This week Captivated By Child Life is excited to share a post from Michelle Finneman. Michelle is a Certified Child Life Specialist who has spent the past year starting a new child life program, with the help of her child life partner, at a hospital which has never previously had child life support. She has experience in the child life profession that spans twelve years within three different child life programs. Starting a new program can seem daunting. Today, Michelle is sharing with us the highs and lows of starting a new child life program and the ways in which her and her partner have found success doing just that.
Having the opportunity to start from scratch, make it your own, offer your community more support and guidance, advocate for children and families, educate colleagues, gain personal and professional development, create new relationships, be faced with new challenges, build and prosper! These were some of the initial thoughts running through my mind when I was presented with the job opportunity to build a brand-new child life program in a facility that had never had these services in the past! So many emotions running through my mind, but I felt ready, I felt motivated, I felt inspired! Now, don’t get me wrong knowing that this facility had never had child life before was also a little daunting. Did I think about having to advocate, educate and constantly prove what we did day in and day out or think about all the little things in between such as space, décor, resources (the list goes on) and how exhausting that could be, of course, but I was up for the challenge and ready for a fresh start!
I have worked as a Certified Child Life Specialist for almost 12 years now and have experienced the ups and down this career path has provided me. I have worked on a variety of units, on many different shifts, I’ve been on small teams, and larger teams. It really just felt like it was time for me to spread my wings, and hopefully fly!
Thankfully, I was not going to have to do this all alone. The hospital was hiring TWO Certified Child Life Specialists right off the bat, which was a huge bonus! Wait, it gets better – after accepting this position I come to find out not only do I have a partner in this new journey, but someone I have worked closely with in the past. I truly couldn’t have asked for a better match, the timing of it all was impeccable!
This really is just the first chapter of our child life program. As I think back over the last year and am so proud of the things we’ve accomplished thus far, this is just the beginning! So, I’ll start there and lead you through some of our struggles and successes to provide you some insight in what starting a program looked like for us, in our community.
Our positions here are set up to have one CCLS in the clinic setting and one CCLS in the hospital, which is an adult hospital with pediatric services throughout; full time M-F daytime hours to start. We have been provided great support by leadership when it comes to our workflow and needs, so we decided to start it would be best to educate. Educate staff on who we are, what we do, how we can help them in their specific roles and units, and most importantly how and when to get ahold of us! We were invited to several staff meetings as guest speakers, we set up one on one’s, we shadowed and orientated in areas we felt most beneficial to learn workflow and processes to best prepare and teach our patients and families for their future visits. In doing this, we certainly had times of feeling drained, but honestly, we had so much support and excitement on the other end it really kept us motivated and excited to keep the education going to promote our services.
Of course, after we educated SO many departments we had to come to terms with the fact that the reality is…. There are ONLY two of us and we are split between campus’ so currently we really have to focus on prioritizing needs and then setting our colleagues up for success with patients if we can’t be there to help support them ourselves. We hope to grow our team in the future, but we all know that typically comes down to a numbers game. Knowing very well that if you have ever done the work of a child life specialist you understand first hand that you could easily spend an entire afternoon with one patient depending on what their needs might be! So, we are tracking every day and having other departments/staff track along with us to show those numbers and prove the need for when the time comes to create a proposal to add to our team!
So, lets dig in…. When I think about our programming in the hospital we really just jumped in to each area and subspecialty we found needed our support most! A big part of what we have done since starting has been working on smoothing out processes and we continue to do so for our pediatric population to help alleviate anxiety related to communication, wait time(s), confusion etc. This piece can definitely have its frustrations and be a struggle at times when patients are visiting multiple areas and staff are not all on the same page or resistant to change, but we’ve found over time, the better the communication we have, the more support we can give and help to become that liaison in between, the greater the success for everyone in the end. Always beneficial to debrief when all is said and done!
One huge success we’ve had in the hospital setting is creating a strong relationship with our anesthesia team!! We have some really great services we now provide that never existed for patients and families before here, and we are so proud to have that relationship and teamwork with them! We started by jumping right in to working with our Radiology department, alongside anesthesia, in working kids off sedation when coming in to have an MRI. It took some convincing and buy in from staff, but once we were able to provide the support and preparation pieces and really show the staff that this can be a success all around we have been able to now get several kids to complete their MRI awake, kids as young as 3 years old!! The other area we’ve worked closely with anesthesia on is the surgical unit. We now have started a pre op tour program and have the ability to provide parent presence in the OR once we’ve made a proper assessment of both the patient and parent(s)/caregiver. This was a huge win for us, as the surgeons and anesthesia team had previously had negative experiences with allowing parents back into the OR before our child life program existed. So, to get the chance to prove how this can be done effectively and be able to use our skills and expertise in assessing and preparing pediatric patients and families for this experience and environment was absolutely thrilling. SO MUCH PRESSURE, but ultimately we knew we could get the job done! Again, I’m not going to say this was a walk in the park. This took many meetings, some hot discussions, and education about what our background and expertise hold, but we were in it for the long haul and we became a stronger team because of it!
