More Butterflies from Princess.....

Okay, so I just felt like I needed to do an addendum to my last blog “Always Look for Your Butterflies.” If you haven’t read my last blog, please take just a moment to do so…it will help you understand the significance of what I’m going to write about now.  This story isn’t really meant to be preachy, but I am definitely a very spiritual person. I just couldn’t pass up the opportunity to share this story of His presence in my life, and how we all have to be open to that presence…and sometimes...you don’t have to look far at all.

On Tuesday of this week, I went to Princess’ visitation. I spent some time visiting with her mom, and then some time at her casket…and she actually did look like a princess….sparkly pink lip gloss and all.  I then stopped to visit with her grandmother. We visited for a very long time. We shared stories that made us laugh and cry, and she told me stories of Princess’ last few days. We had done a lot of pretty significant sharing, so I decided to share with her the story of my butterfly…the swallowtail butterfly that reminded me that child life is what I’m supposed to be doing right now.  As I finished my story she said, “Did you say it was a swallowtail butterfly?” I replied, “Yes” and then she asked, “Did you see the picture of Princess when you signed the guest book? Did you see what she was holding?” (This picture was taken the month before at her Uncle’s wedding; she was the flower girl. Princess was such a beauty and extremely photogenic. She was dressed in a beautiful off-white satin dress, with flowers in her hair.) I said that I did see the picture, but didn’t pay attention to what she was holding. “Debbie, she was holding a butterfly…a swallowtail butterfly.”

Tears immediately began to sting my eyes...this was the same kind of butterfly that God had sent to me as a sign the day before Princess died. “But wait, Debbie, it gets better” said her grandmother. She proceeded to tell me that four days before Princess died, she was at her grandmother’s house and they were out in her backyard. There was a butterfly flitting about and Princess said, “I want to hold the butterfly, Grandma!! Catch it for me, Grandma, catch it!!” She said that the butterfly had landed on one of the bushes so she went over to see if she could catch it. She said the butterfly sat perfectly still with its wings pressed together, seemingly waiting to be picked up. She picked up the butterfly and took it to Princess who held out her finger. Grandma put the butterfly on Princess’ finger.  She held it for a short time and admired its beauty, all the while talking about just how beautiful it was. She then raised her finger to release the butterfly.

It was, naturally, a swallowtail butterfly.  

Her grandma told me that because Princess loved butterflies so much, they decided to have a butterfly etched on her headstone. Two days after she died, Grandma decided to go out into the yard and see if she could find a butterfly to take a picture of…they wanted a picture of one of her real butterflies for her headstone. Grandma went out into the yard to look for a butterfly. She found one sitting right on that same bush. She thought there was no way that butterfly would sit there while she got close enough to photograph it. But that butterfly did sit there while she went to get her camera. When she approached, its wings were pressed together, but as she inched closer and zoomed, the butterfly opened its glorious wings and just waited. Grandma did get that picture…she got the most beautiful picture of that butterfly, and I think by now, you know exactly what kind of butterfly it was….

Princess’ grandma and I both cried…all over again.

You always have to be looking for your butterflies….you just never know where they will be, or when they will appear….but it’s usually just when you need them.

Look for Your Butterflies.....

Wow. What a crappy week. Sometimes we just all have 'em, but jeez...this one was really rough. I'll take out of the equation the fact that my son is gone for 10 days with his dad on vacation which has certainly been an experience for me because I've never been away from him for that long. However, my crappy week was really based on the death of two of my patients, one who was 14 and one who was only four. Both equally tragic in their own right, but putting them in the same week  just seemed a bit excessive to me, Lord...with all due respect.  And then there was the 6 year old who is so horribly ill that when I went to visit, he just didn't even look human. What the heck is that all about?

If you work in health care, you know that this is just the way it goes sometimes...comes with the territory. However, it doesn't mean you ever get used to it.  I mean, can you ever really get used to it? I don't think so....you just do the best you can and try to deal with it as it comes; rely on your coworkers for support, pray more, give your children more hugs.

Well...this week was exceptionally rough. I've always looked forward to when my little four year old friend would come in for chemo, blood, platelets, dressing changes...we'll call her "Princess." Princess would come in a couple times a week, unless it was a chemo week and then it would be four days in a row. We'd formed a pretty special little bond. The crazy thing about Princess was, she didn't know that if you are dying, you are supposed look and act sick. The fact that she was unaware of how she was supposed to look, actually just made it harder for everyone...family and staff included. We just couldn't understand how she could be so sick, and act so...not sick.

I was already feeling extremely saddened over the death of our 14 year old who died early Monday morning when Princess came in that same morning for platelets....and she was in rare form....so...much...fun! Although I was sad inside, she brought smiles to my face and sunshine to my heart like any other day.  She was really, really, REALLY good at that. She had just the kind of beauty (inside and out) that made everything around her magical. After she left that day, her case manager told me that she had an exorbitant amount of blasts (leukemia cells) in her blood...which essentially equated to...she's definitely going to start feeling sick pretty soon.

The next morning she came in with severe leg pain... came in writhing in pain. This wasn't an easy thing for any of us to see our little Princess in so much pain, especially when she seemed just fine less than 24 hours earlier. Unfortunately this whole scenario played out again, the very next day. We all have those kids who just melt our hearts...and to say that Princess melted my heart, is probably the understatement of the year. When she left that very last day (Wednesday), I knew I'd never see her again. At this point, I just needed to get out and go for a walk...right away.  I called my friend, and walking buddy (I'll call her Kay), to see if she could go...right then and there....for a walk. Kay is an inpatient child life specialist, who had also been having a really crappy time with lots of tragedy in her teen population. We used our walks, not only as a way to get exercise, but we often tried to tackle work issues or occasionally tried to solve world peace. Thankfully, she was able to go with me right then, which was a blessing. We both just needed to go outside of the hospital walls and walk off our sadness/anger/frustration.

