Amanda Wilde (Host): Doctor visits and medical stays can raise fears and worries, especially for children. How do we support and comfort our kids? On today's episode, we're joined by child life experts, Amanda Lockett and Maggie Rizza. Together, they'll share invaluable insights and tips used at Prisma Health Children's Hospitals to make healthcare experiences smoother for children and their families.

This is Flourish, a podcast brought to you by Prisma Health. I'm Amanda Wilde, Maggie, Amanda, welcome to you both. Amanda, I'm going to start with you. Is it just kind of a given that kids will have trepidation about medical visits?

Amanda Lockett: Well, thank you. That is a good question. I feel like working in children's hospitals as a child life specialist, needle pain is one of the most common things we see in children and even teens now. I think it's one of those things that they experience as a young child or, you know, a young toddler and they might remember some of those memories of things that maybe didn't go as well as they wanted or maybe as well as it could have. And it starts young and they remember those negative experiences. So, yes, I do think it's one of those things that we see often. Most children are afraid of some sort of invasive procedure or needle pain. And I think you could also say that a lot of parents and caregivers themselves are afraid of invasive procedures and needle pain too. So, we need to figure out how we're helping demystify that process and help them cope with those experiences when we need to have a procedure or we need to utilize some sort of poke procedure in their blood draw.

Host: So with that in mind, Maggie, what are some tips for making regular doctor visits easier?

Maggie Rizza: So, we really just hope that parents can remember that children mirror their behavior. So, if a parent is calm and brings good calming energy to a visit or to talking about an upcoming medical visit, then their children will also reflect that. And they'll trust that their parents are being calm, so they have a higher likelihood of being calm in that situation as well. We also try to focus on the positives of the visit. So, if we do have to have a procedure or a shot or vaccine or something like that, we like to highlight why we need it. So, it's not a punishment. A lot of times, parents can use things as threats like, "If you're not good, the doctor will give you a shot," or things like that. It sounds kind of silly, but it happens a lot in the healthcare environment and we see it pretty much every day. And we are never doing things purposely to harm children. They obviously need these medical procedures, so we hope that parents can help us be those advocates and help them understand why we need these because we need to stay healthy or because something is wrong and we are trying to fix that or we're not feeling good and this is what's going to make us feel better and focusing on the positives of the situation and not the negatives.

Host: Yeah. Because, Amanda, you mentioned parents can share the same fears that the children are having. So, you have to really, as a parent, focus differently than you might. What can you do if your child is scared of needles?

Amanda Lockett: That's a great question. And one of the most basic things that we can do to support our kids is to listen to them, to allow them to feel whatever they're feeling. If they're feeling scared, provide them space and time and the energy to talk about it. And I think as caregivers, often, we want to shield our children from feeling fear, from feeling scared. And we want to say, "Don't worry, don't worry. It's okay." But oftentimes, what they need is for us to hear them, to see them. And so to say, "It's okay to feel nervous. Let's talk about that. What are you feeling most nervous or scared of right now?" And then, going into helping to validating their fears. And then, you can start to fill in any gaps of information that children might have about what's happening. Do they understand why they need this procedure or why they need their blood drawn? Do they understand why they're going to the doctor and making sure that we're trying to help them learn about what's happening?

The other thing I think as adults and caregivers, sometimes we can carry over some of the fear that we had as children experiencing any pain or discomfort during procedures or medical visits. And it's okay for us to say, "You know, I used to be scared too. And here's what I've done that helps me." And so, just offering your child space to feel how they feel and help them process their emotions.

Host: It sounds like that can bring you and your child closer as well. Sharing that experience, acknowledging feelings and questions is a good way to support our kids even when we don't know.

Amanda Lockett: Yes, of course.

Host: Well, Maggie, expanding on that, you touched on visits that aren't regular health checks. If your child, for example, needs surgery, what are some ways parents can help the child and themselves feel less anxious?

Maggie Rizza: Yeah. So, that is a wonderful question, and it's a question that we get often here at the hospital. There are emergency situations, obviously, where a kid would need to come in for an unplanned surgery. But most often, the surgeries that are happening in hospitals are planned outpatient procedures. And so, that works out really well in the child's favor and a child life specialist's favor because, especially at Prisma Health, you can actually call the child life specialist that works in surgery, and either have an on-the-phone conversation, or you can come in and schedule an in-person tour, so you and your child can both come to the hospital before your procedure and ask any questions that you have. You can see the pre-op area, they can show you things that might be used for surgery, such as like IVs if you need an IV placed for your anesthesia, or masks if they're doing a mask induction for anesthesia. So that way, kids get the hands-on experience of being able to master that situation before they're forced to go into it with their parent.

