July 14, 2020

The Child Life team at Texas Children’s has a pretty special job. Through a variety of educational and therapeutic interventions, they strive to alleviate stress and anxiety, while promoting positive coping skills for patients and families during their time at the hospital.

Made up of a variety of teammates – including child life specialist, art, music and animal-assisted therapists along with media professionals and activity, school, library and gaming coordinators – the department focuses on the psychosocial needs of children while collaborating with parents and other health care staff.

The need for such services and expertise has grown exponentially during the pandemic with anxiety and stress among patients and parents at a peak. Texas Children’s Child Life team has stepped in to do their part in calming these new nerves and making patients’ experiences at the hospital the best they can be during these unprecedented times.

“We are glad we are able to be in the room to support patients and families during this challenging time,” said Diane Kaulen, manager of the Texas Child Life Department. “We are there in PPE (personal protective equipment) helping support patients and families through all the emotions that come with illness and hospitalization. Our team is happy to still be working with them.”

The power of play

One way child life team members help children express and process difficult emotions is through play, the power of which can be amazingly strong. Audrey McKim has seen play work wonders time and time again during her tenure as an activity coordinator with Texas Children’s Cancer and Hematology Centers.

“As a child life team we make it a priority to bring patients together through intentional programming anchored by play,” McKim said. “We understand the significance of creating connections and building a community among people who are mere doors apart from each other but have the opportunity to share so much more than a diagnosis.”

Creating these connections during the pandemic has been challenging, but not impossible. McKim said an average day for her begins with huddles in the morning and looks over the census. Based on all the things she and her colleagues know about their patients and their needs, interests, strengths and diversity, they create a new daily challenge game.

Cup stacking and collapsing, ping pong challenge, Play Doh sentences, speed Spot-It, balancing building and trivia are just a few of the games the child life team play with patients in their rooms. To ignite competition among the other patients on the floor, scores reflecting speed and number of questions answered correctly are posted on a giant “Leader Board.”

“Imagine the show ‘Minute to Win It’ happening every day inside patient rooms,” McKim said. “We didn’t even need prizes, bragging rights and Leader Board ranking was enough.

McKim and members of her team also have incorporated photo projects into their repertoire and utilized creative themes burgeoning from social media. They have marked holidays with events like timed St. Patrick’s Day gold coin hunts, Mother’s Day interviews and photos from patient beds, individual egg hunts in rooms, Earth Day and super hero day art.

“What we found is how much patients started looking forward to visits from someone bringing something purposeful and fun that tied people and days together,” McKim said. “In the absence of so much, we have discovered a beauty in the challenge of creating and sustaining community through play all while staying apart from each other.”

The COVID effect

Chandler Townsend, a child life specialist in the Emergency Center, said she quickly learned that COVID-19 has more than just medical side effects.

“A hospitalized child within this pandemic is not just experiencing stressors related to hospitalization,” she said. “Our tiny heroes and their caregivers are now walking through our doors with a whole new set of external stressors, already altered from their baseline.”

Children miss their communities of classmates and playdates. Parents find themselves on a seesaw, balancing their work as professionals and as nurturers. The disappointment of a favorite park being closed, a postponed celebration or a canceled trip to see grandparents is felt by all. And, on top of everything, a visit to the hospital.

It takes extra, special intentionality to address kiddos’ fears and foster resilience, and Townsend and colleagues are doing just that and more. They are engaging family members in supportive conversation, recognizing that due to visitation protocols, they may not have their spouse’s hand to squeeze and may benefit from that extra check in.

They are allowing opportunities for control/mastery over a child’s day through procedural preparation, the dissemination of honest information, validating emotions, re-shaping perspectives, being a supportive presence and creating chances for control and facilitating play.

“Child Life is striving to adapt creatively while still keeping patient-and family-centered care at the center of our minds,” Townsend said. “I’ve been so encouraged by my coworkers and their drive to allow kids to be kids.”

July 13, 2020

For many of us, 2020 has been an unprecedented year filled with numerous challenges. Since March, the COVID-19 global pandemic has disrupted our normal way of life. Many of us are working from home. We’re social distancing ourselves from each other, and wearing protective face masks wherever we go – both at work and in public – to protect ourselves and curb the spread of this virus.

