As a child life specialist in surgical services, Michelle Peterson starts her day at 6:30 a.m. She and two other child life specialists at Akron Children’s Hospital check the surgery schedule to see if any of the patients have been here before.
Today, Peterson sees a familiar name, so she initials the schedule to indicate she’ll work with that family.
“We want the kiddos to feel comfortable with all of the hospital staff, but it can help for the child to see a familiar face,” she said.
Carson is her first stop of the day. He’s at Akron Children’s for a minor surgical procedure, but Peterson knows there’s nothing minor to parents when they bring their child in for surgery.
“The purpose of child life is to make the children and parents feel comfortable about what they are going to encounter,” Peterson said. “We want them to have a positive healthcare experience. Preparing them will go a long way to accomplishing that goal.”
She gets down to eye level with the 2 year old in tiger pajamas and says hello. Understandably nervous, Carson crawls up onto his dad’s lap.
Peterson sits down and inquires about his stuffed toy. “Who is this? Is this Mickey? How is Mickey doing today?”
As Carson begins to relax, Peterson shows him several items that will help him understand what to expect today.
“This is a mask that will help you breathe the medicine air that will make you sleepy,” she explains, pulling a breathing mask from the box.
Carson holds it while she puts another mask to her mouth. “I bet Mickey would like to try it,” Peterson said.
The toddler’s fascination with the mask wins out and he puts it over the stuffed toy’s nose.
“Maybe Mickey would like to try some Chapstick,” said Peterson, taking out two tubes of Chapstick and letting Carson smell them. After he picks one, she asks him to “color” the inside of the mask with it so he’ll smell the strawberry scent when he tries the mask on.
“We want to be able to give the kids realistic choices,” she said. “They don’t have a choice of whether or not they need to be here, but we can let them choose what flavor they smell when they have the mask on their face. It might seem like a small thing, but it empowers them and helps them feel comfortable and in control of their situation.”
After Peterson spends a few more minutes answering the family’s questions, Carson feels comfortable enough to let her carry him to the hallway where he’ll be taken into surgery.
There they pick up two surgical hats and return to the exam room, where Carson’s parents dutifully put on the hats.
“Don’t mommy and daddy look silly in those hats?” Peterson asks. “The doctors and nurses will have on silly hats too.”
This simple act will help Carson when he’s in the OR surrounded by people in similar attire.
In between patient visits, Peterson stops to add notes to the patients’ charts.
“We always check the chart for anything that can help us better relate to the patient,” she said. “It will tell us if this is the child’s first experience in surgery. If they’ve been here before, it could tell us if they had any difficulties such as separation anxiety. We try to tailor our approach to each child. What works for one child might not work for another.”
Peterson, who has been a child life specialist at Children’s for 20 years, holds a bachelor’s degree in child and family development with a specialization in a child life specialist training program from the University of Akron.
“My educational background was invaluable, but I also learned a lot on the job,” Peterson said. “This is an ever-changing field and you have to stay up to date on the research and trends in order to best help your patients.”
Up next is 11-year-old Jessica who had a previous surgery at Akron Children’s and expressed difficulty with her IV.
As Peterson enters the room and greets her, Jessica clutches a fuzzy blanket she brought from home.
After speaking with Jessica and her family about the upcoming surgery, she talks to Jessica about what to expect in the OR.
“The nurse will untie your gown, so you’re not lying on a knot and so you can slip your arm out. But don’t worry. You will be covered at all times and, if you feel uncomfortable, just tell the nurse,” she said, recognizing that with an 11-year-old girl, modesty and privacy are important.
Acknowledging her past problems with IVs, Peterson tells her, “If the IV hurts when the nurse takes it out, it’s ok to say ‘Ouch! Ouch! Ouch!’ and let the nurse know it hurts. But it’s important to keep your arm still.”
Peterson’s goal is to give the children coping techniques to help them deal with their situation. “I never want to minimize a child’s past experience. But some procedures, like IVs, might be inevitable, so I want to make sure the child has a way to handle it.”
A surgical services nurse speaks to Peterson in between patients. She tells her the mother of one of tomorrow’s patients asked if she could accompany her child back to surgery.
Since parents aren’t normally allowed back into the surgical area, it’s helpful for Peterson to know that this issue might come up with the patient family.
“We all work as a cohesive unit,” she said. “The doctors, nurses, anesthesiologists, child life – our goal is to promote family-centered care and make this a positive experience for the child.”
Peterson’s morning goes by quickly. She makes sure to walk the younger patients to the door they’ll go through on the way to surgery.
“Push that blue button. Hear that big clicking sound? You’ll hear that right before they take you through the doors,” Peterson says. “You’ll ride on a big bed and, just like when you ride in a car, the nurse will put a seatbelt on you so that you’re safe.”
In the post-op area, Peterson follows up with Ryan, an 8 year old who had tubes inserted in his ears.
Ryan’s parents tell Peterson that his stomach is upset. She assures them that this is normal and recommends they mention it to Ryan’s nurse when he comes back to check on him.
“It can get pretty hectic and fast paced but it’s important to visit the family again in post-op to make sure everything went as they expected and to reassure them,” she said. “If a child has a particularly difficult time, we may also call the parents at home that evening to ask about the child’s recovery.”
After visiting another child in recovery, Peterson heads back to see Bayleigh. The 14 year old has had several procedures over the years and seems comfortable about what her surgery will entail. Even so, Peterson spends time with Bayleigh and her parents.
“While one of our goals is to make sure the parents and child understand, in layman’s terms, what will happen, I can use more technical terms with the older patients,” she said. “We take our cues from the parents and child and make sure our interaction is always developmentally appropriate.”
After another post-op visit, Peterson sits down briefly to order supplies. Before she has time to place the order, her pager goes off.
One of her earlier patients, 9-year-old Caitlin, is upset and doesn’t want to accompany the nurse back to surgery.
Peterson dons a “bunny suit,” a white, one-piece covering for her clothes and a white hat, and takes Caitlin by the hand to surgery.
In the OR, she helps Caitlin climb up on the table, then holds Caitlin’s hands and reassures her until she drifts off from the anesthesia.
Peterson’s day passes quickly. She and the other child life specialists in surgical services each see about 12 to 15 patients a shift.
At 4:30 p.m., Peterson’s shift is over, but she’ll return at 6:30 p.m. to give 12 families a pre-surgery tour.
“It makes the children and parents feel more comfortable if they’re able to see everything – the pre-op area, operating rooms, post-op area – before they come in for surgery,” she said. “If a family can’t make it for the group tour, we can give them a modified tour anytime during the day.”
“I know the work that our child life specialists do helps to make this hospital experience a more positive one for our patients and their families,” Peterson said. “Research has shown that a positive attitude promotes healing and recuperation – and I’m honored that I can be a part of that process.”
In addition to surgical services, Akron Children’s employs child life specialists throughout the hospital – from the ER and radiology to inpatient units and intensive care – to help children and their families understand and cope with what may be a very difficult time.