Internship: Reflections Week 12

This week has been about building momentum.  My rotation in Pulmonology really revved up this week, with me trying my hand at procedural preparation and support, getting lots of experience with kids with autism, more opportunities to work with adolescents, getting the patient census, etc.  Today I went out on my own to get report from all the nurses, and this week also saw me handling lots of small tasks on my own -- like introducing child life services to new families, meeting kids, finding out their hobbies and selecting age appropriate toys, as well as figuring out which kids to invite to which activities (ie:  music group, toddler group, and some of the big hospital events like bingo and carnival).  I loved the challenge of working with the autistic kids who joined our floor this week, especially the challenge of matching appropriate toys and activities to their individual needs.

Yesterday, I experienced that wonderful confidence booster:  I had several staff members on our floor come up to me, when I was on my own - not with my teacher! - and ask me for help with some child life needs.  To top that, this morning, I had a parent ask me to help her child who was very scared about going to surgery!  That felt pretty good, and made me feel like part of the Pulmonary team!  

There were two kids, in particular, this week who touched my heart.  They were both the same age, and in the hospital for the first time.  The first was extremely anxious about being in the hospital, and terrified to undergo the procedure we went to prepare her for.  We got her through it, though it took a lot of encouragement and still involved a lot of tears.  Later that day, we helped her decorate a "shadow buddy."  These are blank dolls, that kids can decorate with markers, yarn, etc.  She designed hers to look just like her, and then wrote words coming out of the doll's mouth.  "I can't do this!" she wrote.  (Which is what she kept saying about her procedure.)  Then she crossed it out and wrote, "Oh!  That wasn't so bad."  It was like something straight out of a child life textbook.  The next day, I went back to work with her some more, helping her to perform the same procedure on her doll, complete with real needles.  She seemed to love that activity.  Giving kids a chance to reverse roles, to play out the part of the nurse or doctor, is so therapeutic.  It puts them in control, especially when they get to give the doll a needle, and helps them gain mastery over the whole hospital experience.  As we wrapped up the medical play, she told me that her doll did a great job holding still, and that her doll was scared before it started, but now she wasn't scared at all.

The second was very laid back about the whole hospital experience, but it took me several attempts to get her to come out of her room and join in some hospital activities.  Her nurse came to us, asking for help -- she refused to eat.  So, I took her for a stroll around the hospital - a very very slow stroll, as she wanted to handle her wheelchair all by herself.  She didn't need a wheelchair so much as just thought it was a good time.  We walked around, visiting several playrooms, the garden, the teen room, lobby and gift shop . . .  and somewhere along the way, I got her talking.  In the end, she confided to me that the nurse told her yesterday that as soon as she ate something, she would be allowed to go home.  She didn't want to be discharged, she said, she wanted to stay in the hospital and ride the wheelchair and elevator.  In the end, we struck a compromise -- she agreed to eat half her lunch, and I agreed to take her to the afternoon bingo event before she went home.  It all worked out as planned - she even ate more than half, and won several prizes at bingo.  When it came time to leave, she asked me for a hug, and cheerfully rode the wheelchair down to the car to go home.

All in all, a pretty good week!

Internship: Week 11 Reflections

Week 11 marked my move to the Pulmonology Department.  It was a quiet first week among the "wheezers and sneezers."  Most of the kids on my new floor are either cystic fibrosis patients, or asthma patients.  We're just coming out of flu and RSV season here, so only had a handful of kids with those conditions.  Saw some familiar faces, as many kids head to Pulmonary after leaving the PICU.  (Which makes sense, since our floor helps kids who are having issues with breathing, and many of the kids in intensive care are there cuz they stopped breathing.)

My first impressions of the floor are entirely positive.  It's a much more mellow environment than Hem/Onc and PICU were, so it's interesting to see the contrast.  With only 5 weeks in the unit till the end of my internship, my new teacher has put me on an "accelerated" plan.  Generally speaking, I'll be seeing her demonstrate a skill only once or twice before I'm trying it myself.  It was a fairly quiet week, so I'm only checked off on normalization (aka:  playing with kids) so far, but I did get to see a Picc line prep with a teenage patient.  So next Picc line prep that comes up will likely come to me.

