Transcription:
How to Make Hospitals Less Scary for Kids

Melanie Cole (Host): Bringing your child to the hospital can be a stressful time for you and your family. Here to help us understand the difficulties a child may experience while being hospitalized is my guest, Leslie Dempsey. She's a senior certified child life specialist at St. Joseph's Children's Hospital, part of BayCare Health. Leslie, first tell us about what you do. What is a child life specialist?

Leslie Dempsey, BS, CCLS (Guest): So a child life specialist, we are trained in child development and how children respond to medical experiences and hospitalization based on their age or development. So we really work to reduce fear and anxiety that is experienced in a medical environment or with medical procedures or experiences to really help kids cope with those challenges that they face and expressing those emotions that come with illness and procedures, and really just trying to make sure that they are coping in the best way that we can. So we do that a number of different ways.

Melanie: So tell us about some of those ways that you would use to help children, because for a parent, it can be just as scary as for the child but we don't want to show our fear to the child because they pick up on that. So how can you help us?

Leslie: Absolutely. So like I said, we help in a number of ways. We will prepare children for procedures, so knowledge is power. For kids, there is a huge fear of the unknown, so really just helping them understand exactly what's going to happen to them in the hospital environment or what's happening with their bodies is really important.

So we will work with the families, work with the children, just assessing like what are those fears that they have coming into the environment? What do they know about why they're in the hospital and what's going to happen to them, and really just working with them to try and cope with that. So that may look very different for each patient, so we really take their age into consideration and their developmental level and just trying to prepare them in a way that they will understand.

So for example, if I have a three year old coming in that is going to have an IV placed, I may use play really to kind of help them understand what is going to happen. Play is what's normal for a child at that age. They're very into dramatic play, and role playing, so really kind of tailoring that preparation and helping them understand what's going to happen to their development and what's normal for them is going to help them understand that better.

So I might bring a puppet in and bring some medical equipment in to demonstrate and allow the child to feel and touch the equipment that's going to be used on them to help desensitize them, help them be able to do that on a puppet, and give them that control, and give them that knowledge in a way that's going to really benefit them and help them understand what they're going to experience.

Melanie: Leslie, as we watch you help these children understand what they're going to experience, how honest do you want parents to be? If something's going to hurt, do we tell them? If we avoid telling them the truth, then that could instill distrust in them. How honest do we get?

Leslie: Yeah, so that's a great question. You definitely do want to be honest with your child about what's going to happen. Like I was saying, the primary goal of preparing children for their experiences is to reduce fear and anxiety. Knowledge is power. We know that children undergoing experiences in the medical environment can have long-term implications of those experiences. So we see post-traumatic stress, we see increased fears and inability to cope with future medical experiences in kids who've not been prepared for those experiences.

So being honest and letting them know what's going to happen is really important for their overall emotional well-being and learning how to handle those experiences in the future. As far as how honest to be, that really is just based on the child. You definitely want to let them know what's going to happen, but you don't have to go into those specific details that they're going to be having surgery and they're going to be asleep during that surgery. You don't need to tell them those specific details about what's going to happen while they're asleep, but letting them know they will be going to sleep, and how they will be going to sleep, and what they will experience while they're awake is very important. So really preparing the kids for what they will experience is going to help them cope more effectively overall and help them be able to kind of master those future experiences and decrease fear and anxiety.

Melanie: Can they bring items from home? Blankets, stuffed animals, and things?

Leslie: Absolutely. We really encourage that. We really want to bridge the gap between home and the hospital environment. So this is a very unfamiliar- can be a very scary environment for children, so we really encourage families to bring items from home - a favorite stuffed animal, a favorite blanket, toys from home - anything that provides that child with comfort and that can provide that sense of comfort while they're here is definitely something that we encourage.

Melanie: What about siblings and helping the whole family to understand? Does a child life specialist work with the siblings as well? Because that can be very scary watching one of your siblings going through some of this.

Leslie: Absolutely. We definitely provide sibling support. You know, the whole family is affected by a child's illness or hospitalization, and sometimes siblings get left out. You know, they may not be able to be at the hospital with their brother or sister. They have to go to school, they're maintaining their routine at home, while the parent- their parent is at the hospital with their brother or sister. So there's a huge change in routine. You know, sometimes communication can be an issue. The sibling may not know what's going on with their brother or sister, or they may be having fears of, "Is my brother or sister okay? Are they going to die?" Those are very, very normal concerns that siblings have. So we really try to encourage siblings to be involved in the medical process as much as possible.

So we do work with siblings. Some of our long-term patients or critically ill patients that are in the hospital for a long time, we will encourage families to bring the sibling and meet with us one-on-one so that we can really find out what that sibling knows, how they're feeling about their brother or sister in the hospital, and then bringing them to the bedside to see their brother or sister, and kind of help them understand what the equipment is, and how that's helping their brother or sister get better, and really just promoting that emotional expression too with the sibling.

So we work with siblings all the time and we definitely encourage families to keep them involved in the process as well.

Melanie: What about for patients that might be isolation? Siblings can't come or if they're in the ICU or something and siblings can't visit, how does a child life specialist help those children that might be in isolation?

Leslie: So we do have a lot of toys, activities, we have volunteers here that can really go into the rooms and spend time one-on-one with our patients. But regardless of them being in isolation, siblings are able to visit, they just have to take special precautions in wearing gowns and gloves, masks, whatever that calls for. So that can be difficult for a child to be in isolation and not have access to different things that we have here in the hospital, the playrooms, that sort of thing, but we really try to prioritize those patients who are in isolation to provide them- bring play to them, bring the playroom to them, bring toys, and do one-on-one activities with them.

And again, siblings are able to visit. If their brother or sister is in isolation it's just following those hospital protocols of washing hands, and wearing the appropriate equipment. So that's kind of how we help all around, the patient and the sibling, if that child is in isolation.

Melanie: Leslie, wrap it up for us. And what a great job that you have, helping parents and siblings and child patients understand and make the hospital a little bit less scary. Tell the listeners how they can find out about child life specialists, such as yourself, and how they can help by giving their children a choice in their care, even something as simple as picking a bandaid out, and what you do. Tell the listeners what you want them to know.

Leslie: So what I would want the listeners to know on how to just help children overall is definitely being honest with your child about what's going to happen. If something is going to hurt, and they ask, "Is this going to hurt?" telling them yes is okay. You want to be honest and let them know what they're going to experience.

A lot of parents have fear themselves and they want to protect their child. That's a natural reaction as a parent, to want to protect your child from things that are scary or difficult, but they really are doing a disservice to the child and their overall coping and emotional well-being by keeping that information from them. So be honest with your child. Let them know what they're coming to the hospital for, let them know if they're going to have a painful procedure.

If you as a parent don't know how to do that, and don't know how to tell your child what is going to happen to them, ask for a child life specialist. We are in most all children's hospitals; some adult hospitals do have a child life specialist on staff if there is a pediatric unit. So if you don't know how to help your child, ask for child life, and we are happy to come and talk with your child, and see what their fears are, and talk with you as a parent, and what your fears are, and how you can best help your child. So being honest, I would say, is what I would like to convey the most because we do see so many children where parents are just afraid to kind of tell them what they're coming to the hospital for, and just that information alone can make a huge difference in their coping process.

Melanie: Thank you so much, Leslie, for coming on today and sharing your expertise so that parents and the children can understand what being in the hospital is like, and that it's not that scary, and thank you for helping them to understand that. You're listening to BayCare Health Chat. For more information, please visit www.BayCare.org. That's www.BayCare.org. I'm Melanie Cole, thanks so much for listening.