I hope you caught my last post on how children look to us as their models of behavior. I talk about how the same principle applies in medical settings. When children are in these new, unfamiliar, and threatening situations, they are observing our behavior to know how to respond themselves. The calmer we are, the more likely our children will be calm too.
We know we need to be our children's support in these situations, but often the circumstances are difficult for us to bear too. So I'm giving you my two cents on how to maintain your calm during these moments.
I'm going to break this up into 3 different situations.
1. Procedures - an outpatient appointment, doctor visit, ER visit
2. Hospital Admissions - overnight stay at the hospital, whether it's one night or 100
3. New Diagnosis - from peanut allergies to serious diseases
1. Keeping Calm During PROCEDURES
While I have worked in many areas of the hospital, the majority of my experience as a Child Life Specialist has been working in outpatient settings. I worked in the Emergency Department and in Radiology, so I have seen kids and families who have come to the hospital for planned and unplanned visits. When these visits are unplanned, they can be even more difficult for us to remain calm. However, sometimes the planned visits don't go the way we imagined or they affect us differently than we expected. I'm sharing how I get through these experiences as a clinician and as a mother.
Often my role can be quite sad and I don't do well with sad, I'll be honest. I'm typically a pretty optimistic person who cannot watch the news because it's just too much for me to bear. For this reason, I never ever ever ever would have imagined myself working in the hospital setting. You can bet I had to get over that quickly.
What did I do?
The beauty of Child Life is that we are helpers. We are helpers for the kids. We are helpers for the parents and family. We are helpers for the medical team. What I realized was that whenever I am in a situation where I need to be strong and a support person for a child and family, I think about how I can help in the moment. What active role can I play that will help? Now that I think about it, it sounds a bit like Mr. Rogers who said this famous quote:
"When I was a boy and I would see scary things in the news, my mother would say to me, "Look for the helpers. You will always find people who are helping." To this day, especially in times of 'disaster,' I remember my mother's words and I am always comforted by realizing that there are still so many helpers – so many caring people in this world." - Fred Rogers
Let's use this optimism with an example. Let's say my child is getting an IV placed. There are many ways I could respond to this situation, but let's talk about two.
Option 1 - I could make a big deal when I hear the news that he needs an IV. I could tell my child it's going to hurt and that I'm so sorry and I won't let these people touch him again after this. I could act very upset and might cry enough that I may even need to leave the room during the procedure. I could promise him Toys R Us after it's over.
Option 2 - I could calmly tell my child "his body needs the IV to help get medicine and water to his body quickly. It will be a quick pinch, but it will be over soon." I hold my child during the procedure and I could tell him to sing his favorite song with me. After it's over, I ask him how it felt for him.
Obviously, option 2 is the more appropriate response to this situation. In option 1, the parent played the victim. In option 2, the parent played a more active role in the procedure. She saw where she could help her child get through it rather than wishing he could avoid it altogether and trying to make her child forget about it. Can you see how option 2 allows the child to trust his parent?
You can be the helper! Framing your mind this way can make such a huge difference! I know it won't always solve all your problems, but it allows you to take an active role in the situation, rather than thinking about your child's role as the victim. I would love for you to try it next time and let me know how it goes!
2. Keeping Calm During HOSPITAL ADMISSIONS
Raise your hand if you've stayed just one night with your child in the hospital and it felt like a week? There's something about that sterile environment that just feels, well, sterile! One night makes you feel so much empathy for the parents and kids who endure many nights sleeping at the hospital.
Keeping calm during a procedure is one thing, but when you have to be strong for your child over a really long hospital stay, this can be incredibly challenging and taxing! Your comforts have been taken away from you (that's enough to drive me up the wall! Keep me in the U.S., well-fed, rested, and with AC and I'm a pretty pleasant person). You're under-slept and on top of everything, you're stressed and worried about your child.
My biggest piece of advice to stay calm during a hospital admission can be summarized into one word:
Routines are important for you as the caregiver and for your child as the patient.
You need routines to keep you sane. Your routines at home help to keep you functioning, so do what you can to keep them in place while in the hospital! During a hospital admission your life has been turned upside down and you need some stability. Find what that is for you. Often it's what helps you at home. For me (and I learned this from my mom), I need a shower before I can function. For others, that may be exercise. Find those things you need daily to keep you going and make sure you maintain them! You cannot take care of your child until you have taken care of you. Don't you dare neglect you! Your child will suffer for it. He needs you at your best, so take care of yourself. Get the rest you need to function. Make the necessary adjustments you need to so you can do the best job you can to support your child.
