5/5/09
Happy Cinco de Mayo, amigos!! This week (so far) at RCCH it has been just Jamie and I. Cara and Taylor are gone and Caroline has been away with her parents while they are visiting. Mondays are one of the big theatre days. There were 8 kids of the 18 on C2 scheduled for the ONE theatre reserved for burns. The remaining 10 inpatients and 5 outpatients all had dressings to change and attention spans to occupy. Even still, the ward was entirely manageable and the morning passed fluidly.
While in theatre with a patient (who was passed out on meds and taken in almost immediately), I ran into another patient who I recognized from past visits to C2. She is 7 years old and a spitfire. Weighing in at about 30lbs, she is affectionate, busy, talkative, and energetic. Her injuries are pretty involved and she has a history of theatre anxiety, particularly with the large lights and the mask used to administer anesthesia. Today, waiting her turn for surgery, she was her bubbly self. We began to play solely for fun. Before long, the doctors called for her and she became teary and clingy to her mother. The mother asked me to accompany them…and bring bubbles. As we passed through the doors to the theatre, the patient ‘hit the ceiling’ (as we say). She was reaching for the door and crying. When she spotted the mask on the bed, she out her hand over her face and shouted, “my nose is closed! My nose is closed!” The team led mom and the patient back out into the hallway and we discussed trying an IV (instead of the mask). They gave her some numbing cream and sent us to a bench to color. I gathered that neither mom nor the patient understood what the cream was for. I did an impromptu preparation; explaining the IV and the purpose of the cream. By child life standards it was far from an ideal prep situation, but it rarely ever is. Just as I was closing up my sprinted prep session, the doctors called for us again. I asked if mom could hold the patient during the insertion. Implementing, a “comfort hold”, I suggested that the patient sit facing mom. This would allow them to hug each other and minimize the patient’s space to squirm (but in a non-threatening way!). After two attempts at inserting an IV, and lots of crying and bubbles, the mother stood up and announced that they were finished. In the past, this patient has always been medicated before surgery because of her anxiety. Because the patient was admitted from a general pedi unit (not C2), her history was not known and she was not pre-medicated. The patient’s surgery was rescheduled at mom’s request.
Later, Jenny Thomas (head of anesthesia-and our ‘boss’) found me. She began to describe the patient I had been with in theatre that morning. She was seeking us out to help prepare the child appropriately. She feels strongly about the work we do in child life and goes the extra miles to ensure that our services are present where needed. I told her I had been with the patient that morning and was hoping to work with her further. Jenny informed me that I would have that opportunity since she scheduled the patient to come in next week for the sole purpose of being prepared. As a child life specialist, it is common to slip under the radar. We often have to seek out the patients in need ourselves and then beg for a few minutes alone with the child for a quick preparation. It was refreshing to be so accommodated for. The only thing weighing on me now is that I pray I am successful!
I should use this time to talk about the Child Life program at RCCH. I realized I haven’t talked much about that, as big a role as it has played on my time spent here. What’s happening here is nothing short of extraordinary. Jenny or Prof (the respective title given to head doctors) has been an amazing advocate for our practice. Jenny believes child life plays is an integral part of the medical team and is nothing but supportive. She has been extremely instrumental in implementing the program, providing our (generous by Child life standards) office space, and connecting
Happy Cinco de Mayo, amigos!! This week (so far) at RCCH it has been just Jamie and I. Cara and Taylor are gone and Caroline has been away with her parents while they are visiting. Mondays are one of the big theatre days. There were 8 kids of the 18 on C2 scheduled for the ONE theatre reserved for burns. The remaining 10 inpatients and 5 outpatients all had dressings to change and attention spans to occupy. Even still, the ward was entirely manageable and the morning passed fluidly.
