Setting up child life services in India: Success in the Face of Continued Challenges

As National Child Life Month draws to a close, we continue our spotlight on Jeanine Clapsaddle. Jeanine is a Child Life specialist from Children’s who is in India for two months to help set up Child Life services at Manipal Hospital.

Jeanine’s trip is in partnership with the Priyanka Foundation, which was established to fulfill the dying wish of a former Children’s patient who wanted other kids around the world to get the same care she received. Jeanine is documenting her experiences through this blog series.

This is the fourth report from her trip:

 

The Child Life office here at Manipal is located just off the waiting room to the vaccination clinic. I am provided with ample opportunity to watch families with children of all ages interact while they wait or recover from their visit. I have been invited to gaze upon babies who, quite frankly, are breathtakingly beautiful with their heads of full, lustrous hair and dark eyes.

On more than one occasion every day, I am treated to games of peek-a-boo with curious toddlers who delight with running in and out of the open office door. Some grab their parents by the hand and drag them to the door to show them what they’ve discovered.

Parents are always gracious and smile, sometimes sharing the child’s name or asking questions about where I come from and what I’m doing at Manipal.

Today, in this same waiting room, I was witness how far my students have come in the short time I have been here, as well as how far we have to go.

I was in the office with my student, Sunitha, when we heard, as we frequently do, the traumatic screams of a child being carried to the vaccination room.  Somehow this girl of about 6 was able to escape her father’s arms and run back out into the waiting room. She was hunkered down in a corner sobbing.

In the blink of an eye, without any prodding from me, Sunitha grabbed a bubble tumbler and took off to approach the girl. Although the girl did not want to blow the bubbles, she was able to watch Sunitha blow them and settle herself some. Sunitha was able to talk with her quietly until the girl’s father could come and sit down next to her.

When the father was able to pick his daughter up, he approached our office door and Sunitha explained that I was here training her and as such we could give him some help with the situation.  I explained the work of Child Life as quickly as I could, shared some strategies such as positioning for comfort and distraction, and walked with him to the vaccination room, hoping that this would be the in-road that I had been longing for with the staff.

No such luck. The nurse was quick to dismiss us and our suggestions to the point of shutting the door in our faces. Sunitha and I walked the 10 steps back to our office to endure the resulting screams. As they left the vaccination room, the father stopped by the office door and thanked us for our help.

Despite the less than optimal outcome, I couldn’t have been more proud of Sunitha’s initiative and genuine attempts to help this child. I have observed the work of my students consistently and know that their skills are progressing. We spend time discussing various aspects of child life practice, dissecting my observations as well as theirs and converting understanding into guided actions.

But in this moment, I was aware that at some point the culmination of teaching is the development of some internal instinct about the work. Sunitha didn’t stop and ask me if she should or how to intervene with this child.  She grabbed the bubbles and took off. And I stood in the doorway to not only to use the opportunity to observe her work, but to also appreciate the intuition that activated her.

Being a good advocate, like in this case, does not always secure the actions or outcomes we strive for, with staff or with families. In the past week, we have done presentations for nearly five hundred of the physicians and nurses in the hospital, introducing them to the work of Child Life. And although I would speculate that this vaccination clinic nurse didn’t attend any of the presentations, I know that new and innovative programs are often met with resistance.

There are lessons to be learned about approaching barriers with subtly and persistence.  There will always be medical providers of all sorts, in hospitals everywhere, who see the work of child life as an intrusion or unnecessary.

But knowing that we gave this child a moment of respite to catch her breath, and her father some tools that he can use in the future, is enough to know that we do make an important difference in the lives of children and their families.

I hope that this is something my students will learn along with the technical aspects of providing care.

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