I have been back home for a few weeks now and have had lots of people ask me how my trip was. When I first got home I didn’t know how to answer that question because there was just so much that happened over the 4 weeks and I was extremely jetlagged. Now that I know when night and day are and I have had some time to process I am finally finding the words to describe my time in Laos. Week 3 in Laos was the hardest week of my career and it is this week that made it hard to me to describe my experience to people in a quick conversation.
So the weather turned cold on Sunday, and really put a damper on my vibe. Yes, I know I’m Canadian and should be used to a little cold weather BUT where I’m from in Alberta there is no such thing as “damp cold.” Albertan winters can be really stinkin’ cold, but they are a bitter dry cold, not a damp, bone-chilling, no-hope-of-ever-getting-warm kinda cold. In Laos the cold is the former, the damp kind. Laos also does not get cold like this very often. The temperature went down to about 7 degrees Celsius and paired with no heating systems the whole country felt the chill. It was kind of like a weeklong full moon Friday afternoon in the emergency department – if you know what I mean. The acuity of the patients went up and we were faced with some really serious cases. The language barrier was really frustrating because I really wanted to comfort the patients and their families, but I had to let go of that control and let Lee take the lead on the support and comfort for our families. I feel that during hard times teams usually get closer to get themselves through, and it was no different for us. We worked together as a team, leaning on one another to get us through the week.
Right in the middle of this crazy week we reached some really big milestones. The Lao Friends Hospital for Children celebrated their first birthday and we had a day of celebrations. We also saw our first (real) patient in the child development screening clinic. And maybe the most significant milestone that happened was, a team of all Lao medical staff completed a sedated procedure on a patient. Included in that team was Lee, the play therapist! She did an amazing job keeping the patient calm and distracted through his potentially distressing dressing change!
Thankfully towards the end of the week the sun started to come out, boosting our morale, and giving me the energy to get through my final week!
During the second week is when I really started to feel comfortable and “build” the child life/play program. I was beginning to learn the more common illnesses of our patient population and the daily flow of the departments, as well as the how the Lao staff communicate.
The Lao Friends Hospital for Children operates through a partnership between the Friends Without A Boarder (FWB) organization and the country of Lao. FWB and the hospital have a 10-year partnership to help the hospital to provide high-quality, locally appropriated medical care through the mentorship of ex-patriots. Once the 10-years have past, it is their goal that the Lao medical staff will have the skills and education to operate the hospital independently.
It is amazing to be apart of what is really the beginning phase of this project. The hospital will just be turning 1 next week, so there is a ton of growth and development to be done. I’ve often thought how lucky this hospital is. The staff and families are so fortunate to have leadership that has advocated for a family-centred care program – like child life. I have had no experience developing a program before, all things considered, I’ve really had little experience working in a well-established program at all! But this was my task and I had to figure things out fast. First thing on my to-do list was to spend every free second on the unit with the patients and families and figure out their exact needs because surely they had to have some differences from the families back home in Canada. What I quickly figured out was that the kid’s needs were pretty basic. They just wanted something to do and someone to play with! The family’s needs were similarly simple, they just wanted someone to care for their children.
I’ve had little experience working with a language barrier before, and at times this seemed like a total road block, but then I would succeed in communicating with a patient without needing to speak the same language. I did learn a few words in Lao, mainly colours and numbers thanks to the card game UNO. UNO was a big hit with the older patients. There were many occasions we would rolled a couple of beds and a wheelchair together so a group of patients and staff could play together. I even caught a group of dads playing it together one day!
Over the coming weeks I would develop some pretty strong relationships with four of our long-term patients. All four were admitted for the same diagnosis. Each would require long-term antibiotics for infections, hours of rehab and weeks of potential boredom. These kids would teach me about patience, compassion, resiliency and most of all bravery.
During the second week I was asked to present at morning educational rounds…twice! Thankfully, McMaster (forced) taught me how to prepare presentations in a short amount of time, and to fill at least 1 hour. My first presentation was introducing the role of Child Life Specialist and Play Therapist to the staff. Most, if not all of the Lao staff had not heard of child life or the idea of play as a form of therapy. I also had compliments from the ex-pat staff, and how amazed they were that a job like this existed and how they looked forward to working with us!
Week 2 was a really busy week because once the stress of preparing for educational rounds was over, we attended training from Handicap International. I was recruited to come to Laos through a grant that provided the hospital with a developmental milestone assessment tool. The tool, called The Blue Box, included a formal assessment and a box of cards that contained activities to help children meet developmental milestones. The Lao play therapist, physiotherapist, and a couple doctors and nurses attended the training along with the ex-pat physiotherapist and I. We learned how to perform the assessment, which included many questions and activities to test the child’s development in the domains of language, social, cognitive, and fine and gross motor skills. Next we learned how to use the Blue Box cards to help the child and the family work towards those missing milestones. Finally we had a few practice patients to assess. The training was great, I learned so much during those days about child development and got to see some really cute kids!
Week 2 ended on a high note, which was great because week 3 was a challenge!
