Monthly Archives: March 2014

Healing through play: Meet Sam Schackman

Sam Schackman is a child life specialist in the Cancer and Blood Disorders clinic.

We end March, which included Child Life Week, by getting to know Sam Schackman, a child life specialist.

How long have you worked at Children’s?

This will be my third year at Children’s. I started in 2011.

What do you love most about your job?

The kids, of course! But that’s an easy answer, so I would say one thing I love most is working alongside children and their families and being able to see them overcome challenges.

What is one thing you’d like people to know about your profession?

Child life specialists have a minimum of a bachelor’s degree or a master’s degree in a major that focuses on child development, child psychology and working with families. Child life specialists must complete a supervised clinical internship and pass a national certification exam.

What is a typical day like for you?

I work in the Cancer and Blood Disorders clinic, and each day is different! My day may consist of providing preparation for medical procedures, helping to facilitate coping during invasion procedures and pokes, facilitating therapeutic and normative activities, providing developmentally appropriate education about a child’s body or illness, and providing support for siblings and other family members. Each day looks different, but each day I know I get to spend with amazing kids and their families.

The theme of Child Life Week is “everyone plays in the same language.” What was your favorite childhood toy?

I loved dolls and stuffed animals. One of my most favorites was a Minnie Mouse doll that had a light-up bow.

Minneapolis among 10 best U.S. cities for health care

Minneapolis was named one of the 10 best U.S. cities for health care, according to Becker’s Hospital Review and a release from iVantage Health Analytics and its Hospital Strength INDEX, a rating system analyzing publicly available data to measure hospitals across 10 pillars of performance and 66 metrics.

Minneapolis was named one of the 10 best U.S. cities for health care. (2014 file / Children's Hospitals and Clinics of Minnesota)

List of cities in top 10 (in alphabetical order):

  • Atlanta
  • Boston
  • Charlotte, N.C.
  • Chicago
  • Minneapolis
  • New York
  • Philadelphia
  • Portland, Ore.
  • St. Louis
  • Washington, D.C.

The 10 cities serve approximately 60 million people, 19 percent of the U.S. population, according to the report.

Sources: Becker’s Hospital Review and iVantage Health Analytics

Five Question Friday: Joanna Davis

It’s Child Life Week at Children’s, so we’re dedicating this week’s Five Question Friday to learning more about Joanna Davis, a child life specialist and the coordinator of the new Child Life Zone at our St. Paul campus.

Joanna Davis is a child life specialist and the coordinator of the new Child Life Zone at our St. Paul campus.

How long have you worked at Children’s?

I have worked here since July 2013. Before I came to Children’s, I worked at a children’s hospital in Alaska.

Why did you decide to become a child life specialist?

I knew I wanted to work with kids, but I didn’t know what I wanted to do. At the time I had never heard of the child life profession. While I was in college, my sister was doing her nursing clinicals and she followed a child life specialist around for a day. She called me up immediately after to tell me she found the perfect job for me. I looked up all I could about child life. Ever since then, I knew that’s what I wanted to do. I did everything I could to get my certification in child life, and I give all the credit to my sister, for finding me my perfect job!

We recently opened the new Child Life Zone in St. Paul. Can you tell us more about the new space?

The Child Life Zone is a state-of-the-art, therapeutic play area, located on the St. Paul campus. It’s a place that patients, siblings and families can play, hang out, have fun and just relax. Inside we have a therapeutic craft and play area, media wall and gaming area, Children’s library, Star Studio performance space and kitchen area for special events. We also offer sibling play services for kids whose brother or sister is in the hospital.

What do you love most about your job?

Working with kids and their families, and helping make their experience here at Children’s even more positive. The Child Life Zone draws kids from all over the hospital ­– we have outpatient kids that come weekly after their therapy appointments, infusion kids that come up and play from the short-stay unit while getting their meds, and inpatient kids that come down daily if they are able to. It’s really nice getting to see these kids come to a space in the hospital where they feel safe, and they really open up to you.

The theme for Child Life Week is “everyone plays in the same language.” What was your favorite childhood toy?

I loved my Easy Bake Oven! I played with it all the time until I got old enough that I started baking in the kitchen. Baking cookies is one of my favorite things to do.

