Positioning for Comfort

I’ve been going through resources on comfort positioning recently and rediscovered this video from Dell Children’s Medical Center.  Using comfort positions for procedures can make a huge difference in children’s level of anxiety and cooperation for new/scary medical procedures.  Being in a more upright position with a trusted parent or caregiver is a relatively quick and easy intervention with big benefits.  I love this video from Dell as it explains why comfort positioning is helpful, gives examples of positions for different procedures, and is presented by an awesome nurse from the emergency department (sometimes medical staff respond better to hearing from other providers).  Hope this resource helps those of you looking to increase the use of comfort positioning at your hospital!


Peer Video Support

One of the most difficult things for many patients in the hospital is feeling alone in their experiences.  Knowing there are other youth out there going through similar procedures and treatments can help.  While I try to foster lots of face-to-face socialization, sometimes patients want specific knowledge or I don’t have a good “peer match” for them at the hospital at the right time.  In these cases technology and social media offer wonderful resources. Today, I was looking for a video to share with a patient at the hospital that was apprehensive about the possibility of getting a nasogastric (NG) tube.  You Tube to the rescue! I found a great video by Natalie (gbasp10), a young teen girl, demonstrating how she inserts an ng-tube (nasogastric tube). In the video, Natalie gathers equipment, explains the process, offer tips and gives practical and accurate advice.  I was impressed with her confident delivery and demonstration.  When combined with hands-on teaching and preparation, peer-to-peer videos can be a powerful tool in helping patients cope with new medical experiences.

Thanks Natalie for sharing your video and experience with others!

A Pick Me Up

I met a new patient at the hospital this week: a preschool age girl getting IV medications that I will call Lila.  I spent a good bit of time with her in medical play and in the activity room and she was just such a great and timely reminder of the best parts of my job.  She and her mom have a good relationship- and I was able to help both of them feel more comfortable in the hospital.  Lila was having some anxiety when the doctors needed to examine her and also during a procedure she has weekly.  I brought in Hunter, my medical teaching doll and we did a session of open-ended medical play.  Later we did a procedural teaching.  Lila then had her procedure again and mom held Lila in a comfort position, and I was able to work with mom on reminding Lila of the steps of the procedure and engaging in distraction.  The procedure was calm. Lila didn’t need anyone to help hold and it was really rewarding to see her so proud of herself for doing her job so well.  I’ve been in many successful procedures, but something about this child and her mom really touched me.  Everything clicked, and it really made my week. Play is so amazing.

Tools of the Trade: I Spy

what do you see?

Hidden Pictures. Look and Find. I Spy. There are many names for this classic game of searching for pictures and objects.  There’s a reason there are now lots of books, games, worksheets and posters available in stores.  This activity scores big on distraction, is low cost, and can be played anywhere. I love to use the large books during procedures (especially IV starts and blood draws) with children who have decided they don’t want to watch.  The book serves as a visual barrier between the child and the person doing the procedure. Child life or a parent can hold the book and help prompt/praise the child as each object is found. You can still provide important cuing information so there are no surprises (“the nurse is going to clean your arm, the soap will feel cool and wet”) and then return to searching. While the books, coloring pages and worksheets are great, you don’t need them to make use of this fun game. You can play “I Spy”by searching for objects in the hospital room and taking turns guessing and giving clues. Anyone in the room can be a part of the fun. Picture search worksheets and books are also a great addition to waiting rooms as a quiet activity that helps pass the time.

You can create your own picture search by using a white sheet or large paper as a background.  Gather small toys and trinkets and spread them on the background. Legos, beads, alphabet blocks, crayons and other small colorful items make for great “filler” to help hide objects to find. Take photographs, print, and laminate for ease of cleaning. You can also place the pictures in a heavy plastic sheet protector. Patients can then circle pictures with a dry erase marker. Many child life departments have created picture search badge cards for staff to always have a quick distraction tool.

Photo Credit: Tom Maglieri via Flickr