Child Life Specialists Do You Have Them Where You Work/What Do You Think Of Them

Pediatric Critical Care Columnist · Mar 2, 2008

I've worked in two hospitals that have child-life specialists on staff.

At one hospital, they are fantastic! The department is very forward-thinking and each area of the hospital has their own child-life specialist assigned, including the ICUs. They have a therapeutic clown named Hubert who visits all the inpatient and outpatient areas of the hospital two days a week and a music therapist who works two different days a week. As well, there is a closed-circuit television station that runs a daily in-house program called the Good Day Show, complete with puppet program host, No-Name. There is enough room in the studio for several wheelchairs or even a bed. The show airs during the part of the day when inpatients are supposed to be spending quiet time in their rooms. In the morning the child-life staff makes tours of the wards, looking for kids who'd like to be on TV, or for those who'd like to say hi to somone but can't get out of bed. They have daily contests and prizes and the kids love it. For kids in the ICU who are awake and interactive, but still too sick to go to the ward, they bring music, games, movies and other activities to the bedside and spend time visiting or entertaining. Their visits are often the highlight of the child's day. Each inpatient unit has a playroom on the unit with TV, toys, games, books and music. There's also a huge second-floor playroom bursting at the seams with toys, games, sand and water play tables, video games, a pool table, arts and crafts supplies, an aquarium and a plethora of fun stuff. In the summer there's a playdeck overlooking the hospital grounds where kids can climb, jump, ride trikes and do outdoor activities. The playrooms are off-limits to any kind of nursing or medical interventions, so the kids feel safe there. The preschoolers go down to the big playroom in the morning, the adolescents in the afternoon. For the chronically critical or kids with technological dependencies the child life specialist engages in developmental play and encourages them to meet their developmental milestones.

The other hospital, on the other hand, doesn't have nearly the program development of the first. There are a number of people on staff, and a huge fourth-floor playroom called the Beach, where the kids are safe from any nursing interventions. The adolescents have pizza and a movie once a week and there are lots of diversions for the kids. But the ICU patients are all but ignored. There is a specialist assigned to the cardiology patients in the ICU (a good 2/3 of the kids we admit) but I've never seen her do anything with the kids, except for the few alert and interactive older kids who are able to converse with her. She sweeps through the unit in the morning, stops and chats with some of the parents she recognises and then heads into the staff lounge to check her email and surf the Web for a bit before disappearing again. We have a number of long-stay post-operative cardiac infants who are losing developmental ground every day but she has no time for them. On the other hand, there is another specialist whose assignment to the medical ward means that she will have patients in the unit sometimes. She comes sometimes several times a day when she has kids in the unit and she does all the things I expect of the child-life specialist.

I know first hand that child-life is a vital and integral part of caring for sick children, since my son spent months and months of his life in hospital years ago. The child-life staff who were involved with him were terrific and made a big difference to all of our lives. We still have the video the medicine and oncology specialists made for us in 1989 when we were in a hospital several hundred miles away for months and missed our home so badly. But the provision of services depends so much on the individual taskeed with providing them. If you have someone who loves what they do more than they love the money they're paid to do it, you'll get the cream of the crop. I think you'll be that.

lpnstudentin2010, LPN · Mar 2, 2008

Yes the hospital where I am a patient has an AMAZING child life program. This is where I learned about it in the first place. I have had many surgeries so having them is no big deal to me, but the first one I had in a few years was when I was 17. I was in pre-op waiting to do all the check stuff they do a few days before to prepare for the surgery. I was coloring with the little kids, since I have always loved kids, and the child life specialist came, sat down next to me and started a conversation. She wanted to make sure I knew what was going on with my health and that I was, indeed, all right and not all upset over it. She was awesome. Back then I still wanted to be a nurse.

I then met some more who I do not specifically remember. Then came the day I realized that I could not do science. I was doing very poorly in school as a pre-nursing major and needed a change. I realized that I wanted to be a nurse to help kids through being in the hospital; it was what I had wanted to do since I was 5. I realized I could do that, maybe even more then as a nurse, as a child life specialist.

I have since talked with a lot of them at my hospital, especially that one in the pre-op clinic.

At my hospital every ward has its own CLS. Along with the pre-op clinic, pre-op holding, day surgery pre-op holding, radiology, nuclear medicine and probably others that I just have not needed to go to so I have no experience there.

Thank you for your experience.