An advocate for kids: Meet child life specialist Judy Sawyer

It’s Child Life Week, and we’re excited to bring you some profiles about our team at Children’s. For Judy Sawyer, no two days at work are ever the same, and she wouldn’t have it any other way! Learn more about Judy and her role at Children’s.

Judy Sawyer has been a child life specialist at Children's for 23 years.

How long have you worked at Children’s?

I started in November of 1990 … 23 years.

What’s one thing you’d like people to know about your profession?

The most important role for me is to be an advocate, providing consistent support for patients and families during their admission. Whether it is being the “non-medical person” providing support/distraction during a lab draw, education to provide a better understanding of the medical experience, or bringing a child a developmentally appropriate activity, my goal is to help the child have as positive an experience as possible while they are at Children’s.

What is a typical day like for you?

One of the things I love about working in child life is that no two days are ever the same!

A typical day begins by obtaining a census, reviewing it for new admissions on the two critical care units I work on, CVCC and PICU, check to see if there are any cardiac pre-op appointments for patients scheduled for heart surgery the next day and attend patient review where information is shared and updated between the charge nurse and the multidisciplinary staff.

I provide followup support for patients already on these units. If a child is scheduled for heart surgery, I work with the CV Par 4 staff to provide preparation information using photos and a walk through of the CVCC Unit so they have an understanding of what to expect the day of surgery. Child Life Specialists use the senses as a guide… what will they “see, hear, feel, smell and taste”? By preparing the patient and family to know what to expect, my goal is to have them leave the hospital feeling confident to return the next day for surgery. I work closely with multidisciplinary staff on the critical care units to support our families during what is often a very stressful time.

If you could travel anywhere in the world, where would you go and why?

I would love to travel to Paris! I love art, history, wine and French food so it feels like a perfect destination spot!

The importance of play – for kids and adults

Hands-on play, where a child uses his or her imagination and ideas to self-discover, creates the best learning environment. (iStock photo / Getty Images)

By Jeri Kayser

When people try and remember the name of my profession, child life specialist, they often shorten it to “play lady.” That used to bug me when I was a young professional and ready to solve all of the world’s problems, but now I recognize the compliment. We breathe, drink and eat to stay alive – we play to bring forth a reason for all of that effort. Play is how we learn about our world, practice that knowledge and foster our sense of well-being and personal joy; it’s an honor to promote play in the world of health care, but it’s not without its challenges.

One current challenge is tied to the hot topic in popular culture about the value of gaming devices. Is playing a game on a smartphone when you’re 2 years old considered quality play? Short answer: No. The Academy of Pediatrics recommends no screen time for kids 2 and younger and only one to two hours a day for older children. The core aspect of the definition of “play” is that it’s self-directive. You’re deciding what you’re going to do with whatever you’re interacting with. One of the problems with electronic games is that game designers have done most of that for you.

Your toddler recognizes the status that phone holds, and it works for a bit to keep a child distracted from the fact that he or she is in the hospital or in a long checkout line at the grocery store.

So what can we use to help guide our decisions to promote healthy play? A great way to look at this is similar to how we all work to promote healthy choices for our diet. Potato chips are fine for an occasional treat, but we wouldn’t want to eat them all the time. If we did, we’d feel awful. Video games kind of are the junk food of play. The more the play requires from the child, the better the value and healthier the choice.

I notice this in the hospital when I come into a room to meet with a family about what to expect with surgery. People often are busy with an electronic device, but as soon as we start to talk, the interest is there to engage and the devices get turned off. When I bring a toy or some arts and crafts activities, kids always gravitate towards that; they want what they need.

I used to work in a summer daycare program for school-aged kids. We would spend the morning on a field trip and the afternoon at a beach. The director wanted us to provide structured activities for the kids in the afternoon, but we quickly learned that the combination of water, sand and friends led to a more-creative, imaginative and enriched play than anything with which we could have come up. Hands-on play, where a child uses his or her imagination and ideas to self-discover, creates the best learning environment.

I heard an interesting story on public radio on my long commute home. At the electronic show in Austin, Texas, at the South by Southwest conference, the big news at the conference was the “Maker Movement,” stressing the importance of hands-on play to promote understanding of how our world works. They interviewed an inventor, Ayah Bdeir, who created a toy of electronic bits that fit together with magnets, creating circuits. With this process, you can make all kinds of fun things. He explained the value of this explorative play by stating, “We need to remember that we are all makers and touching things with our hands is powerful and inspiring.”

