Child life specialist brings magic touch to help sick children

The Report: February / March 2007 vol.28 num.1

by YUKIE KURAHASHI

s part of her job, Sandra Wyatt makes extraordinary dreams come true for gravely ill children. Her expertise and abundant empathy give every sick child she works with the best possible chance for effective treatment and recovery.

Its a tall order, but that only begins to describe Wyatts job as a child life specialist at Prince George Regional Hospital.

Facilitating treatment

One day, the work might be helping a young needle-phobic asthma patient get a flu shot.

-Asthmatic kids really should have a flu shot," she says. -But we have quite a few who are afraid of needles. So at the beginning of each school year I send a little blurb around to all the health nurses, and when they go into the schools and come across a child who is really scared, they talk to that childs parent ... and suggest they call me.

-For example, one child had to come to the ER due to a respiratory illness," Wyatt says. -She was a severe asthmatic who had not had her flu shot due to, as her mother put it, total fear of needles after having been restrained many times by health care professionals.

-Being held down to receive a shot is not the best approach, so after being seen by the respiratory nurse, it was suggested she pay me a visit."

-I invite them to come into paediatrics and do a one-on-one with the child, using stuffed cloth dolls that have no faces ... different colours for all ethnic groups ... and what the child can do is practise on the doll."

After -practising" on the doll, with a variety of medical equipment that Wyatt provides, the child is allowed to take the doll home.

-Many children put happy faces on one side, then turn it over and put a sad face on the other side. I try and desensitize them as best as I can. Often it takes one visit, sometimes more. The purpose is to educate ... address their fears and concerns in a nonthreatening manner through the use of medical play."

So how did things turn out with the severely asthmatic young patient?

-I asked, do you want to have your shot at the doctors office, the health unit, or here in my office? And she chose my office, because she wanted me to be there. When she arrived, she got comfy in a childsize chair with her stuffed doll, where we practiced our breathing exercises along with a squeeze ball. The nurse came in, gave her the shot, and she didnt even wince!

-Her mom cried. It was the first time in eight years her daughter didnt scream. She was overwhelmed. I received a very nice letter from her," she says, smiling.

Patient advocacy, education, and outreach

Wyatt also works with asthmatic children in an educational capacity.

-You can have all the medicine in the world, but if youre not using the right medicine at the right time with proper technique, youre not going to get the best outcome you need to keep asthma under control," she says. The respiratory educator, Linda Hunter, thought that a program for child asthmatics would help reduce the number of children who end up in the ER. Wyatt created and now runs an educational program, using play and hands-on activity to teach children about asthma.

-Parents are invited to stay and learn, and the kids get to know each other and realize they are not the only one with this disease. The more a child knows, the better; knowledge is power and promotes self esteem," Wyatt says, because once an attack sets in the child may only have limited time to self-administer crucial medication.

Wyatt routinely goes into area schools to teach about asthma and smoking. -I have all kinds of gadgets," she says, with a sly smile. -We build a lung, view dust mites that have been magnified on a poster, handle Mister Gross Mouth, plus a poison box." One gets the sense she really loves that poison box.

-We also have a movie for the older kids, which was made by teens for teens, a -Wheel of Misfortune" and -Jeopardy", which all help to keep the class engaged in this important topic."

But Wyatts work is not limited to working with children with respiratory issues.

She helps set up all the paediatric clinics ... for example, cardiac, asthmatic and genetic clinics.

One of her current projects is working with the hospitals dietitian on a snack program.

-Most young children receive snacks at home• especially when (theyre) sick, eating is not always a priority. Snacks should be offered at least twice daily. Having long gaps in between meals does not hold well for the little ones. They like to graze, and a little bit is better than nothing to help provide energy for getting better"

She works with the physiotherapists to implement therapy protocols. She organizes all the birthday parties, special visitors and -chemo parties," celebrating a childs last chemo treatment. She also works with children in isolation, providing activities and a trained ear to listen.

-A hospital is a hospital, but I try and provide fun things for the kids to do that they are capable of doing, with the illness that they have," she says. -And maybe I pick up on where theres something else going on in the family that no one else has picked up on.

-Its amazing what children will tell you while playing snakes and ladders!"

-By providing information on whats going to happen through the use of medical play, children often trust me because I dont do any of the medical procedures. Im there to help provide distraction, comfort and reassurance to both child and parent if needed. Sometimes theyll say, well I dont like them doing it this way and Ill ask, why is that?"

The providers then can use the information to work around the childs concerns and create an atmosphere for the best possible outcome.

Children often dont know how to express their fears and ideas, and its Wyatts job to uncover them. -You have to incorporate the questions that you want answered, in a way that you can help them the most - sometimes without them really realizing it," she says.

As an advocate for her young patients, Wyatt displays formidable skills in gathering resources, even when budgets are tight around the hospital.

At Christmas, she rounds up community donations and makes sure Santa can make a visit to the children. Recently, she enlisted a friends help securing two TV/VCRs for the pediatric area of the ER, along with some movies so that the -little patients" can pass the time, instead of listening to the sometimes scary noises, which an ER can present.

Last year Wyatt created ways to raise money for fibre optic lights for the new Pediatric ward, which was the number one wish of past patients and their families. She organized a fundraising evening with all proceeds to benefit the Pediatrics department.

For the gravely ill, Wyatt pulls out all the stops to make the childs dearest wish come true. For one terminally ill child with cancer, she was even able to arrange for a phone call from Shania Twain ... who not only spoke with the child, but also had a lengthy conversation with his mother.

-[The child] was so ill by that time he was only able to listen to her voice," Wyatt says. -But the look on his face, that smile."

Other programs Wyatt has initiated include an -Art Heals" program with the local art gallery, a Pet Therapy program, and TLC, a program that brings hospital auxiliaries in to play with the children.

Coordinating music therapy has also been important, particularly for babies who are born drug-addicted and who benefit from soothing and calm surroundings.

Living by example

Theres really no stopping Wyatt. Last fall, she wanted to do something to participate in the Run for the Cure.

-I decided since I was not running in the Run for the Cure, I would get patients ... children, all of them were out-patients ... to come and cut my hair to raise funds," she laughed.

-I wanted to add a twist to it. My goal being the -play lady" was to get my kids to come in, and they thoroughly enjoyed it, trust me! It was not only to generate awareness - and obviously money to help with the research - but to generate interest in young people. They need to keep this going, they are the future to possibly finding a cure for this horrible disease," she said. -And this is something they wont forget. Its a serious topic, but a fun thing to do.

-If you have cancer, this is what it looks like, and its a look that our chemotherapy kids are familiar with."

In addition to raising hundreds of dollars towards breast cancer research, all three local papers sent photographers. She and her young -barbers" were the front page photo of the next days Prince George Citizen.

Becoming a child life specialist

For Wyatt, working with children seems to be a natural fit. -I work with all kinds of children, not just the seriously ill ...the age range being zero to 16."

And rescuing those who cant always speak for themselves seems to be another passion that drives her. In what spare time she has, Wyatt rescues dogs. But thats another story.