Along with these areas we spend our days floating throughout the hospital, we’ve created signage in ALL departments and have spent time meeting staff and giving them a short synopsis of what we do and how to get ahold of us! So, we spend our days rounding and assessing patient needs on our PEDS and NICU units, creating supportive programming as we find the time and floating around the hospital in our sub-specialty clinics, adult units, ED, lab, procedural areas etc. Like most other child life programs we just go with the flow and expect the unexpected. We still, and probably will always be, dealing with days of having to bust into patient rooms when we hear a crying kid from the hallway who is getting vitals or a procedure done without our support when we’ve worked so hard on a plan of deep breathing or guided imagery, but we take it in stride and can be there to assist in their recovery and develop a better plan for “next time.” Not to mention, these times then become teaching opportunities for us and opportunities to debrief with staff. We will probably always have days where we never hear our “real” name and will continue to respond to, “Hey child life!” being yelled down the hallway, but that’s the name of the game somedays!
Our other “home” right now is the clinic setting. Clinic has also been an area that is near and dear to my heart. I have worked in a few different clinics in my career so it’s interesting to compare and pull the positives from each one and share amongst those I work with! After providing education, meeting with staff one on one and passing out signage of what we do and how to get a hold of us we have begun to work closely with our pediatricians and nursing staff on offering our services outside of the day to day immunizations.
This has been a huge success for us to broaden our services in the clinic. That said, we will talk to families during appointment times if their child has an upcoming surgery scheduled, lab draw, and/or procedure to help prepare them and alleviate fear and anxiety at that time. We will call families to discuss anxiety coming into the clinic, even just for a well child check-up. We will advocate and assist with pain management, however that may look. The clinic staff has been extremely receptive to our role and how we can support our patients and work together on creating the best experience now and for future visits. We still struggle with nurses sometimes not seeing the bigger picture or not being as receptive to feedback, but we try to spend the extra time before and after to reiterate and help those to get to a place of understanding how trauma begins and how it only takes ONE experience to set you back for years to come.
Another big win for us over this last year is that we have been working hard to implement comfort positioning for ALL ages and procedures, this of course goes beyond the clinic setting, but this was our big initiative in the beginning. This has been a work in progress and still continues to be, but we have shown our frontline nursing staff how comfort positioning not only provides a sense of security to a child and is important for families to feel involved, but also is a MUCH safer approach when done correctly. We have created our own comfort position flyer, poster and pull up banner using our very own models within our teams to help market this service for staff and patients and are continuing to help guide staff to feel confident in allowing caregivers to comfort hold vs. restrain.
At this point I feel like we have built a great foundation for child life in the clinic and work hard to continue to do so. We still will get those cringing comments of, “so you get paid to play games all day, what a fun job.” and “I wish I could blow bubbles, sing and dance all day long.” These comments used to just dig under my skin. In the beginning I would even let it ruin parts of my day. I just wanted everyone to understand the depths of what we do! I have learned over the years to really appreciate that we wear so many hats throughout the day and one of those is PLAYING! It’s important for me to remind myself that this is a huge piece in what we do and to take it as a compliment even when it doesn’t always feel like one!
Some days building a program is hard, draining, brain busting and just plain exhausting. Other days it is inspiring, drives my passion, exciting, and reassures me that this is what I am meant to do! I’ve worked so hard to get to where I am. I look back, and do I miss having a team of 5 or even 15 Child Life Specialists? Sure, it’s nice to be able to bounce ideas off co-workers and learn from others’ expertise and experiences, not to mention get a good laugh in reminiscing about a child life jab or two you received during the day (i.e. “Hey iPad lady” ). Sure, it would be easier to have resources at my fingertips and not have to create time and time again, but I also didn’t sign up for easy and every time I look back I wouldn’t trade this opportunity for anything, even on the hardest of days.
I have the BEST partner to experience the highs and lows of building a program with, which also makes the struggles and successes that much easier to overcome and greater to celebrate! We lift each other up when days are tough, we motivate one another to be our best selves, we encourage self-care, we lend a hand or an ear when needed, and we know where our strengths and weaknesses lie. We continue to help each other grow and become successful in the work we do. Child life work is not always rainbows and butterflies, nor is building a brand new program, but if you do the work, align yourself with those who will encourage and push you in the right direction and keep your head in the game, you will always flourish in the end!
-Michelle Finneman, CCLS, CIMI, CPST
Comments