In another century, another scientist noted the same thing. Albert Einstein declared, “Play is the highest form of research.”

Self-directed play offers the healthiest value for our play “diet,” and this extends throughout our lives. We all need to play. As I wrote this, I overheard a conversation between two anesthesiologists talking about how they used play to help them cope with life stressors. One likes his guitar, while the other enjoys making remote-control helicopters.

This important fact, one of the highest forms of self-care, needs to be part of the planning of how we provide health care. Play is important for all age groups, not just those adorable preschoolers. We need to incorporate this in everything we do, for teens, parents and staff.

Late Irish playwright George Bernard Shaw said it best: “We don’t stop playing because we grow old; we grow old because we stop playing.”

Jeri Kayser is a child life specialist at Children’s Hospitals and Clinics of Minnesota.

Child life specialist helps patients conquer fears

Happy Child Life Week! Meet Betsy Brand, a child life specialist who has worked at Children’s for 26 years, across four different locations.

Betsy Brand, a Child Life at Children's, demonstrates an MRI to a young patient in St. Paul.

What’s a typical day like for you?

Every day is different, which is what I love about the job. I work in Sedation and Procedural Services (SPS) at Children’s — St. Paul, helping prepare and support patients for sedated and unsedated MRIs, CTs, voiding cystourethrograms (VCUGs), nitrous procedures and IV starts. On the Short Stay Unit side of SPS, I check in with families after surgery to help find developmentally supportive activities for patients and prepare patients for tests and procedures.

What’s one thing you’d like people to know about Child Life?

We all have at least a four-year degree, and many of us have master’s degrees in child development-related fields.

What do you love most about your job?

Being a part of a positive medical experience, witnessing patients conquering their fears and mastering their health care challenges.

What do you think makes kids great?

Their honesty and how their play reveals their needs and the developmental needs they are working on.

The theme for Child Life Week is “everyone plays in the same language.” What was your favorite childhood toy?

My dolls, Barbies and stuffed animals.

Five Question Friday: Karen Jensen

March is Social Work Month, and today we’re highlighting Karen Jensen, MSW, LICSW, clinical social worker in Children’s cancer and blood disorders department.

Karen Jensen, MSW, LICSW, is a clinical social worker in Children’s cancer and blood disorders department.

How long have you worked at Children’s?

Almost two years.

Describe your role.

I work with children with brain tumors and their families. My role is to support families throughout their journey from diagnosis, through treatment and in survivorship. I help families plan their “new lives” around a child with a significant medical issue — from school to work, to day-to-day life.

What do you love most about your job?

I love the families that I work with. It is so rewarding to be able to assist families through one of the most difficult times in their lives — through the ups and downs, through the tears and joys. It is amazing to see how the children and families that I work with change throughout this journey. I feel so privileged to be able to be a part of their lives.

What is one thing you’d like people to know about social work?

The group of social workers at Children’s Hospitals and Clinics of Minnesota is the most professional, ethical and competent group of social workers that I have ever worked with, and I’m so proud to be a part of this amazing team!

What do you like to do outside of work?

I love to spend time with family and travel, and I enjoy photography, hiking, biking and volunteering. I have a special love for Guatemala, and I support several children there.

 

 

A childhood goal turned into reality

In recognition of Social Work Month, we’re sharing profiles of some of our social workers and highlighting the important work they do for our patients and families. Today, meet Cathy Schacher, on-call social worker, who found her calling early in life and never looked back.

Cathy Schacher has wanted to be a social worker since she was 10.

How long have you worked at Children’s?

Since December 2009.

Why did you decide to go into social work?

When I was 10 years old and attended a week of church camp in central Iowa, I met a boy from Des Moines who told me about being “ripped” from his home by a foster care social worker. I told him that I would grow up to be the best social worker ever – even though I’d never heard of that type of job before in my small-town-America world!

What’s one thing you’d like others to know about your profession?

That we’re not all a bunch of bleeding hearts out to save the world. As a part of any team that we work within, we are able to provide a bigger-picture perspective that can help organize the information, prioritize the needs, provide insight into the rest of the story that might not come out during a 20-minute office visit, and assist with patients and clients following-through on the directions or taking other action steps that they might not otherwise be able to take without our support.

