Coping & Comfort Tools
Name one item someone could hold in their hand to distract them.
parents hand, stress ball, light spinner
For infants, what is one thing you can do to support coping with a painful procedure such as a poke for bloodwork or an IV Start?
Sucrose on a soother/bottle or breast feeding, comfort position such as parent holding and talking to them, and asking if a parent wants to step out - their anxiety or inability to cope/see their child in pain is valid and permission to step out can be helpful.
Name 1 thing you should always try and use when doing a poke?
numbing cream, if safe for Pt.
A 12-year-old inpatient is bored, withdrawn, and only needs more physical walking to be discharged, do you make a referral, to who?
Rec Therapy
What is my primary caseload?
Oncology, diagnosis education, port insertion, chemo, hair loss, wonders wishes, worries.
Name 2 comfort position options.
sitting vs. laying, back to chest, side by side, chest to chest
For toddlers, what is one thing you can do to support coping with a painful procedure such as a poke for bloodwork or an IV Start?
Numbing cream, option to look or not look, validation of feelings, comfort position with parent, Buzzy Bee, something to look at such as a TV show, light spinner, bubble timer, etc.
Should you block the view of the child from the poke and/or direct parents to block view?
No, choice and freedom to look/look away provides a sense of control.
A 6-year-old with developmental delay is admitted after trauma, has frequent procedures, and becomes highly distressed with staff interactions and parents are not often at hospital — do you make a referral, and to who?
Child life and Rec Therapy
In what way does the support from a Child Life Specialist help you as a nurse?
You can focus on what you're doing - I can support and direct parents and child.
For parents with young children who cry/scream throughout the procedure, what can you tell them to demonstrate their child's ability to cope?
Recovery time is most important at a young age, if a child is able to self regulate within 1 minute after, they are doing well. Their brain is trying to protect them.
For school age children and adolescents, what is one thing you can do to support coping with a painful procedure such as a poke for bloodwork or an IV Start?
Choice of location (right or left, hand or elbow pit), countdown or not, numbing cream, option to look or not look, validation of feelings, comfort position with parent, Buzzy Bee, something to look at such as a TV show, light spinner, bubble timer, etc.
When giving a countdown, what is the max length to start from?
5 or 3
7 year old is in PICU following MVC, is currently intubated and medically sedated with 12 year old sibling who has not seen them, do you make a referral, to who?
Child life, sibling support and once they wake, coping with understanding and coping.
In what way do rec therapy and child life differ? Where do they overlap?
Both use play but rec therapy is about bringing normative childhood play and experiences into hospital to support development and overall coping whereas a child life specialist focuses on the medical side of their hospitalization experience to support coping emotionally and physically with all that happens.
What is medical play?
CLS specific activity to role play medical procedures to support understanding/prepare/create a coping plan/find a sense of control medical procedures or diagnosis.
At what point should a nurse say "all done" when doing an IV Start?
When hands are off.
What is a fun fact about an IV you can share with children?
The needle comes out and a plastic medicine straw is in their arm.
This is the primary goal of Child Life Specialist?
To support children coping with medical interventions with my personal goal of providing as may choice to support a sense of control and safety.
What are the 3 P's of pain management?
Pharmacological, Physical, and Psychological
What is the youngest age one can use MAXALINE and what is the minimum time it needs to be effective and how long after removal is it effective?
2 years+
Needs 20 – 30 minutes to work
Lasts only 30 minutes once removed
If a parents says: "we just need to hold them down, they're too young to understand", what can you respond with?
Validate and refer to child life
Best way to request child life services?
Referral vis SCM or vocera for immediate support.
If a Child Life Specialist has worked with a child, where can you find the notes from these interactions?
Progress Notes in chart or Coping Plan in front of chart.