The global pandemic has been especially difficult for children and their parents. Children are having to cope with closed schools, limited social gatherings, and cancelled extracurricular activities. And with the uncertainty of whether it is safe for schools to re-open this fall, many parents are adding the new role of “teacher” to their list of parental responsibilities. These circumstances have prompted researchers to ask: What emotional and social impact is the COVID-19 global pandemic having on children and their parents/caregivers?

In collaboration with Geri LoBiondo-Wood, PhD, RN, FAAN from the UTHealth Cizik School of Nursing, two nurses from Texas Children’s – Karla Abela, PhD, RN, CPN, CCRN-K, assistant director of clinical practice in the PICU and Darlene Acorda, PhD, APRN, CNE, CPNP, clinical specialist in the PICU – are conducting a research study that will highlight the specific anxiety and post-traumatic stress-related mental health needs of children and parents. The study will also investigate the associations between parental/caregiver and child mental health during a pandemic.

“Our understanding of the impact of a global pandemic on the mental health of children and their parents is very limited,” Abela said. “We hope that our findings from this study will lead to future studies aimed at understanding these concepts better, and eventually, leading to supportive interventions for the family unit.”

Researchers at the UTHealth Cizik School of Nursing are recruiting children ages 9 to 17 years old and their parents to take part in the research study. Participation in the study involves a short, online survey with separate questions for parents and children to answer. The online survey includes questions about demographics and an assessment of anxiety and stress related to the COVID-19 pandemic.

“We encourage Texas Children’s employees and their families to participate in this secure, anonymous online survey,” said Acorda. “We encourage you to also share this flyer with anyone who may be interested in participating in the COVID-19 parent-child study.”

Once the survey closes at the end of August, the research team will analyze the findings before submitting the results for publication.

How to participate in COVID-19 parent-child study

If you are a parent or caregiver and have a child between the ages of 9 and 17, and are interested in participating in this research study, click here to complete the survey. Participation involves a short online survey for both parents and children.

If you have any questions or would like more information about this COVID-19 parent-child study, please contact Karla Abela at Karla.M.Abela@uth.tmc.edu or Darlene Acorda at Darlene.E.Acorda@uth.tmc.edu.

Medicaid applications can be overwhelming and intimidating, but their difficulty doesn’t have to be a barrier to joining Texas Children’s Health Plan. Thanks to the health plan’s application assistance team incoming members can receive help with the process from start to finish.

The team of three works to help potential members fill out the forms and submit the necessary paperwork. “We work with both English and Spanish speaking families to ensure that they have support in navigating the process,” said Lupe Fraga, application assistance specialist. “The absolute best part of our jobs is educating families so that they know that they can get medical, dental, vision and access to other social services resources in the community. That’s our greatest joy — providing valuable information.”

Fraga’s teammate, Elizabeth Gallegos, added that families are amazed about how easy the process can be. “People truly are in disbelief that it is so simple. They feel a sense of relief that with our help they can receive so many benefits.”

But with any great reward, there also comes challenges and that is where a lack of trust comes in. Gallegos said that getting the community to trust the team is something they are constantly working on.

“In order to help, we have to be trusted,” Gallegos said. “They have to trust us to fill out the application and submit important paperwork.”

When trust does take place, negative consequences can be avoided. Elizabeth Tobar, the third member on the team says that because of the complexity of the application, families can be denied coverage because of errors. “Unfortunately this can be so discouraging that many go without coverage or needed care for long periods of time. Having the opportunity to help navigate them through the process and overcome those barriers is so rewarding, especially at a time like this.”

The team is currently averaging about 35 to 40 applications per week and with a steady increase in membership, they are slated to do much more in the weeks ahead.

The application assistance team was created in 2017 and is led by Claudia Garcia, marketing manager.

To learn more about Texas Children’s Health Plan visit TexasChildrensHealthPlan.org. To read about the health plan’s new marketing plan geared toward the unemployed read this story.

July 7, 2020

If you hop on social media these days – or even watch the news – it’s hard not to come across conflicting opinions regarding the effectiveness of wearing masks to protect ourselves from the spread of COVID-19.