It’s hard to believe that just over a month ago I shared the news that I was coming to Luang Prabang, Laos to volunteer at a newly built children’s hospital and now I’m reflecting on my first week here. This week has been truly beautiful and life changing. Anyone who has been to Laos will agree that this home of one of the most beautiful landscapes and some of the most gentle people.
After 27 hours of travel through 4 airports, with 1 full-on sprint across an airport to catch a flight and 1 lost bag later, I arrived in the one terminal international airport in Luang Prabang. I was met by a hospital staff holding a sign with my name (I’ve always wanted to be greeted at an airport like that) and I was off in a tuk tuk to my home for the next month.
I arrived at the hospital bright and early on Monday morning, with zero expectations of how the next month would go. I hadn’t really asked for too much information about the hospital or what the hospital’s plans were for me because I didn’t want any disappointments during this trip. All I knew was that I was there to train a locally hired Play Therapist and that I would be attending some child development screening training. So when I arrived at the hospital, I met with the HR staff to get my ID and I was off to catch morning rounds.
The hospital is made up of three main units/areas – the outpatient department (OPD), the inpatient department (IPD) and emergency. OPD is open daily from 8-4pm and runs in a clinic/fast-track model. Patients are triaged by Lao nurses and then seen by a Lao and an ex-pat doctor team. If the patient can be treated by the OPD doctors, then they are sent home, if they need more medical attention they are triaged to either IPD or emergency (just like fast-track at home). There were lots of great distraction opportunities in OPD for the Play Specialist and I.
Next is IPD – a one-room unit with 20 beds. This is where I spent most of my time during the first week. The unit is staffed by 3-4 Lao nurses, 1 ex-pat nurse, 2 Lao doctors and 1 ex-pat doc. The model is that the ex-pat staff will supervise and mentor the Lao staff, while the Lao staff actually carry out the care and make the orders. Each morning at 9am rounds start, where the medical team goes from patient to patient. This provided me with great learning. Since the ex-pat doctors where teaching during rounds, to Lao staff who’s English was basic, I was able to learn a lot in non-medial jargon.
The emergency department has 2 beds, along with 2 isolation/ICU rooms and ebbs and flows, much like any ED at home.
After rounds I finally met up with Lee, the newly hired Play Specialist! She had started at the hospital just a week prior to my arrival, and had just been getting comfortable with the environment. A newly graduated teacher, Lee didn’t expect to get a job quite like this one – so we both had a lot of learning to accomplish in the coming weeks.
It’s hard to believe that it’s been over a year since I started this journey of becoming of a child life specialist! I have checked all the boxes that I wanted to:
- Get into McMaster’s Child Life program
- Survive Independent Study
- Write my Child Life Certification exam (and pass)
- Work as a CLS at the Alberta Children’s Hospital
I have been so lucky to be able to achieve all these amazing things and been giving all the great experiences I have over the past 6 months as a working CLS. Since my last update I have been working in the Mental Health Unit. This position is not a traditional CL role, but it has been a great opportunity for me to challenge myself. Not one day is ever the same and there is never a dull moment in Mental Health! These children have taught me so much about patience, acceptance and starting everyday with a clean slate. My role primarily consists of group programming, and recreation therapy. I teach gym class daily and then run 2 different groups and also try and make the transition from leaving normal home life to coming to our program a little easier.
Now for the really exciting news…
A few weeks ago my CL manager was approached by a doctor working at a newly opened children’s hospital in Laos looking for help in developing a child development program. Since I only work casually, my manager asked me if I would be interested in this opportunity and I said YES! On January 9th I will be travelling to Luang Prabang to volunteer at the Lao Friends Hospital for Children for 4 weeks! The exact details about my work there are yet to be worked out but as those develop I will update you.
I have created a fundraising page for those who are able to donate to my travel expenses, and tools that I will need establish this program.
Thank you for all your support!
The past couple months have been some of the hardest. I moved back to Alberta from school in Ontario with hopes of finding a job right away. I knew that I wouldn’t be able to find a Child Life job right away, but I had hoped to at least use my past work experience and undergrad education and get a communications job to replenish my bank account. What I didn’t realize is that Alberta is undergoing a recession and the oil and gas companies for laying people off instead of hiring. So that left me with a few weeks of unemployment, and questioning if I had done the right thing by moving back to Alberta.
So in my time off, I asked the Alberta Children’s Hospital (ACH) if I could come and share my experience at McMaster with their Child Life staff. They were happy to have me and even excited to hear a different perspective from the hospitals that I had interned in. I gave my presentation at the end of May, and during that time the CL leader asked me to send her my updated resume and let me know that they were looking at hiring an additional casual CLS. I sent my resume promptly as soon as I got home. It wasn’t until the end of June when I finally got contacted for an interview. Oddly enough I wasn’t that nervous for the interview, I knew the staff that was going to be doing the interviewing and I had also had CL interview experience from my internships during school. I was also confident in my skills and knew that I had experience and knowledge that I could bring to the ACH team.
