June - 10/8/2020 👍

Thursday October 8th was a very exciting day for me.  I interviewed someone whom I have admired for a while.  June went to Rhode Island College and got her undergrad in Youth Development, then was able to go to Wheelock College for her masters in Child Life Therapy.  Now she works at Boston Children/s Hospital.  Although she just had a baby and is currently on maternity leave, she was able to give me plenty of insight and information on how Child Life has adapted to the pandemic and what that means for children in the hospitals.

https://emailric-my.sharepoint.com/:v:/g/personal/npatenaude_0387_email_ric_edu/EVK_SGOtg4NOoly2y-C9qp0Bb67kQWLo0EqfUpkHUeWZHw?e=wL4HEY

It was interesting seeing the difference between my interview with Rachel and then this one with June.  June was such a great resource for me because I was able to really talk to her about specific techniques and the effects that COVID has had on child life specialists during this pandemic.

   Interview Transcript:

In your own words, how would you describe child life therapy in child life specialists? 

A:  So today, say what we do is we are there to normalise the environment for patients and families. The hospital can be a really scary place for kids. It can be a scary place for adults as well.
So our job is to kind of come in and meet the child where they're at and help them still be a kid while they're there, helping them understand what's happening to them procedures and just kind of being that support person in that safe person for them while they're in the hospital. A lot of studies have shown that kids who are prepared and know what's happening to them before it happens or have an idea and a developmentally appropriate way do much better.
So that is that is our job. And a lot of what we do is doing that through play, because that's what kids understand. That's their language. So we meet them where they're at through play and hopefully make a difference while they're with us. I love that answer. I love it because a lot of the interviews I've done, it's always meet them where they're at. So I love how that huge.

How did you become interested in child life, so I became interested. 

A:  My older brother was a cancer patient at Hasbro Children's Hospital in Boston Children's Hospital when I was very young. I was his bone marrow donor twice, two and a half and three and a half. And then he unfortunately passed away when I was five. But I still have memories from our time in the hospital and we have pictures with our child life specialists. So I kind of always had in the back of my mind growing up and, you know, I ended up going down that path and I love it.
So it's really cool. And it's especially cool to be back at I'm at Children's right now, Boston Children's. So it's really interesting to be back at the place that we spent a lot of time at when I was a kid. And now kind of being on the other side is is really cool.

Do you think that that your experience has helped you? 

A:  I think so.I think I have a little bit of a different understanding than maybe some people coming into it, just because I've kind of been on both sides of the side helping patients and families. But I've also been on the side of having a sick sibling and seeing what my parents kind of understanding now more as I'm older, but what my parents had to go through. So I think it definitely gives me a little bit of a different perspective when I'm working with patients and families for sure.

What's interesting, so after you got interested in everything, how what was your path like educationally, professionally? How did you get to where you are? 

A:  Absolutely.  So I started I didn't I wasn't fully set on child life through high school and so forth that I kind of always wanted to be. I didn't always but I kind of had teaching in the back of my mind as well. So I started at Rick. I did my undergrad at Rick, and I started an education, but kind of knew it wasn't it wasn't really for me once I started getting into it. I loved working with kids, but I didn't want to be in the classroom, really. And then I think youth development kind of became the thing like a major kind of when we were in it. And I knew I kind of had in the back of my mind at that point that I wanted to go for child life.
But I knew I needed a a undergrad degree of related field. Yeah. So if I had to go through teaching, I would have done it. But I figured youth development kind of would have been kind of the best, best path excuse me. That way you kind of get a little bit of everything.
So I did that with the idea that after I graduated I would apply to grad school and try to get my child life degree, which I ended up doing. So I went to I took a year off, actually. I went to Beilock for for grad school, their program. I think they're the first child life program in the country and they have a really good job life program. But the only problem is they get hundreds of applicants and only accept like nine or ten people. So the first year after undergrad, I applied and I got waitlisted.

So I was the second I think there was one girl ahead of me there waiting for her decision. If she had said no, I would have gone in. But she said yes, she went in. So it kind of derailed me a little bit. And I was like, I didn't really know where I was if I was going to try again. Or maybe it wasn't the path for me. But I actually met with Leslie and Karen a lot and they kind of helped me through it, which is awesome. So I applied the next year and I got in and the rest is history.

It was it was a good a good stepping stone because it did get me in for those internships kind of to make connections within the child life world. And that's ultimately how I ended up getting him both jobs, both the two child left jobs I worked, which I know that you work at Boston now, Children's.

