Supporting Children's Emotions in the Emergency Room

Child Life Specialists are professionals in child development who are further trained in child health, multiculturalism and family studies to provide services that address the psychosocial and developmental needs of children and families in a variety of health care settings. In the emergency room, Robin Miller explains her role is to "help children and families cope with the hospital environment." Miller and other Child Life Specialists are aware of the fact that, especially on a first visit, a child will experience an emergency room as strange and, often, scary. The fact that a child's visit to an ER is due to being sick or injured will make most children even more vulnerable to feelings of fear and anxiety - emotional states that can make medical treatment difficult. "My job," states Miller, "is to focus completely on what a child patient needs emotionally in order to be treated medically." Often, the simple fact that someone is there, completely focused on helping a child feel safe, is all it takes to make a visit to the hospital comfortable and non-threatening.

Depending on a child's developmental stage, a Child Life Specialist's interventions can range from distraction to information and education. Distraction, for example, is a primary intervention for toddlers and young children both prior to and during a medical procedure.

With older children, Child Life Specialists are more verbally and intellectually interactive. Miller explains with the example of a 7 year old brought to the hospital with stomach pains. "I would talk more directly with this child about his or her experience. Have they ever been in a hospital before? How are they feeling about being here now? If their condition necessitated a procedure," she states, "I would explain that procedure in terms the child could understand. Because older children anticipate and are concerned about pain, I explain how certain things will feel. I also have a teaching doll and books that are used to show children where certain organs are located and what they look like. This 7 year old, for example," explains Miller, "may have appendicitis and need surgery. Prior to the surgery, to both occupy and inform the child, I would show where the appendix is, explain that a small opening will be made to take it out because it is no longer needed. I would also explain that the child won't feel anything, and offer reassurance that a doctor will be present the entire time to make sure he or she doesn't wake up. Since children don't understand what anesthesia is and how it works, worrying about waking up during surgery is a pretty universal concern among children."

Any parent can testify that children's needs go far beyond the physical in their experience of an acute illness or traumatic injury. A child's age, size and stage of physical, emotional and intellectual development play a major role in their responses to every experience, especially a crisis. At Newton Wellesley- Hospital's Pediatric Emergency Department, the Child Life Specialist is an integral member of the emergency response team, a team of professionals who respond to and treat the whole child, and not just a child's injuries or illness.




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