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Nursing Excellence

The Online Newsletter for Children's Nurses
e-Edition, Issue 7

Marian Faccianimary Beth JonesNursing and Child Life,
A Team Approached

Written By: (from left to right)
Marian Facciani, CCLS - Child Life Specialist II
Mary Beth Jones, CCLS - Supervisor, Child Life Services 


Imagine being four years old, left alone in an unfamiliar room, wearing pajamas that are not your own, clutching the stuffed animal someone handed you just after your mother left to go home. You have been poked more than once, and you have tubes taped to your arms and attached to big plastic bags hanging from a hook on a tall pole. The blankets and sheets don’t smell like home, lights are bright, and there is a loud beeping noise coming from somewhere. Every now and then someone comes in to ask how you are and seems in a hurry. He or she looks at the machine on the pole, writes down some numbers and leaves again. When you look out your door, you see people writing in charts, talking on phones, and walking quickly past your room.

After a few days you get used to the routine. You only talk to your mom when she comes at night to visit for a few hours when she gets off of work and before she has to go home to fix dinner for your siblings. You wish she could stay, but know she cannot. You are in a new room and you have a roommate whose mom is there all of the time. You want to ask her to sit by your bed, but you are too shy to ask.

One morning a new face arrives at your bedside. She tells you she is a child life specialist (CLS) and is here to take you to the playroom. Your nurse comes in with a wagon and suddenly you are being wheeled away, your IV pole clanking behind. You are taken into a room that is bright and cheerful. There are toys and books and other children playing at tables and on the floor. You are given child size versions of the very equipment that the nurses and doctors use, and at first you are reluctant to touch them. Then the CLS hands you a stuffed animal, explaining that the animal is sick and needs your help to get better. You use the stethoscope the way you have seen the doctors and nurses do, then you go on to the “shots,” making sure to clean each spot with alcohol. At the urging of the CLS, you explain to the stuffed animal (who you have named Josh) what you are doing. By the end of the session, you feel comfortable enough to talk to the staff in the playroom, and are able to tell your nurse what you want for lunch when you get back to your room. By the end of your hospital stay, you are the “expert” at IV starts and “hold classes” for the student nurses. You are always careful to remind them to call the child life specialist before the IV start, and to tell their patient that they can cry, but they must hold very still. This is important work.

Being in the hospital is a traumatic event in any child’s life. Understanding why they are here and what is going to happen while they are in the hospital is crucial to how children cope with a hospitalization. Child Life works in collaboration with the medical team and is a valuable part of a child’s care.

Child Life provides a variety of activities that help a child cope with hospitalization.

  • For children scheduled to have surgery, Child Life offers a pre-hospitalization tour and education for patients and families. Every Tuesday at 4 p.m. in Day Surgery, a child life specialist and Day Surgery staff member provide a tour of the area and allow children the opportunity to ask questions and engage in medical play.
  • Child Life provides non-medical preparation and support for children undergoing tests, surgeries and other medical procedures. They also provide illness and disease instruction using age appropriate tools and language.
  • Sometimes children have already been traumatized by a medical procedure and become uncooperative with medical/health care staff. Child Life provides experiences to allow the child an opportunity to express their fear, anger and frustration. Many times during a session misconceptions about procedures can be corrected. Medical play allows the child a sense of mastery.
  • Child Life can often help with children who find it difficult to cooperate with staff requests, such as taking medication or allowing necessary assessments.
  • Child Life supports parents during their child’s hospital experience by giving parents the necessary tools to maintain normalcy in the lives of the patients and siblings. The child life specialist can provide teaching and emotional support to siblings affected by illness or trauma.
  • Child life specialists are assigned to all in-patient areas of the hospital and are available Monday through Saturday, 8:30 a.m. – 5 p.m. Please make a Meditech referral to Child Life when involvement may be helpful.

All child life specialists have a BS or MS in child life development, recreation therapy or early childhood education. Each specialist completed an internship and is certified through the Child Life Council.


In This Issue

A Walk On The Family Side

Patient Family Satisfaction

Family-Centered Medical Care

Family-Centered Communication

Nursing and Child Life

Spiritual Care


Family-Centered CARE

Pediatric Diabetes Care

Supporting Teens on Dialysis

Patient Satisfaction Comments