I started my final internship because you do two in the Child Life program at Wheelock. My final internship was in the emergency room at St. Luke's Hospital in New Bedford. So I was there for my final semester. It's a very small program, one person program, the woman who runs it was the one who started it and she hired me after my internship. So it was just me and her kind of running the inpatient unit in the ed.

But I was working per diem, so I didn't have benefits. I was getting pretty much close to full time hours, but they weren't giving me benefits. So I was there for seven months and then a job at Children's kind of opened up. And I had connections through Wheelock and new people there and was able to kind of get in. Oh yeah. And now I that's where I've been for two years now. So that's awesome. Yeah.

What strengths you think that you have for child life? 

A:  I think part of what we said earlier, I think I have a unique perspective just because I've kind of been on both sides. I love, love working with siblings. Just, again, kind of that unique perspective.

And I kind of can understand where they're coming from. But I think the biggest strength is I feel like I'm able to kind of, again, as I said earlier, kind of get down and meet the child where they're at. And I feel like it's gotten especially with experience. I've gotten better at it and the environment in which I've worked kind of the high.

It's a very fast paced settings to be able to kind of go in a room, assess them pretty quickly, and then it's kind of a challenge to try to see what you can do to kind of make a connection with somebody, whether it's a teenager or a four year old, whether it's the family that's incredibly nervous because they're waiting for results for their child.

I feel like I've gotten pretty good at going in and trying to kind of feeling out the room and hopefully connecting with them in whatever way works best for them, whether it be talking about something, a blanket that the child has proper or maybe dad has like a sports hat on or something, just finding like little ways to connect with them, to make them feel more comfortable and hopefully open up a little bit more to me.

Do you think that has anything to do with your age, the like connecting with with the children? 

A:  I do actually.  I have we do have there's I think in our department children's there's 70 of us, not all child like specialist that we count like music therapy in there. And we do have some people that have been there for years. The two women I work with on my team, my drug team, they've been there for twenty five years and they're phenomenal. They're amazing at what they do. But I think sometimes when young people come in the room, for whatever reasons, kids are a little bit more depending on the age, too, I think, especially for teenagers or maybe that like pre-teen. I don't know if it's because they can relate better, which is my guests.

And just being younger and knowing kind of what like teenagers are into and hearing that, I think it does, they feel a little bit more likely to open up. And I think it does help them open up as well. OK, so you talked about play as one of your big techniques. Yeah. Do you have a specific. Interaction or play technique or something like that that you felt really successful with? Yeah, it's very dependent on the patient. It's also dependent on where you work.

Like I'm an MRI. That's the unit, like radiology, MRI, mostly an MRI. But I do float around to other units in radiology. So our kids are you have to be careful and MRI one because it's all MRI safe. And I have certain things with like magnets or any of that. The biggest thing, again, it depends on the child. And because we're fast paced as an anesthesia unit mostly.

So they're coming in. They have any and they're usually pretty cranky, you know, and they're kind of moving things along. They're getting an IV started and they're kind of going under. So I don't have I'm also there's also five rooms running at once. So I don't have the kind of leisure time to just sit and kind of sit and play with them. So it's mostly procedural based play. I've.

The biggest thing kids love is an iPad. We have four iPads that float through our unit and we use it very big for like distraction kind of kids getting an IV started. Know, we always tell them if they want to look, they certainly can look. Some kids do really well watching some kids. You kind of have to divert their attention. And the iPad is huge. And to be able to one, if you want to block kind of what they're seeing, that's kind of a nice way to do it.

Or sometimes they like to like, look over, but they're so kind of into the game they're playing that they're going to like, OK, well, this is happening. But this really cool game on the iPad, that's a big one. That's what we use. And a lot of the times I'll always start off and I'll be like, let me show you my favorite game, which is like it actually I do have a favorite game is the silly haircut game I love. So all the kids, then I'll show them and they usually get pretty into it with me. So it's kind of like that.

And sometimes it's even if the child doesn't want to play but they want to watch, it's me playing for them, which can be big in our field sometimes with kids too sick to play or they have stuff on their hands or they can't play and kind of watching someone else play or helping them play can be big. So those are the two main things we ought to do is buy books. A lot of our kids like I buy books. So like I said, a lot of the play I'm doing is play for distraction and diversion to kind of ease any anxiety.

And over those five starts, which is basically pretty much how most of our kids go under anesthesia therapy. Have you had any difficulties, were there any difficult situations with not doing well? 

A:  No, absolutely. We see a lot a lot of patients with behavioral plans, which we have a whole behavioral response team that kind of helps out with child life as well. So a lot of difficult kids coming in who they either don't tolerate.

Some of them are children who have a lot of sensory needs. We have a very high population of children with autism coming in. So those visits can be hard on. Our unit is very overstimulating.

