A day in Child Life: How child life specialists work with Penn State Hershey’s youngest patients

Editor’s Note: March is Child Life Awareness Month. Penn State Hershey thanks its Child Life team for the work they do every day with our youngest patients. This story is a look at what the child life specialists add to the Penn State Hershey experience and how our patients appreciate their involvement in their care. View the “A day in Child Life” photo album.

Hospitals can be scary places for children.

Penn State Hershey Children’s Hospital has a team of certified child life specialists (CCLSs) who help children feel comfortable and safe—to help them understand that the doctors and nurses want to help them get better.

While their days may seem filled with toys, games and a whole lot of Playdoh, the role of a child life specialist is so much more.

Kate Denlinger, certified child life specialist helps patient Kaitlyn Teeter, 5, decorate her anesthesia mask with stickers prior to a procedure she regularly receives at Penn State Hershey Children’s Hospital. “Instead of coping with a bad diagnosis, she just has to cope with the routine of coming in so that she can continue being healthy,” Kate says.

“Child life addresses the psycho-social, emotional, and developmental needs of pediatric patients and families in any kind of health care setting,” said Ashley Kane, Child Life manager.

Child life specialists are constantly on the go and reprioritizing when things do not go as planned. A day in Child Life looks something like this:

6:00 a.m.

Surgical child life specialist Kate Denlinger arrives in the Children’s Hospital pre-op unit to prepare young patients for surgical procedures. “Kids come to the hospital for surgery for really simple things and things that are life changing like spinal fusions or open heart surgeries,” she says. “My kid needs that kind of care sometimes – so I try to make the hospital as normal as I can, and I try to familiarize them with all of the things they are about to see.

“There’s a lot of research that says if kids know what they’re about to experience, they’re more willing to participate in their care than they are to have things done to them,” she says.

Among her patients today is 5-year-old Kaitlyn Teeter, who relies on regular surgical procedures to help with breathing and allow her to eat properly.

“She’s really special in the sense that this is like her second home and she knows all of us,” Kate says.

Kaitlyn has a bit of a ritual prior to her procedure. She wears her own pajamas and she chose a special Winnie the Pooh pillow case from ones donated by community members through the ConKerr Cancer pillowcase project.

Using a medicine cup and tongue suppressors to cut and shape her pink Playdoh is also a regular part of her visit. She makes a new animal every time and takes it home to add to her collection.

“Kaitlyn has been through the procedure many times and she does the same thing every time,” Kate says. “Routine is important with her.”

The routine is part of what helps Kaitlyn cope, though you would not guess she was about to go into surgery by all the smiles and giggles.

“Instead of coping with a bad diagnosis, she just has to cope with the routine of coming in so that she can continue being healthy,” Kate says.

CCLSs use medical play to familiarize children with the items they may see. As they play, Kate talks to Kaitlyn about her procedure. “Do you know what your procedure is going to do today?” Kate says. “It will help you eat again.”

Kaitlynn dresses up like her doctor complete with mask and a pager.

“Do you want to practice on your doll and pretend you’re the doctor?”

Her new doll friend that she decorates can accompany her into the operating room since mom and dad can’t.

Kate Denlinger, certified child life specialist, shows Meney Richards, 5, how medicine cups and tongue depressors can be used to play with Playdoh. Meney brought her Frozen-themed blanket for her surgery visit.

Kate also visits with 5-year-old Meney Richards who brought her Frozen-themed Ana and Elsa blanket with her for her first surgery.

When Kate introduces herself, Meney shares that she is a little scared.

The fear subsides as Kate shows her an anesthesia mask and offers her Frozen stickers to decorate it.

As they play, Kate explains what the mask is for and gives Meney a special scent to put inside because the anesthesia can be “kind of stinky.”

“When you start to breathe in medicine, you’ll feel really tired,” she says.

View the “A day in Child Life” photo album.

 9:00 a.m. 

On her way to the pediatric Oncology/Infusion Outpatient Clinic, Becky Combs picks up a banner she made to celebrate the last procedure of one of her patients. “We have to savor all the good moments we can in this environment,” she says.

Anything from losing a tooth to an A on a test can be turned into a celebration.

Her office is overflowing with toys and activities for the children. She chooses her iPad to take to her next patient.

Becky Combs, certified child life specialist, works to distract Trey Fry, 3, during a visit to Penn State Hershey Children’s Hospital. Trey is questioning extra instruments he noticed on the nurse’s tray. Becky explains they’re not for him and that he’s there only for the catheter changer he’s been told about. “No surprises, remember?” she says.

Three-year-old Trey Fry arrives to change his catheter. First, he decides to stop to help staff do office work.