Pediatric Critical Care Columnist · Mar 2, 2008

This sounds like the perfect choice for you. There are so many more ways of helping kids through illness and hospitalization than just nursing. You have insight and compassion and I think you'll be a great CLS. Go for it!

rbs105, ADN, MSN, RN · Mar 19, 2008

I came from SLC, UT where they had an incredible child life program at Primary Children's Medical Center. I got my degree at the University of Utah and got an internship for Child Life but then adopted my special needs son so I wasn't able to complete it. It was amazing there and they took care of ALL kids. My son cannot see or hear very well and he is tube fed, but when he was hospitalized, they still included us in all activities, events, etc. They made a huge poster for him that said what he liked, didn't like, what comforted him, what was the best way to hold him, so all the doctors and nurses could see it-right over his bed. They were incredible!!

So when I moved to PA near a "highly rated" peds hospital, I was expecting the same treatment. WOW was I disappointed. I had to seek out a specialist and when I did, I was actually asked, well how can he even participate (because of his special needs)? I don't care-that is your job to find a way!! In the ICU, he was completely ignored. I finally became my own child life specialist. I made him a poster and the nurses and docs were like, 'wow, what a great idea'!! DUH! Basically, they have no set program or adaptation in place for children w/special needs such as a communication impairment. I have made proposals and suggested ideas and they just look at me.

The best way is to find a hospital w/an internship and get your hours in. You can then actually take an exam and get certified. BUT, my point from above is, look around-just because a hospital is highly ranked, doesn't necessarily mean they have a single clue when it comes to child life. YOu might be surprised where you can get your best education. We MISS Primary Children's Medical Center!!!

rbs105

wanttobeanavynurse · Mar 20, 2008

I know all about Primary Children's!!! There is a fantastic Child Life program there. Each unit has their own child life specialist and there are others on-call if needed. They help prepare patients for invasive procedures and can work with any child of any age - even if they are severely developmentally delayed. I often seek out our CLS when I have a kid going for surgery who has never had surgery before, or for in-room procedures such as PICC placements. Each week there is Bingo on TV and the kids get all sorts of prizes. There is a playroom that has tons of video games and is a fun place for kids to gather and be free. (bringing meds in there is a big no-no). There is even a teen night where the teens get together and make crafts, watch tv, etc - parents not allowed. lol. They are a great part of the interdisciplenary team and I don't know what a peds hospital would do without them!!!

rbs105, ADN, MSN, RN · Mar 20, 2008

Amazing, aren't they?? We loved BINGO-even though my son didn't even know it was on, we still participated for him and every time he won a prize. He also received the most beautiful quilt on one of his ICU stays. We were in the ICU once with our good friends-our sons both had the same procedure done and our friend's little boy died. Not only did they care for our friends, they took care of us, made sure we were okay, that we were reassured. They know SO Much out there about treating the WHOLE child. I wish sometimes that out east here they would realize that although they have made great medical advances, they are so far behind in treating the whole child. Someday....

rbs105

lpnstudentin2010, LPN · Mar 21, 2008

I know all about Primary Children's!!! There is a fantastic Child Life program there. Each unit has their own child life specialist and there are others on-call if needed. They help prepare patients for invasive procedures and can work with any child of any age - even if they are severely developmentally delayed. I often seek out our CLS when I have a kid going for surgery who has never had surgery before, or for in-room procedures such as PICC placements. Each week there is Bingo on TV and the kids get all sorts of prizes. There is a playroom that has tons of video games and is a fun place for kids to gather and be free. (bringing meds in there is a big no-no). There is even a teen night where the teens get together and make crafts, watch tv, etc - parents not allowed. lol. They are a great part of the interdisciplenary team and I don't know what a peds hospital would do without them!!!

This sounds exactly like the hospital I am a patient Children's Hospital Boston. When I was 17 and having a surgery (had had many over my life but there was a new cls) and the cls made sure I was ok by making conversation to me and bringing stuff up. She is now the one I am closest with, and she has done marvelous things for me in helping me on my way to being a cls myself.

MikeyJ, RN · Mar 21, 2008

The unit I work on has one child life specialist assigned to it, and the PICU as one assigned to them. I see our specialists chatting with the staff rather than working with the children on a regular basis. When they do work with the children, they are good at what they do...however, I don't think they are progressive thinkers. You could do SO MUCH as a child life specialist -- in terms of developing and implementing programs and thinking of ways of making the children's hospital stay a bit more pleasant.