They meet five, six, seven, eight people coming in and out of their rooms within a couple hours. They're getting a lot of things done to them. The IVs sometimes are taking a premed. Sometimes it's the mask over their face. And a lot of the times a lot of their triggers are not eating and waiting. And our kids come in again, not eating. And they sometimes have to wait. Like if there's a delay in anesthesia, there's sometimes there's an emergency and cases get pushed back.

They're sitting in this tiny little room, sometimes for hours, which can be really hard for them. So we've definitely had kids come in who either sometimes are just having a bad day, but kids who have a lot of needs. And you kind of have to plan around how can we make this environment as comfortable as possible for them while they're here with us for two hours. And a lot of the times it's working with the families.

We always say the parent knows the child best and kind of having them give us what they think is going to work best. And sometimes it can be even worse leaving the kid alone.

Sometimes they don't want to be distracted. They don't want it. Just sometimes you're another person in the room. So the best therapeutic approach sometimes is like check and see if anything, but kind of understanding when it's OK to step back and just kind of let the parents handle it, which is can sometimes be hard in our fields because I think a lot of staff often misunderstand what our role is.

And they hear a child crying and they automatically are like, OK, go work your magic. But sometimes crying is coping. So sometimes kids just need to cry. And that's OK. It doesn't need to always be fixed. So that can be kind of a great challenge. But I think the biggest is definitely our behavioral patients who, like I said, they have sometimes a tough time waiting and they're hungry. I get it. I'm hungry. I get angry too. So I don't blame you.

Yeah, well, it can be tough. 

Do you have kids from group homes that might not have a parent bringing them in? 

A:  We do, yeah. We see that a lot to a lot of a lot of group homes they're coming in with just like whatever workers with the Monday times.  It's a worker they have a relationship with. Sometimes it's not that can be tough, especially if they don't have a relationship with them, because, like I said, in our our environment can be very overstimulating and very scary for kids. So, you know, mom or dad's not there. That just makes it even worse. That's hard. Mm hmm. Um.

So I know that you've been pregnant throughout a covid, but before you left, did you see changes in how you were working with kids? 

A:  Absolutely, yeah, I worked. I actually worked all throughout the pregnancy. I was off for about six weeks, kind of when things started, because they weren't they weren't really sure what to pregnant women. So they're like, yeah, you can stay over for a little bit. But then after they're like, you know, it's time you got to come back. So I worked from out all of April. I went back in May and then I worked all through up until I delivered. I delivered two weeks early, actually.

So I was there. And it definitely everything was harder. It's the biggest thing starting as we all started wearing masks so kids couldn't see our faces, which is awful nervous and absolutely. So it was just so forth, like you can't even it's hard. They couldn't even see us smiling. So it's like someone's coming in. I would always try to do with my eyes like, oh, so they knew. But I mean, it's scary.

Another big thing we blow bubbles a lot in our unit is super distraction tool for toddlers, even like three, four. Even school age kids sometimes love it. We were no longer allowed to use bubbles or pinwheels for helping them through their breathing. Yeah, because we couldn't we couldn't take our masks off and it couldn't be anything that we were blowing.

The kids were encouraged to keep their masks on, which is hard for a lot of kids. And their parents came home and he absolutely so under two they didn't have to but two and over, we had asked that they do. A lot of our kids didn't.

And then the biggest thing was when our kids fall asleep under anesthesia, they go to an induction room and one parent is allowed to go with them. And some of our anesthesiologists decided, well, I think the department decided that parents could no longer go back into that room because it was too many people because of covid, which caused.

A huge I mean, for I think I saw it more than anybody else, but it really it's hard it's hard to tell a kid that they can't have their parent, especially for our kids who had maybe a little bit higher needs coming in. Some anaesthesiologist were very flexible and they would kind of let it happen.

Some of our older kids, they would kind of give up premed in their ivy before they took them so that they didn't really know what was going on. But for our young kids are like toddlers and infants, it was sometimes taking the kids away from their parents screaming. And it's hard to explain to a two year old why we're doing that. So that, I think, was the most difficult thing for me to navigate and for our kids and families, too. I mean, no parent wants to do what they're done, nervous to begin with and then to kind of like watch their kid be ripped away from them as they're screaming down the hall.

That was the biggest thing, social distancing, trying to stay away from people. And a lot of what we do like getting down on kids levels and like kind of getting close to them. And we had to be a little bit more mindful of that. So it was just a little it's harder to connect when you have a mask on and you can't get super close and you can't use the things that kids. You know, that help kids like bubbles or pinwheels.

So it was tough. It was really tough.

