Social Work and Child Life

Sept. 20, 2019 – During this visit I got a remarkable glimpse into the world of our social workers and child life specialists. These team members experience an incredible range of emotions with our patients and families on a daily basis, from moments that are inspiring and uplifting to situations that are incredibly difficult, sad and stressful.

We began with breakfast burritos (always a good way to start!) and then watched a fun video featuring members of the social work team sporting their trademark blue behavioral health services beanies. Then Medical Social Work and Child Life Manager Jacqui Small began an eye-opening presentation about what a day on the job can be like for a social worker in each of the Hospital’s units.

Getting a glimpse into the life of a social worker

In the emergency department, you may find a social worker chasing after a psychiatric patient during a code green (missing high risk patient) to ensure the patient’s safety; helping a physician with a parent who just fainted after hearing their child has been diagnosed with cancer; or trying to coordinate support for a child brought in after a car accident that led to their parent’s death. As Jacqui put it, “it’s fast-paced, high-stress, high-volume and can be horrifying at times, but it’s what we do.”

Next, I heard about the social workers in the intensive care units, such as the NICU, PICU and CVICU. Here, you may find a social worker listening to a parent cry as they talk about how they will never take their newborn home; working with security to report a parent who is threatening staff; or assisting parents by helping them process information and connect with resources.

The hematology/oncology social workers face their own set of challenging situations on a daily basis, such as educating a patient and parent about managing a chronic blood disorder; supporting an upset patient who has just learned she will not be able to attend her senior year of high school due to her diagnosis and treatment; and problem-solving with a single mom who is the sole provider for her three kids and will now have to stop working to support her child’s cancer care needs. Despite all of the difficult scenarios that social workers tackle on this unit, Jacqui summed it up by saying, “It is inspiring, rewarding and an honor to be a social worker in hematology/oncology.”

Next, we talked about situations a social worker might face in 2 Rose, 3 East and 4 East, including celebrating birthdays and other life events with chronic patients who spend many months admitted here; navigating complex custody situations and visitations at bedside to ensure a patient does not have to be here alone because their parents can’t get along; and recognizing signs of sex trafficking and alerting the team and authorities when a child may be a victim.

Finally, we looked at scenarios social workers handle in the outpatient clinics, such as helping families whose children have chronic illness to process medical information and connect with support groups; encouraging parents who are often full-time caregivers to practice self-care and address their own mental health needs; and backing members of the multidisciplinary care team by responding to questions about child protection, mental health and access to resources. The life of a social worker isn’t for everyone, which is why we are so thankful for the expert care and support they provide to our patients and families.

The child life team with the tools of their trade

For the second part of this visit, I met with the team of child life specialists, who help patients and their families understand and cope with the sometimes stressful experiences that occur in a health care environment. They had tables full of engaging tools they use to take the fear out of a hospital stay, and, in some cases, even make it fun!

Carissa Menard showed me some items they use with cystic fibrosis patients, including an interactive patient checklist and a Love Your Lungs game that involves earning tokens for prizes. There are also special dolls outfitted with medical devices, such as tracheostomies and gastrostomy tubes, that help with patient and parent education. I also got to check out the latest popular device: virtual reality goggles that have shown great promise for pain management and are the subject of a Rady Children’s research study.

Next, Katie Fesenmaier from 3 East walked me through some of her tools of the trade. These included a doll that has its internal organs on display (to describe an appendix operation, for example, to a child); Ollie the Ostomy Bear, who comes with an “Awesome Ollie” book; and tips and tricks to get children to take their medicine.

A plush bone with blood cells helps educate cancer patients

Andie Sherman, who works in inpatient hematology/oncology, had some other cool visual aids to help kids understand their diagnoses and care plans, such as a giant plush bone with red and white blood cells inside to describe leukemia to a patient and a backpack full of age-appropriate books about chemotherapy and having cancer. She also talks about wigs to kids undergoing chemotherapy after they’ve lost their hair.

Next, Danni Leonard, who works in the outpatient hematology/oncology clinic, showed me another doll that has a port installed to help walk parents and patients through port access; a prep book filled with photos that help patients know what to expect from procedures and how to prepare for them; and one of my favorites, an AFLAC duck that helps patients express how they are feeling that day by quacking their mood.

The funny but effective mood-sensing AFLAC duck

Lisa Tweed then described some of the important functions of child life specialists, including helping a child go back to school after an extended time away from the classroom; leading oncology support groups for patients and their siblings; planning celebrations for kids in the Hospital; and facilitating special visits, such as when organizations like SeaWorld or LEGOLAND visit.

After that, Mariemel Gawaran brought me up to speed on the playrooms in the inpatients units. Filled with games and toys, these are “no poke” zones where kids have a safe space away from anything medical and are free to just be kids. Playrooms are also where celebrations such as birthday parties happen, and are a favorite place for our trained volunteers to help out.

Next, Rachel Pedinoff, who works in the PICU and CVICU, showed me a heart transplant doll and accompanying book that, similar to her teammates’ visual aids, helps set expectations for patients and prepare and educate the patient and their siblings. There are also books that lend support to families when their child is facing end-of-life or has passed away. They are heart-wrenching, but very helpful for families struggling through an extremely difficult time.

Erin Carpenter then talked to be about how she supports kids who have brain surgery and other neurological procedures. There is a plush monkey with “rainbow strings” attached to the top of his head. The strings mimic the monitoring wires that are part of a video electroencephalograph test, which records what the patient is doing or experiencing while an EEG test records brainwaves. There is another specially outfitted stuffed animal (Rufus the bear) that comes with his own book to help kids with diabetes practice injecting insulin.

From there, Madeline Zinngrabe showed me how radiology patients prepare for procedures such as CT scans and X-rays with a digital prep book that is viewed on an iPad. They can even choose the scent of the anesthesia mask — cupcake or bubblegum!

An example of a social story viewed on an iPad

Taylor Keightley then walked me through a social story, viewed on an iPad, which is frequently used to help children on the autism spectrum feel more comfortable going into surgery. They can see photos of the operating room in advance and become familiar with the sequence of events, which can help reduce anxiety.  She also showed me one of the cool backpacks filled with toys and diversions that these kids get.

Finally, Aislinn Mooney described how she helps out patients in the emergency department with diversions to distract them from their injuries and illnesses, such as when they’re getting a cast or laceration repaired or being hooked up to an IV. She has an arsenal of items including wands, light spinners, bubbles and even an iPad to keep these kids calm. Aislinn also helps interpret what medical staff is saying so that our young patients are clear on what is going on, and clarifies words and phrases kids commonly misinterpret, such as “dye,” “put you to sleep” and “CAT scan.”

This was such an informative visit, and it illuminated just how critical the social work and child life teams are to our families and staff. They are at the tip of the spear when it comes to patient care and, day after day, shine brightly during some incredibly difficult situations. Thank you for everything you do.