Do you have a favorite memory from working at Children’s?

I was able to serve during the most beautiful death experience, in which the family was at peace and was able to receive countless visits from well-known hospital staff who had walked with them through a long journey of chronic illness and hospitalizations.  When the room was packed with staff, family and friends, the song “I Can Only Imagine” came on the radio, and the patient’s mother asked everyone to stop talking while she sang that song into her child’s ear. Not a dry eye in the room! That experience taught me that I’m not “just” an on-call social worker, coming in as a total stranger, and that I was able to help the family and staff in just the right way that they needed that day.

When you were a kid, what did you want to be when you grew up?

A social worker, since I was 10!

Study: Concussion recovery time doubles when injury is sustained during school year

A patient visits the concussion clinic at Children's — St Paul on March 11, 2014. (Photo by Scott Streble)

A patient visits the Concussion Clinic at Children's — St Paul on March 11, 2014. (Photo by Scott Streble)

Concussions and the treatment after one is sustained have been at the forefront of media coverage in recent years. What once was viewed by some as brag-worthy or a badge of honor now is being taken seriously for its potential immediate and long-term effects.

While progress has been made in how the seriousness of a concussion is perceived, it’s still relatively unknown when it’s acceptable for individuals, including children, to return to normal cognitive and physical activity after suffering one.

According to a study by the Concussion Clinic at Children’s Hospitals and Clinics of Minnesota, a child who sustains a concussion during the school year takes significantly more time to recover than one who suffers a similar injury during the summer.

“We were surprised at the magnitude of the differences,” Robert Doss, PsyD, co-director of the Pediatric Concussion Program and one of the study’s researchers, said. “We weren’t surprised that it was in that direction; just simply that the magnitude was what it was.”

Researchers took patients seen in the Concussion Clinic at Children’s from 2011-12 — 43 children who suffered concussions during the school year and 44 injured in the summer — and monitored their progress. For the children who sustained a concussion in the summer, the average number of days to recover was 35. Recovery time more than doubled (72 days) when the injury was sustained during the school year.

Another study, “Returning to Learning Following a Concussion,” published in October in Pediatrics, the official journal of the American Academy of Pediatrics (AAP), explains the difficulties children experience in a school setting after suffering a concussion. Post-concussive symptoms often can linger or increase in severity without proper adjustments to a child’s environment or academic routine. Research suggests that academic demands and school environment may be a barrier to recovery.

Because each concussion and child is different, the AAP study recommends creating a multidisciplinary team to facilitate a student’s recovery and help him or her return to normal activities. Those four teams are: 

  • Family (student, parents, guardians, grandparents, peers, teammates and family friends)
  • Medical (emergency department, primary care provider, concussion specialist, clinical psychologist, neuropsychologist, team and/or school physician)
  • School academic (teacher, school counselor, school psychologist, social worker, school nurse, school administrator, school physician)
  • School physical activity (school nurse, athletic trainer, coach, physical education teacher, playground supervisor, school physician).

“It’s important to understand the individual child,” Doss said. “It seems like our practitioners are noticing more responsiveness by the schools to put forth accommodations for these kids. Some schools are more accommodating than others. Some seem to have a grasp of concussions.

“Overall, I think our perception is that schools are more receptive and thinking about it more actively. They’re instituting programs on their own, so they’re prepared for what comes next.”

Subjects were evaluated and treated in the Concussion Clinic after presenting with symptoms consistent with mild head trauma.

Researchers identified two groups based upon whether they recovered from their concussions during the school year or summer months and were ages 7 and older. The school year was defined as September through May. The school group was matched to the summer group by age and gender.

The average age of the children in the study at the time of injury was 14 years old.

Date of recovery was defined as the final visit date in the Concussion Clinic.

Doss also cautions parents and kids that they aren’t out of the woods once recovery is complete.

“It seems pretty clear in some of the guidelines that prior history of a concussion puts you at a higher risk for subsequent concussions,” he said.

However, according to the Children’s study, there’s little empirical support for the amount or duration of cognitive and physical rest after a concussion and the time frame for children to safely return to normal daily activities without experiencing ongoing cognitive or physical deficits.