Speaking of my new teacher, I really enjoy working with her.  I like her style as a CLS, and her style as a teacher (which can be two very different things!)  One of the first things I noticed about her, as a teacher, is that she has a very different style teaching a child life student, than she does a child (patient).  One of the most useful tools in teaching young children is repetition.  The means that CLS spend their days working with patients who need to be told the same thing 5 times, in five slightly different ways, to help support their learning.  Naturally, many CLS pick up this habit, and subconsciously apply it to all teaching.  In some ways, it's kind of hilarious to listen to a group of CLS (or any childhood educators, I imagine) sit around and explain something to each other.  They frequently repeat the same information 4 or 5 times in a row!  My new mentor doesn't seem to fall into this habit at all.  She explains something once, then asked if I understand.  If I say "yes," that's it, and we move onto the next thing.  I love that!!!

I feel like the end of the internship is suddenly rushing towards me, much faster than I expected.  I have so much still to learn!  Our Friday afternoon workshop this week was on resume, cover letter and interviewing.  I'll start sending out resumes in the next couple weeks, and could conceivably start a job as a Child Life Specialist as early as the end of April!!  Can you imagine?  No wonder I feel like time is rushing by in the blink of an eye!

I know a few of my readers have asked, and more are wondering  . . . . where will this job be?  Who knows?!  There are no openings here in Atlanta that I know of, so finding a job in Child Life means moving.  We knew that before I started the internship, and aren't terribly fond of Atlanta anyway.  We decided a while ago that we'd never be staying here long term, unless something drastically changed our minds.  Matthew's job is a "post doc" and that means it's pretty informal, including how long it will last.  Matthew told me the night before my internship started that when I finished, he'd pack up our family, and moved where ever I wanted for my job.  He's reiterated that offer again this week, as I've been looking at job listings in child life.

So far, I've found 6 openings in San Diego, which would put us significantly closer to my parents (and Aunt & Uncle, and cousins depending on the time of year).  Two openings in NYC, which would be close to my brother, and reasonable driving distance to Matthew's parents and extended family, and Malcolm's birth family (plus all our friends in Rochester!).  I've seen other positions in Florida, Arizona, Texas, Washington, Connecticut, D.C., Massachusetts, and Ohio.  I ruled a few others out on the basis that they get more snow and cold than upstate NY.  Ugh.

Given the economy, our primary goal is a job.  Any job.  And I'll be grateful to have it.  Provided Matthew can find another post-doc in town where said job would be.  After that, something close to family would be nice.  Given that we have family in Buffalo (Matt's immediate and extended family), Rochester (Malcolm's birth family), and NYC (my brother), something within reasonable driving distance (read 8 hours or less) from there would be nice.  That would leave us only having to fly to see my family in California.  Not bad.  In the 8-hour drive radius, we're aiming for something more southernly, to try to escape the cold and snow as much as possible.  Maybe West Virginia?  But an opening in Maine might be worth the cold and snow, as it would put us close to family (my Aunt, Uncle, and Cousins).  I don't know.  The whole process is so complicated, with so many factors!

What do you think?  (Please, I really am asking your opinion, so respond!)  You can respond in the website by clicking the little link below, labeled "Comment," or you can send me an e-mail.  Looking forward to hearing from you!  

Internship: Week 10 Reflections

Hello.  As some of you may have noticed (and a few even e-mailed me to comment), my usual Friday night post never made it up.  Here it is Wednesday evening, and I'm just now sharing my reflections on week 10 (which was second week of the new rotation).  It was a super short week, with only two and a half days in the PICU.  I spent Tuesday shadowing another Specialist (more on that in a moment) and Friday the interns had the day off.  The other intern and I spent our day off writing term papers, and going to a movie together.  Fun!

Shadowing was really neat!  I spent my shadow day at another hospital in town.  Hugh Spaulding Children's Hospital is located downtown, in a rougher part of town.  The hospital is super small, with only 21 inpatient beds, an Emergency Department, a transfusion clinic for sickle cell patients, and outpatient general pediatric section.  The hospital employs one Child Life Specialist for the whole hospital.  It was quite intriguing to see how a one-specialist arrangement works.  I'll give you a hint -- you need really strong skills in prioritizing and organizing your time.  She was fabulous, and I really enjoyed my day with her.  I learned a lot, too!

Week 10 wrapped up my time in the PICU, and I'll be starting in Pulmonary week 11, with a heavy emphasis on Cystic Fibrosis and Asthma patients.  I'll try to post on time for week 11!

