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Making the Hospital a More Kid-Friendly Place

From stuffed animals to playing doctor, program seeks to remove the fear factor

FRIDAY, March 31, 2006 (HealthDay News) -- Hailey Camacho carefully wrapped a bandage around Lisa's arm after she'd inserted an intravenous tube.

"She said, 'It hurts,' " Hailey reported to Talia Haviv, a child life specialist at Children's Hospital at Montefiore in New York City. "She wants to go home."

Haviv nodded sympathetically and patted Hailey on the shoulder, professional to professional.

Except Hailey isn't a professional, she's a lively 3-year-old patient in the hospital with pneumonia who has an IV inserted in her own tiny arm. And Lisa isn't a patient, but a stuffed animal that Hailey is ministering to as part of a program at the hospital to help children cope with the uncertainty, pain and consequences of medical treatment.

Spending time in a hospital is no picnic for anyone, but especially for children, said Meghan Kelly, the director of Child Life at the hospital. "There are a lot of people touching and poking you, strange smells, and kids pick up a parent's anxiety, then they come here."

Easing that anxiety is a goal for Kelly and the eight child life specialists at Montefiore who work with as many as 135 children a day to prepare them for procedures they must undergo and give them a sense of control over their surroundings.

It's an approach that's catching on with more and more hospitals around the country that are looking for ways to make a child's stay as pleasant as possible. And March has been designated Child Life Month by the Child Life Council, which works with medical centers to establish play, preparation and educational programs for kids.

At Children's Hospital at Montefiore, that approach can take a variety of forms, from preparing children for surgery by showing them photos of the operating room and of how the doctors and nurses look wearing surgical masks and gowns; to a teddy bear clinic in a colorful playroom where children take care of stuffed animals in the same way that they are taken care of; to one-on-one medical "play sessions" like Hailey's, in which child life specialists give individual attention to the kids who need it.

"About one-third to one-half of the children who come here need some individual attention, especially kids going into the operating room," Kelly said. "The children are very responsive to the program," she added.

That was certainly true in Hailey's case, who dove into the red, plastic "doctor's bag" that Haviv had brought into her room, pulling out play versions of a blood pressure sleeve, a stethoscope, a syringe, an otoscope --for looking in the ears -- and especially for Hailey, IV tubing just like the one she had.

That morning, Hailey's IV had almost come out, and it took the nurses some time to readjust it, which had upset Hailey, who was in tears and doesn't like to be touched. Haviv learned about this from the nurses, who work closely with the child specialist staff to alert them to children who need extra attention.

So Haviv went into talk to Hailey, gave her a stuffed sheep, which Hailey named Lisa, and promised to come back to play after lunch.

That afternoon, Haviv sat with Hailey on her bed and gently suggested that Lisa the sheep was sick and needed some help. Would Hailey like to help make her better?

Hailey needed little encouragement to start her exam, looking in Lisa's ear, taking her blood pressure -- "any minute," she said, perfectly mimicking the nurses who treat her -- and reluctantly agreeing that Lisa needed an IV, even though it "pinched."

When they had "inserted" the IV, Haviv asked Hailey if she should hang Lisa's IV fluid bag up next to Hailey's on the IV pole, and Hailey agreed.

Throughout their exchange, Haviv always asked Hailey for her advice before doing anything, letting the little girl call the shots -- literally. When Hailey reported -- twice-- that the IV hurt and that Lisa wanted to go home, Haviv nodded sympathetically and explained that the IV was needed to make her better, and suggested that Hailey hold Lisa's hand and sing to her to make her feel better.

Finally, Hailey whispered something to Lisa. "I talked to her, and now she understands," Hailey told Haviv.

"These are coping skills, which give children some control over a negative situation," Haviv said, after she'd left Hailey with her family.

The Children's Hospital at Montefiore treats nearly 100,000 children a year for many serious illnesses, including cancer; blood disorders like sickle cell anemia, asthma, and kidney failure, Kelly said. And the Child Life program significantly improves care, she said.

"The program is not only therapeutic but better for the medical staff as well," Kelly said.

A relaxed child means medical procedures go far more smoothly. For instance, a radiologist can get a clearer image if a child is sitting still rather than wiggling, and a calm child needs less sedation during surgery, lowering health risks for the child.

Kelly also believes that easing a child's path through a difficult stay in the hospital has benefits that long outlast an illness.

"These are life skills that children can take with them," she said. "By learning to cope here, they are empowered to get through different challenges as they grow."

More information

To learn more, visit the Child Life Council.

SOURCES: Meghan Kelly, M.S. CCS, director, Child Life, Children's Hospital at Montefiore, Bronx, N.Y.; Talia Haviv, certified child life specialist, Children's Hospital at Montefiore, Bronx, N.Y.
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