While in theatre with a patient (who was passed out on meds and taken in almost immediately), I ran into another patient who I recognized from past visits to C2. She is 7 years old and a spitfire. Weighing in at about 30lbs, she is affectionate, busy, talkative, and energetic. Her injuries are pretty involved and she has a history of theatre anxiety, particularly with the large lights and the mask used to administer anesthesia. Today, waiting her turn for surgery, she was her bubbly self. We began to play solely for fun. Before long, the doctors called for her and she became teary and clingy to her mother. The mother asked me to accompany them…and bring bubbles. As we passed through the doors to the theatre, the patient ‘hit the ceiling’ (as we say). She was reaching for the door and crying. When she spotted the mask on the bed, she out her hand over her face and shouted, “my nose is closed! My nose is closed!” The team led mom and the patient back out into the hallway and we discussed trying an IV (instead of the mask). They gave her some numbing cream and sent us to a bench to color. I gathered that neither mom nor the patient understood what the cream was for. I did an impromptu preparation; explaining the IV and the purpose of the cream. By child life standards it was far from an ideal prep situation, but it rarely ever is. Just as I was closing up my sprinted prep session, the doctors called for us again. I asked if mom could hold the patient during the insertion. Implementing, a “comfort hold”, I suggested that the patient sit facing mom. This would allow them to hug each other and minimize the patient’s space to squirm (but in a non-threatening way!). After two attempts at inserting an IV, and lots of crying and bubbles, the mother stood up and announced that they were finished. In the past, this patient has always been medicated before surgery because of her anxiety. Because the patient was admitted from a general pedi unit (not C2), her history was not known and she was not pre-medicated. The patient’s surgery was rescheduled at mom’s request.
Later, Jenny Thomas (head of anesthesia-and our ‘boss’) found me. She began to describe the patient I had been with in theatre that morning. She was seeking us out to help prepare the child appropriately. She feels strongly about the work we do in child life and goes the extra miles to ensure that our services are present where needed. I told her I had been with the patient that morning and was hoping to work with her further. Jenny informed me that I would have that opportunity since she scheduled the patient to come in next week for the sole purpose of being prepared. As a child life specialist, it is common to slip under the radar. We often have to seek out the patients in need ourselves and then beg for a few minutes alone with the child for a quick preparation. It was refreshing to be so accommodated for. The only thing weighing on me now is that I pray I am successful!
I should use this time to talk about the Child Life program at RCCH. I realized I haven’t talked much about that, as big a role as it has played on my time spent here. What’s happening here is nothing short of extraordinary. Jenny or Prof (the respective title given to head doctors) has been an amazing advocate for our practice. Jenny believes child life plays is an integral part of the medical team and is nothing but supportive. She has been extremely instrumental in implementing the program, providing our (generous by Child life standards) office space, and connecting us with patient’s who are in need of our services.
At the weekly Pain Management (our department) meeting this morning, I attended in Caroline’s absence. Jenny reiterated the case of the anxious 7 year old and then presented a follow up with a few other patients child life assisted with. One of the women asked, “What will happen once the girls are gone and who will take their place?” Jenny’s response was profound and touching. I wish I had a tape recorder or had at least taken notes, but this was the jist:
“…I want you to understand something. The work that these girls do is a practiced skill. They are not volunteers, they are not students. They have four years education in their field. That is not something that just gets replaced. If they leave, the services stop…I don’t know if any of you have had the opportunity to observe the work that they do but is absolutely awesome…it’s humbling…and it’s marvelous the changes I’ve seen in children…these kids don’t need pre-meds, child life is their pre-med.”
I was almost moved to tears. Mostly because I haven’t heard anyone outside of child life speak about it so passionately and respectfully. All of the staff have been receptive to child life on the unit. On Cara and Taylor’s last day at RCCH we had our own farewell tea on Tuesday. Caroline’s parents were visiting and joined in on the celebrations. For all staff, Wednesday’s Tea was a gaggle of farewell speeches and thank yous. One of the residents shared his appreciation for the respect shown for all staff on C2. Even though Prof (head doctor) calls the shots, there is generally no true hierarchy. The sense of teamwork is tangible on C2. Staff members (child life included!) are able to speak up and make an argument for their practice without being snubbed. On the contrary, the staff are open to new ideas and therapies. Prof went on to talk about his appreciation for “complimentary medicine” (i.e. Child Life J). He noted its contribution in all aspects of healthcare, form the wards to the theatre. He paid tribute the difference it makes; not just a small one, but a large, very visible one. He ended his message with hopes that complimentary medicine would become a permanent fixture at RCCH. Connect 123 is has been meeting with us and (the almighty and fabulous!) Caroline to add her to the Connect team. She just signed a contract this afternoon to stay in Cape Town (employed by connect and working at Red Cross) for the next YEAR!! Child life is coming to Cape Town, and we are the pioneers!
In the evening, a group of us went out for a Mexican dinner. We ended up on Long Street at “Mexican Kitchen”. We had margaritas and nachos while sitting outside in the not-so-sitting-outside weather. But still had a great time. Jamie and I headed back early (since we had an early morning ahead of us) with a few of the newer connect people. Driving home, I listened to them make the same comments I once made about Cape Town. Without a second thought I was explaining things to them. I immediately thought, ‘What do I know?! I just got here!!’ But I realized that I had graduated from ‘newbie’ to ‘veteran’. I sat in silence for the rest of the ride swallowing the idea and watching Cape Town pass by my window.