They made me wait another week before I finally got the call congratulating me on getting the job! It was the call that I had just worked so hard for years to get – and man did it ever feel good!!
My first day as a real Child Life Specialist at the Alberta Children’s Hospital was on July 13, 2015. The whole day (and even now) I just reminding myself that I was actually getting paid to do this! The first few weeks, I was working at day camps for children seen by our neuroscience teams. It was probably the best way to start my new career because everyday was so fun. We went on a field trip everyday – bowling, rafting, horseback riding!
So I am a casual CLS, and that means that I do not have a permanent position and am not guaranteed hours. The only way that I get hours, is if other CLS go on vacation, are on maternity leave, or how it has been working for me – current CLS go do their CL internships. At ACH, CLS have not had to be Certified. For us, being Certified does not mean a pay increase, but it means more creditability in the healthcare field. So some of our experienced CLS are finally going to get their requirements before the Child Life Council changes the requirements for certification. This has worked out great for me because I have been given TWO temporary positions to give me work until the end of 2015.
Currently I am working at the Rotary Flames House, our pediatric hospice and palliative care unit and beginning in October I will be in our outpatient Mental Health program.
I can’t believe that my dreams are actually coming true. For all those who read my blog – hard work does pay off; you just have to have the passion and persistence!
I’ve struggled to write this final blog entry – and have started to write a couple times but I’m not really sure where to start. I’m so sad that this crazy journey has come to an end. My McMaster Child Life experience was truly life changing.
The profession of child life is more than just a job – it’s a passion and an honour. I have had the opportunity to get a glimpse of this over the past 8 months.
In the final few weeks of the McMaster program is really when the rubber hit the road for me. It was only during the final shifts of my internship in SickKids Emergency when I finally felt like I was ready to “Child Life” on my own. I had finally developed the vital relationships with the staff, where they trusted my skills and began to call me for support. I began to trust my assessment skills, and become confident in my interventions. On one of my final shifts – I had my first solo shift. That day from the moment that I entered the department I was being called from room to room to provide support for some pretty serious cases and I survived!
I also survived my Independent Study presentation. This was the one part of the program that I was dreading! We each had to present one aspect of our Independent Study research papers – in a 1-hour presentation. My presentation was on the benefit of group programming for Military children. My advice to those just beginning the program is to choose a topic with research! My topic – although interesting, did not have very much research and it was really a struggle for me to fill 20 pages, and 1 hour. With a lot of hard work, determination and support from my friends, I got through!!
Now that the program is over, the real hard work begins. I have decided to move back to Alberta to try and pursue a career here.
Thank you for those who followed my journey from the beginning. I hope that this blog has been helpful to those seeking more information about McMaster’s Child Life program and also the profession of Child Life. I am excited to see what the next chapter in my Child Life journey has in store for me.
Also GOOD LUCK to those who were given an interview to this year’s program, and to those who didn’t get that interview this year GOOD LUCK on next year’s application.
Time has flown by and I’m excited and sad to be nearing the end of this crazy journey. This week is the final week of my internship in the SickKids Emergency Department and the week after is the final week of classes. This second internship has flown by – especially with all the travelling back and forth I have been doing from my apartment in Hamilton to Toronto. I was lucky enough to have a friend who had an extra room for me to stay in Toronto during my work weeks, but I’ve been coming back to Hamilton on my days off to rest and work on homework.
This internship has been nothing like I was expecting. I was expecting to see lots of traumas and gory injuries but I actually haven’t seen many at all. It has, however, tested each of my child life skills – assessment, distraction, education, coping, crisis intervention, and avocation (and probably others that I can’t think of). There have been many occasions where I have been paged to a room, and the only tools are the ones that I happen to have in my pocket. There have also been times where I am just walking down the hall and hear crying from a room and go in knowing nothing about the situation including procedure or illness or injury. I have come to realize that this program and both of my internships have actually provided me with the skills that I need to do this job. I have the foundational knowledge of child development, and I have been taught the basic intervention and distraction skills – I just have to trust my knowledge. There have been times where I feel like a glorified iPad stand and can’t see the benefits that I have been providing, but then there have been others where patients and families have thanked me for the support that I was able to provide for them.
I have enjoyed the variety of illness and injury that an emergency department sees. Another great thing about working in a busy ED is if I mess up the wording on an IV prep, I’ll get a chance for redemption quickly. This environment also has given me the chance to try different interventions with patients. I’ve tried a few different ways to introduce myself and the role of Child Life, and continue to tweak it depending on the patient and family.
I am constantly surprised by how diverse the role of child life is depending on the area that you work in or the hospital. And with each role that I try out, I fall in love with this profession a little more. Although, I have a few more things to do before I can call myself a Child Life Specialist. The final assignment of the McMaster Child Life Program is an hour-long presentation. We have to present one concept from our research papers that we handed in last month. We got to choose the topic of our papers – mine was the Role of Child Life in Military Families Facing Deployment. Next week I will be presenting the benefits of peer group programs for these children – wish me luck!