Do you think that you were still able to play as effectively? I think we made it work. I think I made it work.

A:  A lot of our time and everybody on our team, really the whole we kind of it's crazy how we were able to just kind of be very creative and we got like bubble guns that would spit bubbles out on their own and finding ways to connect the kids as best we could.

But I think it I think for me, there were times especially vary depending on the patient and their needs. But there were times where I was not able to, I think, as effectively do what I would have had normally would have done had we not had those precautions. We did our best and I think it worked for some kids, but for some kids, I think it definitely, I think made a difference for sure.

I didn't in my unit, just because we were outpatient, a lot of a lot of us actually ended up working from home like a day or two a week just because the hospital wanted us. They didn't want a ton of people in the hospital. We cut down to like, I think 20 percent of employees. So we would do like administrative stuff that we had to do, but we would just do it from home. And a lot of our child life specialists on the inpatient units would do like virtual visits from home with the kids that well.

And then our our pet therapy program, pawprints, they and I think our clowned to they went completely virtual because the dogs were not allowed in the hospital. They're still not at this time. And the clowns kind of weren't allowed either. So they set up a bunch of virtual things to kind of keep patients connected so they could still see the dogs and the clowns kind of did shows in our secret studios, which is run by Ryan Seacrest.

Did you guys do any virtual stuff? 

A:  We did.  They kind of did all kinds of virtual things. So the kids get it on their TVs in their room to find ways, like I said, to keep kids involved and assess their needs. But doing it in a safe and virtual way, that's awesome. Yeah. So, OK, so this one's a little funky, but.

Did you personally or in the hospital or anything like that find that covid was it affecting specifically low income minorities? Because I guess that's what the research is showing. But what is your take on that in terms of. Like this, the sickness, like if they're getting, like, asking if they're we're seeing more of that. 

A:  Yeah, like I didn't.  So the way my unit worked is because there's anesthesia. We did not the the patient trial tested twenty four hours before they came in to us. So they had to be they couldn't go under anesthesia unless we knew they were positive or not. We did have kids from the floor who were positive. That did come down for like emergency things. But we didn't have a ton of our senses for covid wasn't very large.

I think it's the most we had like seven in patients with it. So I it's hard to say if it was if we saw, like, more lower income families getting sick. What I can say is, I think made it a little bit harder for our lower income families coming in because they had to arrange twenty four hours beforehand. They had to drive to the hospital to get tested. So they had to arrange for transportation, transportation, which can be a problem for a lot of our lower income families.

And a lot of the times they had we have a one visitor rule or one parent, two parents really for anesthesia. We're allowed to come in. But siblings were not and are still not. And we found a lot of families were having trouble finding child care for the other children. So it was really hard to come to the hospital twenty four hours before with one kid, but have to find arrangements for their other kids and get transportation, which they couldn't afford. Or it was hard to get transportation because they were scared to get in a car with somebody, someone that they don't know.

So in that I saw in that way affect them, I can't totally speak on whether or not we saw more patients who are lower socioeconomic sic. The data kind of has shown that it was kind of affecting those populations more. So I would assume it may have, but I didn't really see those those patients, so I'm not sure.

So. Forgive my frankness, but how does your identity as a white woman affect how you're working in the populations that you're working with and, you know, having families identify with you and connect with you? 

A:  Absolutely. I think about this a lot, especially now in kind of what we're dealing with right now with all this all these awful things happening in the world. It was interesting because we and we hadn't talked about it kind of with some of my colleagues.

I think the majority of us are white, were white women. I think we have one nurse who is black.

And I often thought about that when I was going in to patient rooms and trying to connect. And, you know, one, they don't know me. Who am I? But two, it's like if we have young girls and I say young girls especially this because I feel like there but I guess young males to coming in. Wouldn't it be nice for them to see more people who look like them, you know, who they can probably identify with more, who understand probably the struggles that they're going through families way more than I can as a white woman.

So it's something in the back of my head. I always try to be kind of with families to, like you say, with kids, to relate to them as best I can. But there are I think some of it is just having understanding that there are ways that I can't relate to them and I probably never will be able to relate to them in that way again because of the white privilege I have.

So, again, trying to be as understanding as possible, letting them be open and hopefully making it a comfortable space for them to kind of express anything that they feel they want to express to me as we're talking. But I do think and we have a lot of things that we've done kind of in our department with everything going on, kind of talking about being more open.

And a lot of the things we're talking about is that we don't have a lot of nurses or even some doctors. We do, but even doctors who are black. So I think it I think it's definitely a conversation. And I think we should have people who everyone, all different cultures and races can relate to, because I think I think it would be so much more helpful for their care. And I think there's almost like a different level of trust there, just like, you know, when someone comes in and, you know, like they understand they understand me that.