Becky explains that many of the patients visit so often that they get to know most of the staff and make themselves at home. Trey is one of many little office workers who like to help.

Trey is immediately thrown off by being in a different room than he usually visits, and he notices extra instruments on his nurse’s tray.

He is not easily distracted by the games on Becky’s iPad and gets upset, questioning the extra “stuff.”

Becky assures him they’re not for him and he’s only having his catheter changed as he was told.

“No surprises, remember?” she says.

Trey gets through the procedure despite the change in routine and runs right back out to finish his work after earning a Spider-Man sticker, of course.

In between his procedures, Trey finds child life assistant Diane Shenk in the playroom, along with Penn State student volunteers. Diane has a snowman craft to keep him busy and gives his dad a chance to go get breakfast.

She checks in with children as they arrive and invites them to participate in activities or to check out the toys or movies they have. Many of the children visit weekly or monthly for treatments.

Diane says while watching such young patients go through treatments can be difficult, she does whatever she can to make their days better. “If I can bring crayons and the next five minutes are better, that’s all it takes,” she says.

“That’s what motivates me.”

View the “A day in Child Life” photo album.

10:30 a.m.

Child Life specialist Natalie Chango visits with a regular patient in the Pediatric Acute Care Unit. She brings Playdoh and a Doc Mc Stuffins play kit. This particular little friend gets uneasy around certain tools and equipment, and Natalie hopes playing with the stethoscope and other items will ease those anxieties for her.

It’s noticeable that the staff brighten her day, despite being stuck in bed, and she says she looks forward to more visits and what surprises they may bring.

For Natalie and the rest of the staff, watching children with chronic conditions can be daunting. “It can be challenging because you know that they’re going to be back,” she says. “Those hard times are balanced by those happy moments. They still want to play and have fun and do all the things that kids do.”

Natalie introduces herself to a new patient and her family in an isolation room. When she offers them Child Life’s services, mom shares that the four-year-old loves medical play and is fascinated by treatments.

This little doctor in the making receives a doctor kit and a doll to be her own patient.

11:30 a.m. 

Child Life Assistant Tiffaney Horner checks in with the inpatient unit’s staff to ask if there are any specific patients she needs to see before making her daily rounds.

She fields questions and requests from patients and introduces herself to a new family with a young infant who was fussing during her feeding. Tiffany offers mobile and other soothing toys in addition to any help the baby’s grandmother might need.

She offers to relay a message to the baby’s nurse that she was fussing and not having the best morning.

Tiffaney also checks in on a member of the Advisory Council of Teens (ACT.)

ACT is made up of former child patients ages 12 through high school graduation who offer feedback on their hospital experiences and share their thoughts on new ideas. Some of the children that participate have similar diagnoses, and the group offers peers who have been in similar situations.

“They got into a conversation about operating room visits — what it’s like to go to the O.R., what it’s like to have the meds that you get in the O.R. and how you feel after,” she says.

As she enters some rooms, patients are sleeping or have left for testing or treatment. She continues down her list to see what else needs to be done.

1:00 p.m.

In the Emergency Department, Bethany Figueroa checks the current census to discover 20 pediatric patients. She checks to see if they’ve been admitted before and focuses on the children who have been there a while and will be admitted.

Bethany introduces herself and offers services to a family she has not met before.

The little girl in the bed is bored while waiting for a scan and tries to be content with Sponge Bob as a distraction.

Her face lights up at the offer of Playdoh and hospital items, including an oral syringe to make spaghetti.

Bethany hears a baby fussing behind a curtain.

His mother is trying to keep him from squirming with an IV in his arm by rocking and bouncing him with only the television to distract him.

When Bethany introduces herself, his mom isn’t initially receptive.

When Bethany returns with the requested musical diversions, the baby quiets down and grabs the toys as soon as they are offered. The previously stressed mom smiles and thanks her.

The Emergency Department can be a challenging environment. “One of the most important things we are  involved with is a  trauma,” she says.

The emergency department team reserves child life a spot next to the child where the specialist can talk to the child and explain what’s happening. “It is a little scary. A lot of kids get really freaked out in here, so it’s good to be able to be involved and be here for them,” she says.

 * * *

While only a small glimpse of what Child Life does every day, the emotional and challenging aspects of the job are clear. The Child Life staff do whatever they can to normalize the hospital experience for their patients.

“The best part of our job is when kids come in and feel comfortable here, feel like doctors and nurses are their friends,” Kane said. “We hear kids who say ‘I don’t want to leave, I don’t want to go home’ because we’re able to make the hospital a more comfortable place.”

For more information, visit www.pennstatehershey.org/web/childlife or childlife.org.

View the “A day in Child Life” photo album.

• Jade Kelly Solovey

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