At Texas Children’s, our employees, staff, patients, families and visitors, are required to wear masks at our health care facilities for one reason – it is a simple and effective way to stop the spread of germs.

“There is numerous scientific research that touts the effectiveness of mask wearing to reduce a person’s risk of contracting or transmitting the virus,” said Chief Safety Officer Dr. Joan Shook. “It is too risky to let our guard down right now, particularly when we are supposed to care for our patients who need us the most.”

While different masks provide different levels of protection, Shook says wearing a mask covering protects everybody around you. Surgical or procedural masks, like the ones distributed at our employee screening check-in locations, provide a protective barrier that prevents respiratory droplets from being easily spread from person to person. The N-95 masks, which are required to be worn by health care staff during aerosol-producing procedures (like intubation) and when providing care to COVID-19 positive patients, have a thicker mesh and fit more tightly around the nose and mouth, providing an additional layer of respiratory protection.

In this video below, Texas Children’s employees and staff share why they wear a face mask.

With the mandatory mask order now in effect across Texas requiring face masks to be worn in public, we must do our part at Texas Children’s to protect ourselves and each other. In addition to wearing a face mask, we must:

  • Wash our hands frequently
  • Watch our distance – stay at least 6 feet from others
  • Hold ourselves and each other accountable
  • Stay home when we’re not feeling well.

“It is important that we all continue to fully comply with the safety precautions that have proven successful at combatting this pandemic not just at work, but in our personal lives as well,” Shook said. “While some people may feel it is their right to wear or not wear a face mask in public – as we have seen many times on the news and in social media – I believe everyone has a right to feel safe and protected. When we are masked, we are less likely to get sick, and more likely to reduce the community spread of COVID-19.”

When wearing a face mask at work and in public places, the mask should cover your mouth and nose completely and fit securely to your face to maximize its effectiveness. Click here to view this infographic on ways you should and shouldn’t be using your face mask.

Connecting with our patients

Face masks and other personal protective equipment (PPE) worn by staff to keep everyone safe during the pandemic has made it challenging to connect with patients and add that extra dose of warmth a smile often brings to a high-stress situation.

“Anxiety levels are typically pretty high when patients and families walk into our hospital,” said Diane Kaulen, manager of the Texas Children’s Child Life Department. “COVID-19 has added a whole new level to that, but Texas Children’s is finding creative ways to make our patients and families feel as comfortable as possible during their stay with us.”

To give patients an idea of what they look like without PPE, some Child Life specialists are wearing buttons donned with pictures of their faces. Others are reframing a child’s perspective of PPE, placing stickers of beloved characters on face shields and forming connections by asking patients if they think we look like astronauts or scuba divers or a personality of their own imagination.

Child Life Specialist Chandler Townsend’s personal favorite was when a child she was playing with told her she looked like “Forky,” the very personality that was on the coloring page they were working with.

“We here at Texas Children’s are finding innovative ways to meet the holistic needs of the hospitalized child alongside our health care teammates,” Townsend said. “No matter a patient’s level of visible anxiety, we are cognizant that there is more going on than just hospitalization/diagnoses and we continue to validate that.”

Basic comforting tools and behaviors such as physically getting down to a child’s level when you are talking to them, introducing yourself and talking through PPE and why staff is wearing it goes a long way, said Audrey McKim, an Activity Coordinator with Texas Children’s Cancer and Hematology Centers.

“I try to explain that we might be in goggles, masks and shields but those protections let us walk in their door and provide support in the ways pediatric oncology patients need,” McKim said. “This is so important in a time when so many doors shuttered.”

View a photo gallery below of the face buttons that Child Life team members are wearing to connect with patients during the pandemic.

Joni Justice shares her experience participating in last month’s peaceful protest on racial injustice and how each of us can be a catalyst for change in promoting racial equality, unity and respect in our workplace and in our communities. Read more

Some of Texas Children’s most beloved employees are back in the office! Members of Texas Children’s Pawsitive Play program started seeing patients again last week prompting some much-needed laughter, smiles and fun.

Designed to enhance the emotional well-being of patients and families in the hospital, the program’s animal-assisted therapy dogs provide support to those who may be having trouble coping with a hospital stay, new diagnosis or certain medical procedure.

