Okay, so teaching a dog to sit can be a LITTLE intimidating if you've never done it before...and how about getting a dog to fetch?? Fetching isn't really the hard part...it's getting them to DROP the ball/stick....that's the hard part! So how in the world do you teach an old dog new tricks?? I thought I'd share a little story about how I "trained" the nurses in my area to use the comfort positions. Okay....so "trained" isn't really the right word, but it does go along with the title....so cut me some slack. :-)
The year was (about) 1995, it was Hurt Alert Day at my hospital and I was attending a seminar being offered. One of the subjects the nurse was teaching was Mary Barkey's Positioning for Comfort. This was the first that I'd ever heard of this. What? Really? Not make kids lie down while we "help them" hold still by laying on top of them and smooshing their cute little noses into our armpits?! Count...me...in!! Now, you've got to remember....in 1995 this was a new concept and this was the first I'd ever heard of it.
At this time, I had been practicing in child life for about five years, and had recently started in a new area. I was covering two outpatient areas, as well as the PICU. One of those outpatient areas was a GI clinic/lab.....affectionately known as the "butts and guts" lab. When I'd first started in GI, one of the nurses asked me what I thought about....the use of.....(insert spooky organ music) the papoose board!?! For any non-medical people who might be reading this, a papoose board is a flat board, with wide fabric straps that are used to restrain children when they are having procedures done. Think of...well.....think of a straight jacket...that'll give you a pretty good idea. Well, heck....I knew I didn't like using a papoose board...but that was about all I knew. I didn't have ANY idea of how to do things any differently. (It was 1995 people....we didn't know any better....yet)
Well, the nurse at Hurt Alert Day, did her blurb on positioning for comfort and was such a believer, I just couldn't WAIT to try it out!! But then came the thought....how do I get the staff to let me try it out? I was new to their area, hadn't really fully earned or established their trust yet, etc. I had to approach this delicately....it's always a balancing act....you have to be a little pushy....but not too pushy.
Thankfully, this wasn't even an issue that day. One of the GI nurses had also attended the seminar. Later that day she said, "Hey Debbie, what did you think about that positioning stuff? Maybe we should try it here?" (Ding, ding, ding~we HAVE a winner!!) Of course she wasn't exactly sure what the rest of the staff would think of it, so this is where I had to get my creative child life juices to flowing....hmmm....how could I get staff to try something new? What was an offer they couldn't refuse? I could try the old "it's best for the children" routine, but that still presented the possibility that they might resist. Hmmm.....what could I try? (Tapping finger on chin, eyes gazing thoughtfully in the air) Then....in a flash....I had the answer; the offer they couldn't refuse. Confident that my next project would be how to solve world peace, I walked into the GI lab and announced, "I went to that Hurt Alert Day seminar, and Val (the original nurse) and I learned about something called Positioning for Comfort. We'd like to give it a try tomorrow. So, if you all agree to let me use the comfort positions on all of our patients, I'll bring you bagels in the morning....with....cream cheese. Not the wimpy store kind of bagels....Bruegger's Bagels." In my head, I could hear the sound of their "ooos and ahhhs" just like when they show the prizes during The Price is Right's showcase showdown. "Food? That's your secret, Debbie? I thought you'd have some magic words to utter." Heck yeah, people!! Food IS the magic word....don't EVER be afraid to try bribery!!! I mean, c'mon, we do it with our children...why not our coworkers? That's what I did. I shamelessly bribed my nursing staff with food. And....it worked.
That next day, we had four patients in the toddler/preschool age range, which were typically the ages that our nurses were most likely to want to "help." Guess what happened? The clouds parted, the sun was shining, the trumpets sounded and the angels sang....all of the children were cooperative. Now...we all know that even if we do everything right, kids aren't always cooperative....but on this day...they were. Oh, but don't worry, I had my responses ALL prepared just in case the IV didn't go in on the first try. Heaven knows that when you let a kid sit up and the IV doesn't go in on the first attempt, sometimes a nurses initial thought is to blame it on the positioning. "Well if we'd have made him lay down, we could have held him better." Ever heard THAT one? All the kids that day were cooperative, the IV's all went in on the first try, all the nurses enjoyed their yummy bagels and cream cheese, ane we all lived happily ever after. Sort of. The next day (with NO bagels and cream cheese nearby) one of those same nurses was looking for the papoose board. Sheesh. A child life specialists work is never done!! (Don't worry....we DID end up using the comfort positions that following day and every day after that!)