Right. So I try my best to, like I said, try my best to. You know, be supportive, and I think sometimes it's just saying, listen, I, I don't I don't I can't understand what you're going through. I am with you. But, you know, I support you 100 percent. But and so I think that's sometimes comforting for people. Not that I've ever had the direct conversation with someone about it. Family. No one's ever said anything to me.

But, you know, just kind of having that understanding. 

What advice would you give to a brand new child life specialist or an intern working with kids and family? 

A:  I would say I think the biggest thing is to be flexible and be flexible. A lot of the times you kind of come up with a plan for someone or a patient or family and you go in the room and within 10 seconds that plan is out the window.

You kind of have to be able to think quick and and be flexible and know that things don't always work out perfectly when you're creating a coping plan or when you're working with patients and families.

Sometimes you think one thing is going to work and you end up, you know, it ends up being the thing that was like the worst. So you go in with a lot of options and I think really take the time to to to assess the room and get to know the patient, but also be flexible so that I think especially with with staff, I mean, sometimes because there's still a lot of there's a lot of misconceptions about what we do.

Even in a hospital like Boston Children's Hospital where we're huge, there are still staff that have literally no idea what we're doing. We think we're going in to just entertain kids. So. Kind of you have to be pretty, you have to be pretty strong and be able to kind of advocate for the profession yourself and be flexible with patients and families and also staff, because if not, it can get pretty frustrating for sure.

Yeah. So if you were to give advice for an intern or a new specialist in the realm of covid-19. Yeah. Would that advice change at all? 

A:  I don't think so, I think. I would say I would add be flexible and be creative, be creative, because what you've been trained to do isn't always going to work with these covid guidelines.  But we still have to we still have a job to do and we still are seeing patients. We don't our job doesn't stop for covid. So we have to figure out how we can connect with families in whatever way we possibly can. And it's takes a lot. Out of creativity, a lot of creativity. All right.

You kind of talked about your educational background and all that. Is there anything either in the field of child life therapy or just in general that you would like to learn more about? 

A:  Absolutely. We have a strong background in child development, which is huge. And I would I would tell anybody that's it's like the most important part of our job is knowing child development and knowing ages and stages and kind of understanding that. But I think also.

For me personally, I would like to do more with bereavement.

It is a huge part of our job, not my specific role, just because I don't see that a ton more in the unit I am where outpatient. A lot of our girls upstairs suffer sometimes a ton of what they do is like bereavement support for families and siblings. I don't I don't have a ton of experience in that. So for me personally, I would love to get better at that and to know more and to be more effective and efficient in working with families who are kind of navigating end of life situations where.

How did what was the best things that you learned about play? 

A:  The best things I learned. I think what's up, whether it's a technique or just in general, I think the biggest thing is they're they're kind of like two types of play. There's like very. Child directed play where you just kind of let them. Do their thing, lead the way and let them do their thing, which I find is really helpful because a lot of the time is watching a child play.

You're learning about them and you're learning kind of how what's the way they're thinking and misconceptions.

There's very like you can there's also a very structured play that you kind of come in with a goal and you're trying to either, like, get a child to express themselves or something. But my favorite is this child directed play and just letting them.

Do do what comes naturally to them, and you really do learn a lot about them, whether they're playing with action figures or blocks, sometimes even during the play, they're talking and saying things. So I think the biggest thing we learned is just letting just letting giving the kid an outlet, a safe place to play and be a kid and kind of picking up on details of what they're saying or what they're doing to to help you learn about them.

And the more you know about them, it's easier for you to help them, whether it's coping or distraction or diversion or even their family situation. It's it's a huge rise.

OK, is there anything that I didn't ask that you want to tell me? 

A:  I don't think so. You got some good questions. You covered all the bases, play covid, schooling, internships, I think that's you covered a lot of this with the I'm just checking the boxes. You did good. You got them all. You did good. All right.

Is there anybody that you would like to refer me to that would be willing to talk to me? 

A:  I do, yeah. I spoke with one of my good friends actually at the hospital, Megan. She had mentioned that she would be down to to talk with you. So I can actually I don't have her information ahead of me. I should have gotten it for you. I will email you or I can message you her info, her work, email. She works in cardiology at Children's. She's child life. She's awesome. She's so good at what she does.
So, yeah, she had she had said she would be willing so I can check in with her again, see if she's still able to do it, which I don't, I don't see why she wouldn't be. I think she will be. I'm going to consider your info. I would probably tonight or tomorrow, if that works for you.