Our dogs work full time alongside their animal-assisted therapy coordinators and consult with the multidisciplinary team to provide goal-oriented, therapeutic interventions and emotional support for hospitalized children as well as families and staff.

“We want to ensure thoughtful and intentional visits for each consult,” said Diane Kaulen, manager of the Texas Children’s Child Life Department. “Our animal assisted therapy handlers’ work alongside the medical team to align their interventions to the individualized plan of care.”

This is especially true during the pandemic when anxiety is high and safety is of upmost concern. To ensure the safety of our patients, their families, and our staff – including our therapy dogs and their handlers – the Pawsitive Play program is resuming in a limited capacity and with added restrictions.

We need your help in enforcing these new rules. When requesting a consult for the dogs or when encountering the dogs and their handlers at one of our campuses, please keep in the mind the following:

  • Animal Assisted Therapy will return to patient care for our inpatient populations only. Ambulatory and Emergency Center visits will not resume at this time.
  • Per our normal guidelines, our dogs are not allowed to visit patients on any type of isolation.
  • Patient referrals/consults must have a documented negative COVID-19 test.
  • Patients and family members must wear a mask and wash their hands prior to and after touching the animals.
  • Stopping to pet the animals in the hallways is discouraged due to social distancing guidelines. They will continue to wear their “Please Don’t Pet Me” vests as a friendly reminder of this protective restriction.
  • If employees are in a situation where petting one of our animals is permissible, they will need to wear a mask, practice hand hygiene before and after petting the dog and practice social distancing during the encounter by allowing the dog to approach them.

“We are glad to be back helping our patients have the best experience and outcomes possible during their stay with us,” Kaulen said. “We also appreciate everyone’s help in keeping our dogs and handlers safe during this unprecedented time.”

For more information on the Pawsitive Play Program, click here.

July 1, 2020

As we head into the holiday weekend, it is very important we understand that COVID-19 is not on holiday. That means our traditional July 4th plans must look a bit different this weekend, but they can still be just as enjoyable.

For your safety and that of everyone around you, use this three-day weekend as an opportunity to explore new traditions and activities – ones that will help ensure we’re here to enjoy gatherings in years to come.

With a quick Google search, we found lots of great ideas for spending the holiday safely at home. Here are our top 5:

1. Celebrate virtually. Houston’s Shell Freedom Over Texas celebration will be virtual this year, featuring fireworks and musical acts, like the Houston Symphony and country singer Pat Green. Tune in on July 4 at 7 p.m. on ABC13.com. And while there’s nothing quite like getting an up-close look at the Statue of Liberty, an interactive virtual tour by the National Park Service offers panoramic views of the statue’s exterior and interior. In additional, lots of national museums are offering history-packed videos and virtual tours online.

2. Hamilton anyone? A live recording of Hamilton, the acclaimed Broadway musical from the writer and its star Lin-Manuel Miranda, and the director Thomas Kail, arrives on Disney Plus on Friday. Take the fun up a notch by watching outdoors on the patio.

3. Get physical. Get your blood pumping with an early morning workout, alone, with your spouse or the whole family. Or enjoy an evening bicycle parade with a small group of friends – don’t forget to decorate your bike! Want to keep the fun outdoors? Stock up on lawn games like oversized checkers, tic-tac-toe, Connect 4 and cornhole. Stand-by favorites like sidewalk chalk and bubbles can also be a hit!

4. Bring the fun inside. No backyard? No problem. Bring the camp out indoors – pitch a tent and find a recipe for s’mores you can make in the oven. Or clear the furniture, and set up a picnic right in the family room – picnic basket, checkered linens and all! Spend the day making festive crafts, playing games and enjoying movies or karaoke.

5. Revitalize. While we often think of holidays as a time for celebration, they also can serve as a moment of relaxation. Take advantage of the long weekend by doing something that centers or refreshes you. Read a book, take a walk, attend a virtual church service, phone a friend or family member you’ve lost touch with, or just allow yourself to be still for a bit. Still have energy to burn? Consider tackling a cluttered room or closet, and enjoy the reward of your newly reorganized space.

These ideas are the tip of the iceberg. So explore online, get creative and most importantly stay safe.