It's Good To Be Two!

One of the simple pleasures of being a two-year-old, is that the pediatrician says "He can have peanut butter now."  This week's favorite food . . . "peanut butter pops."  This basically involves scooping up a dollop of peanut butter on a spoon, then handing it to him.  Malcolm gleefully licks the peanut butter off the spoon, like a kid with a lollipop.

Thus the name:  peanut butter pop.

The only thing better than a PB-pop is . . . . . . self serve!

More Ayyam'i'Ha Fun!

Here are a few more fun photos from our Baha'i celebration.  Malcolm enjoyed unwrapping gifts (his and ours!)  His favorite was the Treasure Ball.  This was a treat we made for his classmates and brothers -- and one for him, too!  We used crepe party streamers, and rolled toys up in it to make a ball.  As they unroll it, which is fun all in itself, they find the treasures as they go.  The middle of the Treasure Ball was a ball shaped like an animal (Malcolm's was a parrot) which giggled and squeaked when squeezed it.  The dogs were fascinated!

Internship: Second Rotation Begins (Week Nine Reflections)

Hello Pediatric Intensive Care (PICU)!

This week flew by as I oriented to the new hospital, new floor, new mentor . . .  and all new ways of doing things!  I am, once again, a little fish in a big sea.  But with so much sea to see!  Though I doubt this revelation will surprise anyone -- the PICU is a pretty intense floor. Most of our patients come to us through the Emergency Department with either trauma (sudden injury like a car crash) or acute illness (like pneumonia).  In my first week I've seen a lot and learned a ton.  Each day I come home with a list of new diagnosis I've never heard of before.  My task is to learn the basics of each, and be able to describe them in one sentence, that a 5th grader can understand.  For fun, I'm keeping a running list, to see how many there are by the end of the rotation.  Maybe I'll make it a guessing game, with a prize for the winner?  Hmm . . . .  lemme think about that!

Here are a few examples:

"Osteogenisis imperfecta" -- This means that your bones aren't very strong, so they break easily, or sometimes bend.  (Made famous in the movie Unbreakable.)

"Hirschsprungs": -- The nerves in part of your colon don't work right, so it makes it difficult, or even impossible, for you to poop!  The doctors can fix it with surgery.

"Ondine's Curse" -- (yes, someone actually named a children's disease "curse."  Not really sure what they were thinking!)  When you fall asleep, your body forgets how to keep breathing, so you need to be hooked up to a ventilator when you go to bed.

"Subglottic Stenosis" -- The smallest part of your airway is too narrow, making it really hard for you to breath.  This is the one of the most common reasons that babies get a "trach" (a special tube in your throat that you can breath thru.)  Sometimes, the doctors can fix this with surgery.

And many many more.  Some of the things I see are really neat and interesting from a medical and Child Life perspective (like Toxic Shock Syndrom, Duchenne's, and Pelizaeus Merzbacher disease).  But, it's really hard to see a family standing around their intubated child while the doctor explains to them that he will probably die.  On the other hand, to be able to help that family, to provide support to a sibling who is frightened and confused, feels pretty good.

My High:  catching on fast to all the new medical jargon, and learning about all the new diagnosis.

My Low:  The hardest things to deal with have been the kids hit by cars, the suicide attempts, and the shaken babies.  

On the 1st Day of Ayyam'i'Ha . . .

Ayyam'i'Ha is a time of reflection, celebration, and preparation for the Fast (more on that in a later post).  It's also a time for Matthew, Malcolm and me to share gifts with each other.  This year, we got Malcolm a Doctor's Kit.  His favorite parts are the stethoscope and the anesthesia mask, both of which he greatly enjoyed trying out on the rest of the family, including Mom & Dad, the dogs, and his stuffed Elly Bean.

Here he is, listening to his own heart . . . 

We also splurged on a toy kitchen for him.  (We got the kitchen used, but bought him new food and pans for it.)  It's been a huge hit!  And, I'm pleased to say, it has also provided ample opportunities to successfully practice our "clean up" skills -- every night, just before we start our bedtime routine, we pick up all the many, many toy foods and tiny plastic frying pans, and put them away in a bin.

Check back tomorrow (okay, maybe Wednesday) for more Malcolm!  Coming up . . .  a video of Malcolm and his Treasure Ball!