According to the “Returning to Learning” study, cognitive rest refers to avoiding potential cognitive stressors, such as texting, video games, TV exposure and schoolwork. However, to date, there is no research documenting the benefits or harm of these methods in either the prolongation of symptoms or the ultimate outcome for the student following a concussion.

“Should the kids not be on Xbox versus playing a little bit of Xbox?” Doss said. What may be best during recovery depends on the case. “How much schoolwork is appropriate?”

Doss said the perceptions families and academic institutions have about concussions are evolving.

“Schools across the U.S. did not seem to be prepared. You bump up against the usual: The kids look fine. They’re not limping. They have an injury that’s not visible,” he said. “The general population is dealing with this heightened awareness of concussions.”

Variables collected for analysis included school grade, prior concussion history, loss of consciousness with presenting injury, first clinic visit ImPACT computerized cognitive testing raw scores — verbal memory composite, visual memory composite, visual motor speed composite, reaction time — ImPACT post-concussive symptom  scores, and history of depression and anxiety, migraine, other neurological problems, learning disability or ADHD.

The study was conducted by Robert Doss, PsyD, Neuroscience Center of Children’s Hospitals and Clinics of Minnesota, and Minnesota Epilepsy Group, P.A.; Kara Seaton, MD, Emergency Department of Children’s Hospitals and Clinics of Minnesota; and Mary Dentz, RN, CNP; Joseph Petronio, MD; Julie Mills, RN, CNP; Jane Allen, RN, CNP; and Meysam Kebriaei, MD, of the Neuroscience Center of Children’s Hospitals and Clinics of Minnesota.

Poisoning can be prevented

With one of the busiest pediatric emergency medicine programs in the nation and more than 90,000 emergency department visits annually for a variety of reasons, you can trust we’ve treated just about everything. We love kids here at Children’s, but we’d rather see them safe at home.

In recognition of Poison Prevention Week, we’ve gathered tips from our experts. Share these tips with your kids and print them to share at their schools or with your friends. Together, we can make safe simple.

Keep all potential poisons up high and out of the reach of children — in a locked storage container. Set up safe storage areas for medications, household cleaners, and chemicals like antifreeze. (iStock photo / Getty Images)

What is Poison Prevention Week?

National Poison Prevention Week was established by Congress in 1961 for annual, national recognition. The goal of the week is to educate the public about poisoning risks and what to do to prevent poisonings.

What you should know

Did you know that injuries are a leading cause of death in children? Each year 5,000 children die and another 6 million are hurt as a result of unintentional injuries. One in 4 children is hurt seriously enough to need medical attention. Most childhood injuries occur at home and many of these injuries, including poisoning, could be prevented.

Facts about poisoning

  • More than 1 million accidental poisonings per year occur in children younger than 6 years old.
  • Approximately 1 in 10 poisonings involves cleaning products.
  • Approximately 1 in 10 poisonings involves indoor and outdoor plants.
  • Approximately 1 in 20 poisonings are caused by cosmetic and personal-care products.

Tips to prevent poisoning

  • Review the poison prevention home checklist from the Minnesota Regional Poison Center.
  • Keep all potential poisons up high and out of the reach of children — preferably in a locked storage container. Set up safe storage areas for medications, household cleaners, and chemicals like antifreeze.
  • Keep medications and vitamins out of the reach of children. Never call medicine “candy.”
  • Keep foods and household products separated.
  • Keep products in original containers. Do not use food storage containers to store poisonous substances (i.e. plant food in a drink bottle).
  • Destroy old medications.
  • Identify all household plants to determine if poisonous.
  • Post the Poison Center phone number, 1 (800) 222-1222, near each phone in the home.

What do you do if you suspect someone has been poisoned?

  • Swallowed poison: Remove anything remaining in the mouth. If a person is able to swallow, give about 2 ounces of water to drink.
  • Poison in the eye: Gently flush the eye for 10 minutes using medium-warm water.
  • Poison on the skin: Remove any contaminated clothing and rinse skin with large amounts of water for 10 minutes.
  • Inhaled poison: Get fresh air as soon as possible.
  • Call the Poison Center, 1 (800) 222-1222, immediately.
CROSSWORD PUZZLE: Poison Search