At the weekly Pain Management (our department) meeting this morning, I attended in Caroline’s absence. Jenny reiterated the case of the anxious 7 year old and then presented a follow up with a few other patients child life assisted with. One of the women asked, “What will happen once the girls are gone and who will take their place?” Jenny’s response was profound and touching. I wish I had a tape recorder or had at least taken notes, but this was the jist:
“…I want you to understand something. The work that these girls do is a practiced skill. They are not volunteers, they are not students. They have four years education in their field. That is not something that just gets replaced. If they leave, the services stop…I don’t know if any of you have had the opportunity to observe the work that they do but is absolutely awesome…it’s humbling…and it’s marvelous the changes I’ve seen in children…these kids don’t need pre-meds, child life is their pre-med.”
I was almost moved to tears. Mostly because I haven’t heard anyone outside of child life speak about it so passionately and respectfully. All of the staff have been receptive to child life on the unit. On Cara and Taylor’s last day at RCCH we had our own farewell tea on Tuesday. Caroline’s parents were visiting and joined in on the celebrations. For all staff, Wednesday’s Tea was a gaggle of farewell speeches and thank yous. One of the residents shared his appreciation for the respect shown for all staff on C2. Even though Prof (head doctor) calls the shots, there is generally no true hierarchy. The sense of teamwork is tangible on C2. Staff members (child life included!) are able to speak up and make an argument for their practice without being snubbed. On the contrary, the staff are open to new ideas and therapies. Prof went on to talk about his appreciation for “complimentary medicine” (i.e. Child Life J). He noted its contribution in all aspects of healthcare, form the wards to the theatre. He paid tribute the difference it makes; not just a small one, but a large, very visible one. He ended his message with hopes that complimentary medicine would become a permanent fixture at RCCH. Connect 123 is has been meeting with us and (the almighty and fabulous!) Caroline to add her to the Connect team. She just signed a contract this afternoon to stay in Cape Town (employed by connect and working at Red Cross) for the next YEAR!! Child life is coming to Cape Town, and we are the pioneers!
In the evening, a group of us went out for a Mexican dinner. We ended up on Long Street at “Mexican Kitchen”. We had margaritas and nachos while sitting outside in the not-so-sitting-outside weather. But still had a great time. Jamie and I headed back early (since we had an early morning ahead of us) with a few of the newer connect people. Driving home, I listened to them make the same comments I once made about Cape Town. Without a second thought I was explaining things to them. I immediately thought, ‘What do I know?! I just got here!!’ But I realized that I had graduated from ‘newbie’ to ‘veteran’. I sat in silence for the rest of the ride swallowing the idea and watching Cape Town pass by my window. FYE: Many of our friends from other countries have never heard of the Holiday "Cinco De Mayo". Lucy and Pippa spent the day in utter confusion since they didn't officially learn about it until this evening. Tracey sent a mass SMS saying, "It's Cinco De Mayo. Do you want to go out to dinner?" Lucy spent the day trying to figure out who Cinco De Mayo was; taking Tracey's phone and asking her to dinner while pippa thought someone was asking her about mayonaise.
Connect Word of the Day: Sinceriously
South African Slang:
SMS = text (i.e. ‘sms me when you get back’)
Smiley = lamb head (“an animal that is happy to die…always smiling.” The heads are cooked over and open fire. The meat is eaten straight out of the head. “You go to the bar and eat peanuts. We eat smileys like that.”)
Shabeen = township pub (The pubs consist of a hut within the townships. Beer is brewed and served in large tin buckets for sharing. Drinking beer is always a part of tribal ceremonies and has been for centuries. In continuing this practice, they are connecting with their ancestors.)
Veld = field or area (maybe) "bush veld"
South African Slang:
SMS = text (i.e. ‘sms me when you get back’)
Smiley = lamb head (“an animal that is happy to die…always smiling.” The heads are cooked over and open fire. The meat is eaten straight out of the head. “You go to the bar and eat peanuts. We eat smileys like that.”)
Shabeen = township pub (The pubs consist of a hut within the townships. Beer is brewed and served in large tin buckets for sharing. Drinking beer is always a part of tribal ceremonies and has been for centuries. In continuing this practice, they are connecting with their ancestors.)
Veld = field or area (maybe) "bush veld"
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