddle and hold him for the remainder of the procedure. Finally, I helped a terrified ten-year-old girl understand how it was impossible for her to wake up in the middle of the surgery necessary to remove her appendix. Together, we used a preparation book of pictures to identify each step of the process. She was wheeled off to the operating room chatting about the great dream she would have and clutching a brand new stuffed pig.
I wish that every day could be a success. I wish that I never had to watch families endure terrible diagnoses, heartbreaking loss, and destructive grief. At the end of the day, I don't usually know the outcome of my patients, or where their journeys lead them when they are either discharged or admitted to the hospital. What I can be sure of, is that in some form or another, I will continue to do what I love and love what I do, even if that looks different than I had imagined even six months ago. To my blog followers, I hope that you are as blessed as I am, to have found your calling and true passion in what you do. I hope that you are appreciated, valued, and thanked frequently for the services you provide! If not, I hope you give yourself a pat on the back every so often. Speak kindly to those you work with, support them in their efforts, and blessings to all you love in this world!
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