Host: What a great plan. Now, Amanda, if a child is admitted to the hospital, what can parents do to make the hospital stay easier?

Amanda Lockett: I think one of the things that they can do is just partnering with the healthcare providers within the hospital to share information and to make sure they know what's happening. We want to help the children and families feel as comfortable as possible in this unfamiliar, new, sometimes scary space. So oftentimes, one of my questions is back to the patient and the caregiver to say, "What can we do to help you feel more comfortable? What are some of the favorite things that you do at home? You came in unexpectedly. Do you have any special blankets or stuffed animals that maybe we can't get right now, but what can I provide for you?" We have a lot of things that we try to provide to make sure the hospital is as comfortable as possible. And then, making sure that the patient and the family knows who's in the room and not necessarily in their physical space, but who's your care team. The patient and the family are really important parts of the care team, but do they know who the doctor is? Do they know their bedside nurse today? Do they know the respiratory therapist, the physical therapist? So, making sure we're introducing the patient and family to everybody that they're going to see at the hospital and helping them learn that everybody that's there with them is there just for them. Everybody has a very different job at the hospital, but all of our job is to help you feel better and to help you get out of the hospital as soon as you can. And so, just kind of making sure that we're trying to take the unfamiliar and making a little bit more familiar and providing that comfort in any way that we can.

Host: Well, Maggie, we've been talking about what parents can do to help children. What is Child Life's role at the hospital and how does your team help children when they are in the hospital?

Maggie Rizza: We wear a lot of different hats as child life specialists in the hospital environment. So, our goal is really to make kids feel confident and comfortable in an unfamiliar place and with unfamiliar things happening to them and make sure that they really feel like an advocate for themselves and feel supported in that and how we support those things is by normalizing the environment. So like Amanda said, making the area comfortable, making sure they know where they are, why they're here, and what's going to happen to them. And then, if they do need any procedures while they're here, we help provide developmentally appropriate procedural preparation and support for pediatric patients. So, that would look different for many different age ranges, but we have the developmental knowledge to be able to talk to kids in an appropriate learning level for them on what these procedures are and why they need them and come up with coping plans individualized to them of how they can conquer these procedures with the least amount of discomfort and fear and feel really good about that. And then, we also provide normalization and distraction activities to make the hospital environment a more normalized space. So, keeping your routine and keeping the place fun. It sounds weird to make a hospital fun, but that is really our job is to make people feel comfortable here and make children feel comfortable. And the best ways they know how to do that is usually by playing.

Host: Totally makes sense. And this is so helpful for children. Amanda, what advice do you have for parents of children or teens who need ongoing care for a serious illness like cancer?

Amanda Lockett: One of the things that I think it's good to remember as a healthcare practitioner, a health care team member, and as a caregiver is that your child is going to go through ebbs and flows, I guess, if you will. What they know today is going to change because they're going to learn and grow and mature. They're going to get older as they receive their treatment. So, really remembering to stop and to reassess. As child life specialists, we often say we're going to meet our patients where they're at, but reminding caregivers to do the same. So, your child might be coping really well with information one day. They might understand what cancer is, understand what their port is, understand what chemo is for. And then, the next day. They might wake up and the patient is having a really hard time coping and they're mad at everything. And to remind caregivers that that's normal, that's okay, and just to meet their child where they are. So, let's reassess. Let's figure out how we can help meet them where they are today to provide the support that they need today because what a patient needs one day is not ever going to be what they need the next day. It changes every day.

Host: What an amazing support system you're providing. Maggie, Amanda, thank you both for these insights on creating positive medical experiences for children.

Maggie Rizza: Thank you for having us.

Amanda Lockett: Yes, thank you so much for having us and talking with us.

Host: Amanda Lockett and Maggie Brizza are certified Child Life specialists at Prisma Health Children's Hospitals. For more information and to listen to additional episodes of Flourish, visit prismahealth.org/flourish. This is Flourish, a podcast brought to you by Prisma Health.