Children THRIVE when they have routines they can expect and count on. Routines give children stability and structure, which are so crucial for them to become well-adjusted adults! That's why it's even more important that you maintain your child's routines in the hospital. It's an environment that is completely unstable for kids, so they need something normal and familiar. Keep those routines in your child's life at the hospital just like you do at home. Don't throw in the towel because your child is sick or injured. You are still the parent! You are still parenting. Yes, your child deserves some leniency when appropriate, but he also still deserves some consistency and predictability. If you neglect routines while in the hospital, they'll be even more difficult to get back when you get home.
I'm going dive into routines in a future post, but for now, let's summarize...
Routines are tricky in the hospital because scheduling is so difficult. Much of your day is spent either interrupted, not on time, or both! Often you can try to plan for tests and procedures and then there are delays. You hope to catch your doctors at rounds except they come two hours late. Do your best to maintain some schedule. Be flexible, but try to stick to it as best you can.
When coming up with what routines you want to fit into your daily schedule, be sure not to modify them too much because your child is hospitalized. If your child can do it, then allow them to do it. For example, school work. You will want your child as caught up as possible, but there will be days where it's just not possible. Do what you can! Here are some ideas of routines you can implement (when necessary, ask your medical team if it's safe and possible for your child to do):
Caregiver Routines can include:
Something for you
Prayer / Meditation / Mindfulness
Talk with friends
Podcasts / Reading / Journal
*I want to put a plug in for my favorite podcast "Better Than Happy." There's no better time to get your mental health in check so you can be ready to be the caregiver you need to be.
Patient Routines can include:
Talk with siblings
Arts and crafts time
Don't give up! Do the best you can because it will help you both to keep calm in this challenging environment.
3. Keeping Calm During a NEW DIAGNOSIS
Learning your child has been diagnosed with something new brings a flood of emotions. Fear, worry, stress, anxiety, sadness and grief are just a few. Sometimes you can even begin mourning the life of your child before he's even declined. The most difficult part of hearing a new diagnosis is the unknown. You only know what you've heard about it, if you've heard anything. This allows your mind to run.
You may have heard the frequent phrase doctors tell their patients, "Don't google it." It's more than just a suggestion. This is good advice for many reasons and I want you to take that advice with your child.
The best thing you can do in these moments is to not assume that what you know about the diagnosis will happen to your child. Even if you do know that it will happen to your child, don't teach them about it right then and there. Let's take an example... Diabetes. Your child has just been diagnosed with Diabetes and you know your child will need to have insulin injections for the rest of his life. The first thing you should NOT do when you hear this is tell your teen, "You're going to have tons of needles for the rest of your life!" This doesn't encourage a calm environment if you couldn't figure that out already.
Instead, you will tell your child what this means, but you won't spill everything you know in that second. The way to help your child maintain their calm (and yours) is by taking things as they come, piece by piece, and trust that you will be taught everything you need to know about this new diagnosis in its time. You will have lots of questions in this moment, but you have to tell yourself to wait for the right time to learn the answers.
Teaching your child or teen would look something like this:
"Your body isn't making insulin, which is something your body usually makes after you eat. Your body needs insulin because it gives your body energy. Right now the nurse is going to help you get the insulin your body needs now. She needs to use a needle to get the insulin into your body. Yes, we will monitor the insulin in your body for the rest of your life, but right now, we're just going to worry about the insulin you need now. Then, we'll learn how to calculate that ourselves later. Pretty soon it will probably seem like an every day task like taking your vitamin, brushing your teeth, or putting your shoes on."
This approach doesn't have answers to all the questions, and the parent doesn't assume she has answers to all the questions either. She models for her son a one-step-at-a-time attitude. This is how you promote coping. You are allowing your child to cope with what they have to deal with in the moment, and swallow the big things one at a time.
I hope some of these tips were helpful and provoked some thought on how you take care of yourself in challenging situations so you can be there for your child.
How do you keep calm in stressful moments? Have you ever experienced trauma and were surprised by your reaction? Good or bad? What routines help you? I want to hear your thoughts, advice, and experiences! Please share and have a great week!
| Kara |