Medical Play Box
Goals when preparing to use medical play equipment or medical play box w/ child
Goals:
1. Prepare child to better cope
2. reduce fear/anxiety/stress
3. child have better understanding of equipment
4. giving child control over medical environment
Common placements of child life programs in hospital administrative structures
(COMMON) Nursing, physician champion (such as chief pediatrics), hospital administrators, patient/family care services
(SOME) Duel reporting relationships of reciprocal management or matrix reporting
Mary Salter Ainsworth's contributions to us understanding children experiencing separation and loss
proposed children and infants have a secure base (important attachment figure), before being able to venture into or cope with unfamiliar situations. Concluded that where familial security is lacking, development could be handicapped. Worked with Bowlby and validated his theories.
List 6 non-traditional or alternative child life practice settings
(Possible answers)
1. dental offices
2. ophthalmology/optometry offices
3. pediatric clinics
4. support programs for children of adult patients/parents with trauma or burden
5. specific diagnosis organizations
6. camps for medically ill children
7. wish granting organizations
8. hospice/home care
9. bereavement programs or funeral homes
10. private practice
11. secondary education or elementary programs
12. early intervention
13. legal or law enforcement agencies
14. child abuse centers
15. community family programs
16. media or entertainment consulting
17. architectural and facility layout or design consultation
Importance of volunteers in child life settings
Volunteers provide task specific support (admin, playroom, patient contact) and support child life beyond the work that resources can match
Assessment Steps when preparing to use medical play equipment or medical play box w/ child
1. build rapport
2. determine developmental level
3. assess understanding through questions
4. learn about medical past
5. introduce medical play box related to child's situation
Sources of potential funding
- hospital budget or "hard money" (75% of programs said this is where 70% of their money comes from)
-soft monies (donations or grants)
-Endowments, 20% of programs receive these
Discuss Bowlby: child's need for uninterrupted attachment (3 papers)
Discussed in 3 papers
-focused on signaling behaviors (mailing, crying, sucking, clinging) and material responses to support maternal bond
-"protest" "despair" and "denial or detachment" as defense mechanisms, "separation anxiety" when a child feels threatened with no supportive figure
-proposed recurring losses in infancy and young children would result in inability to form intimate relationships
List at least 5 transferable child life skills in alternative settings
POSSIBLE ANSWERS:
1. reducing impact of difficult experiences on children
2. assessment of trauma from developmental perspective
3. use of play therapies to explore/share/reduce trauma impacts
4. provide educational experiences according to development
5. highlight children's strengths
6. family-centered care
7. promote social skills/problem solving
8. developmentally sound crisis interventions
9. creative solutions to difficult problems
10. developmentally appropriate support groups
Discuss burdens and benefits of offering child life student program
1. child life specialists are under professional obligation to offer training to individuals seeking career
2. 12th principle in child life code of ethics, those who supervise others are personally responsible for providing proper learning opportunities
3. can add in mutual learning and service contributions
describe 6 phases of selecting medical play box equipment
1. learn about child's condition
2. ask/inquire about diagnostic/medical intervention processes
3. inquire about procedures/treatments/interventions that child life/child should be familiar with prior to hospital stay
4. consider development/language to be used
5. select equipment to be used and possible explanations
6. place least threatening on top, introduce more items as comfort increases
Importance of data collection
becomes a source of feedback for managerial evaluation and movement for change
Who is James Roberson? How did he contribute to our understanding of children experience hospitalization and illness?
1948 worked with Bowlby to observe and document on hospitalized and institutionalized children separated from parents.
1950 "A Two Year Old Goes To the Hospital" documentary
Explain non-traditional or alternative settings
child life is associated with hospitals, any setting outside of this is considered non traditional
7 basic guidelines for child life student intern program
1. consensus between all involved on site-specific goals
2. formal orientation with site specific information
3. internship job description
4. training materials
5. supervision contract
6. ongoing assessment and evaluation
7. formal exit evaluation for internship program improvements
describe activity phase of basic medical play box intervention (6)
1. exploration
2. defer to child and await their role-play with each item
3. CCLS in role of "patient"
4. be realistic in role play, acknowledging "that's cold" and "ouch" to needle sticks
5. praise every successful interaction
6. discuss any fears, allowing choice when child moves away from activity
Data distribution process in child life program assessments
After collected and complied, it must be assembled into reports for review/evaluation.
Where time allows, benchmarking projects that compare services and performance statistics against other programs can help in the evaluation processes, and ultimately further program optimization and effectiveness.
Eriksons stages of development
0-1 trust vs mistrust
1-3 autonomy vs shame/doubt
3-6 initiative vs guilt
6-12 industry vs inferiority
12-18 identity vs role confusion
Patient/staff ratio recommendations according to ACLP
full-time staff responsible for 15-20 patients
10 basic guidelines for a child life services volunteer program
1. needs assessment for areas for volunteers to cover
2. explore volunteer skills/traits needed
3. produce recruitment package
4. need/skill specific job descriptions to clarify expectations
5. create interview process
6. produce interest and skills checklist for volunteer matching
7. assemble volunteer orientation guide and manual
8. outline supervision/education/performance review
9. address liability issues
10. establish formal volunteer recognition outlets
Preparation phase of medical play box description (7)
1. introduce box (things may be seen in hospital)
2. allow child to explore
3. tell child use of items in box
4. point out sensations associated with items
5. child led role-play
6. be vigilant to recognize signs of fear or anxiety
7. use medical play box under cycles supervision and allow them to explore when relaxed
Discuss budget issues related to starting child life programs
1. not revenue generating
2. not mandated for accreditation
3. staff salary and benefits consuming 86 percent of budget
4. proficient staff members needed for leadership in budget planning and maintenance
Common diagnosis of hospitalized children (9)
1. intrauterine growth retardation/premature birth/low birth weight
2. infant respiratory distress or failure
3. leukemia
4. psychological disorders prior to adulthood
5. birth heart defects or of the circulatory system
6. pneumonia due to aspiration of meconium (newborn fecal matter drawn into the lungs during birth)
7. other psychological disturbances (anxiety or personality disorders)
8. depression
9. graft, implant, or medical device infections or complications
Common staffing strategies (3)
1. assignment to specific unit (with age or diagnosis subgroups)
2. assignment to multidisciplinary team
3. assignment to particular medical service
9 guidelines for the use of interim/event specific volunteers
1. provide guidelines in advance
2. offer developmentally appropriate strategies to reduce stress
3. acknowledge ethnic and cultural diversity
4. emphasize goals and specific benefits
5. ensure event and related activities are in line with patient/family needs
6. consider infection control/safety
7. consider if majority of patients will enjoy
8. adequate staff ratios/evaluations
9. consider donation safety, security, legality and ethics