II. Professional Responsibility
B. The ability to continuously engage in self-reflective professional child life practice
Selected Knowledge Area/Skillset
Knowledge
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Identify resources and opportunities for professional development
Skill
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Implement a plan for professional development based on the needs of the population served and the knowledge and skill level of the child life specialist
Just as is true in any profession, I am keenly aware that the learning and growth I will experience in my pursuit of a career as a child life specialist does not come to an end when I graduate from Boston University Wheelock College. Child life professionals are constantly undergoing professional development and learning opportunities as is required by the ACLP and is a facet of working in any healthcare setting. This learning includes webinars, conferences, lunch and learns, and the education and practice which comes from each interaction with a patient and their family.
During my internships at both Boston Children’s Hospital and Good Shepherd Community Care Pedi Pal, I have been fortunate enough to engage with a wealth of opportunities for professional development and education. These experiences have shaped my own growth as a student intern and blossoming professional and taught me about the ways in which I hope to interact with and support the patient’s and families whom I serve. In many instances, the most valuable resources for growth were routine interactions with patients and families in which I was able to practice and hone skills of rapport, intervention, and distraction. Additional professional development opportunities included my involvement in two simulation labs at Boston Children’s Hospital, weekly attendance in a family engagement seminar run by the Brazelton Touchpoint Center, and the opportunity to attend the New England Child Life Professionals Conference held in Ashbury, CT. These experiences allowed for interaction with both child life professionals and other clinicians such as ABA therapists, Early intervention professionals, and interdisciplinary care providers, allowing for more exposure to the unique goals and processes of each discipline and the ways in which child life can support and advocate for this support. Attending these conferences and courses also allowed me to experience and consider the ways in which child life professionals approach time management to achieve all necessary PDUs for certification while still meeting the needs of the children and families in their caseload.
Evidence
Good Shepherd Pedi Pal Journal Entry Week 2… During one visit for the children of a recently deceased hospice patient, Jessica and I had the opportunity to accompany the family to the park. The two siblings, a 7-year-old boy and 4- year-old girl, lost their mother earlier this summer and their father has since become the primary caregiver. Pedi Pal was introduced as a service to the family as the mother’s health declined and has since been a method of support for both the children and the father as he takes on this new role of responsibility and grieves the loss of his wife and children’s mother. I was struck most by this visit as Jessica and I debriefed about it because, in many ways, Pedi Pal and child life had become an inherent and assimilated part of this family’s life. Jessica and I were not greeted with the cold, sterility of strangers entering through exam room doors, but rather welcomed into the day-to-day fabric of this family’s life. This is not to say that formality or boundaries do not exist outside of the hospital setting, but the trust and value of these relationships was so evident in the ways we were welcomed into the inner routine and motions of these individuals' days. As I pushed the youngest on the swings, her father shared some of the hardships of losing a partner with Jessica and I watched on as the oldest child attempted to play with his peers. I was excited to see the comfort and trust which this program brings to families, but with this acknowledgement Jessica and I also discussed the hardships of working so closely together with unique and individual family dynamics. While the relationships formed through Pedi Pal are important and dependable for these children and their father, after 13 months their services with Good Shepherd will have to come to an end. This frustration and upset of not being able to do everything for a child or be there with a family indefinitely is a struggle which I imagine many child life specialists face regardless of the setting, and I think grounding myself in the timeline of this scope of practice will prove useful as I move to continue shadowing and eventually adopt my own caseload.
Good Shepherd Pedi Pal Journal Entry Week 3… On Friday, Jessica and I met with a 13 year old patient who had recently been inpatient at Boston Children’s Hospital and Spaulding Rehabilitation Center, following a stroke. This patient had been discharged only a few hours earlier and I was struck by her and her family's willingness to have us in their home even after just getting back…I was amazed to see the comfort and stability which the patient showed while walking and participating in games. She also spoke clearly and her tempo was only mildly slowed, particularly when she spoke about aspects of recall. This highlighted for me the importance of individualized expectations and personalized patient and family care, as I saw how matching her strengths only added to her confidence and excitement throughout the visit.
Good Shepherd Pedi Pal Journal Entry Week 4.. Going into my fourth week as an intern at Good Shepherd Community Care Pedi Pal, I was excited to have a general sense of the schedule and patients which I may visit on a weekly basis. Through this week, however, I have seen how the medical complexities and intricacies of Pedi Pal patients can not only affect child life caseloads but also the unique needs and visits for each child and their families. While Jessica and I may meet at the beginning of the week and plan for x amount of visits, when Friday comes we may find that many scheduled visits were canceled due to illness or changes in schedule and other patients had more pressing needs relative to new admissions or changes in their care. Because of these ever changing needs, six visits may become two or ten, but I have come to see that each visit offers its own unique learning opportunity and when analyzed from the perspective of recognizing the quality and benefit for each family, as opposed to the quantity of visits, patients and families receive more personalized and considerate attention to their needs.
Good Shepherd Pedi Pal Journal Entry Week 7.. I began this week by attending the New England Child Life Professionals Conference hosted at the Hole in the Wall Gang Camp in Ashford, Connecticut. Not only did this event provide me with unique and valuable experiences to learn about relevant topics in the child life field, but I was also able to network and interact with a variety of other child life professionals, all with varied backgrounds, patient populations, and perspectives. In registering, I chose to attend sessions on “Building Blocks of Resilience” and “Guided Imagery and Hypnosis” along with the introductory and keynote presentations on “Spiritual Care” and “Gender Affirming Healthcare.” These variety of topics and clinical perspectives helped highlight the breadth of child life work and potentials for interventions and interdisciplinary work…Through reflections with my peers and discussions during the sessions, I found that key takeaways included: the importance of using skills of advocacy for yourself as a clinician to protect boundaries and better support patients and families, sharing options of alternative medicine and holistic care with families to better expand their potential for choice, and respecting pronouns through both charting and unit-wide education.
Good Shepherd Pedi Pal Journal Entry Week 8… Throughout this week, I had the opportunity to discuss with Jessica how I will model interventions and conversations with children and families as I move into the independent portion of my internship. On Thursday, we visited with a patient who I’ve seen weekly with Jessica to observe their interactions and practice gaining comfort in my own rapport. After gaining approval from her caregiver, we spoke with this patient to discuss the upcoming change of provider from Jessica and I, to me individually. This was met with understanding and after providing supportive, reinforced language stating “just Izzy” she acknowledged the change and we were able to continue on with our planned activities. Jessica also shared that in my interactions with this patient I can practice using present language and verbiage, since reference to the “future” or “next steps” may distract from the intervention.
BCH Journal Entry Week 10… In observing these patient’s individual experiences of ASD, I saw how, with proper preparation and desensitization of the environment, one patient was able to stay still looking at his iPad. This patient’s baseline was mainly non-verbal; therefore, it was crucial to only interject with socialization when completely necessary to maintain an adequate sensory environment for him. The second patient, however, was very sociable and enjoyed asking questions about his surroundings and the next steps. Unfortunately, based on the technologist’s assessment that this patient was “unable to remain still enough for the test”, he felt it necessary to utilize the papoose for restraint of the patient’s legs and arms. Kristin and I spoke later about the ethical and family-centered considerations when papoosing a patient. While at times this practice may be necessary for safety concerns in the space, we felt this was not the case for the second patient and instead it was used more of a mode of convenience, to complete the test promptly. Once the decision to papoose is made, child life staff will often step back and help support the family, as this is not a method we use in our practice or facilitate for children.