So our walk consisted of exactly what it needed to consist of...yelling, crying and questioning. "Why, God, does this have to be so hard??!?!!" "How is this fair?!!" We tried to console each other with words that just really can't make any sense about why kids have to die, because there just aren't any good reasons or words for that. So we walked, we cried, we yelled, we questioned, and then we cried some more. We talked about "signs"...and how we've each asked God for signs about different things in our lives. And then we talked about how we've struggled to figure out if what we were seeing really was a sign...or just our overactive imaginations. I was telling her that it always seems that just when I start to question if this is what I'm supposed to be doing with my life, inevitably, I get a call from a patient...just wanting to say "Hi", or to let me know that they're in the building for a checkup and can I come visit. I told Kay, that those always seem to be my signs from God. When I question, He delivers an answer to me in the form of a patient whose life I've touched...or probably more accurately, who has touched MY life. And honestly, He's usually very prompt. :-)

At this point in our conversation I said, "I don't know. Maybe I'm supposed to do something bigger? Maybe it's time for me to move on? Maybe child life isn't what I'm supposed to be doing anymore, it's just too hard. Is this what I'm supposed to be doing?!" No sooner had those words crossed my lips, the most beautiful swallowtail butterfly crossed our paths. Not only did it cross our path, it dang near hit me in the face! Literally....I felt it fly past my nose. We both stopped dead in our tracks and looked at each other in awe. Kay said, "Wow." I said, "I guess that's our answer." I can't say that before that day, I'd ever seen a swallowtail butterfly in Nebraska? I see lots of those common yellow and white ones and lots of monarchs, but swallowtail? Nope. Sadly, Princess died that very next morning.

We've talked about this since it happened. What were the odds that Kay could go for a walk with me at that exact time, that we would take that exact path, that the butterfly would fly by me at that exact moment in time? Coincidence? I don't think so.

Always be looking for your butterflies.

A Hundred Years from Now......

 ....it will not matter what my bank account was, the sort of house I lived in, or the kind of car I drove...but the world may be different because I was important in the life of a child” by Forest Witcraft.

This is one of my all time favorite quotes....and one that helps bring focus to my life in uncertain times. I'm sure you've all experienced the same problem…the “Wah wah” moments?  YOU know the ones...it just always seems to stockpile..."wah!" on top of "wah!" on top of "wah!"

I get them from time to time and get on my pity pot; "My house is too small....my house is a mess....I wish I had more money....why do I live so far from my family.....why do I live so close to my family....why doesn't the world revolve around me," etc. One thing that working in health care does...it humbles you. It helps you keep your life in perspective. Inevitably when I'm having one of those days where I just can't understand some of the choices I've made and I’m having a hard time trying to kick myself in the butt, I go to work and get a dose of other peoples' realities.  They have loved ones fighting for their very lives. Perhaps a child newly diagnosed with a life threatening/altering condition. Or there’s a parent who has been in a tragic accident, or one who is losing their battle with cancer and facing the reality that they will have to say their goodbyes all too soon. That’s when I always end up telling mySELF to "shut up and quit whining!"

What brings light to my heart?  Children.  And not just my own son (who is 13)....although he is by far the most important thing in my life. He and I have always had a uniquely wonderful bond. I think it’s partly from being a single mom; we always have each other's back. He’s a lot like me and definitely has inherited some of my better traits....and…a few of my not-so-great ones! Sometimes when I’m on my pity pot, I whine to myself (or if they’re lucky, I whine to others) because I am the sole person responsible for getting my son everywhere and doing everything for him. My family lives 2 hours away, and although his father is local, I'm not able to rely on that help (which would be a totally different blog that I choose not to write about). Then there’s always the “I wish had more money....I want to be able to provide him with this or that, or be able to go here or there, or not have to shop at discount stores (one of my life goals is to buy a real box of cereal), or worry about how many years it will take until I can get a bill paid off.”

Not long ago, one of my friends (from a dual income family) was flabbergasted to learn that I'd never had a manicure or a pedicure. Well....there are choices you have to make in life and we all have to make 'em every day. I choose to go without some things in my life (as we all do), so that I can afford to do other things that include my son, or so that I can buy him the new $300 baseball bat that is required...and one day, that real box of cereal.  

Ahhhh.....do you hear it? These, my friends, are the "Wah wahs!!" Beware of the "Wah wahs". They can really take a toll…if you let them.  But at the end of the day, none of it really matters. What matters most to me is living a good life, taking care of myself, setting a good example, loving God, and raising a good son. I want to raise a son who loves the Lord, who is compassionate toward others, is a good friend, husband and father. A son who knows right from wrong, makes good moral choices, is strong enough to stand up for what is right, and to stand up for those who aren't able to speak up for themselves.

It’s equally important that we are able to influence positively, those children around us. I really have the greatest job in the world! I have the ability to affect children’s lives…every single day, and that is a blessing. To look into the eyes of a child or teen who is potentially facing a new diagnosis of cancer, is a powerful thing….truly powerful indeed. There’s the “deer in the headlights” look, the tears, the sadness, the anger, the fear…it’s all there. And it’s there in the eyes of the parents too.

I get the opportunity to help prepare them for what the next few hours and days are going to be like; prepare them for what lies ahead; arm them with the swords for battle. Knowledge is power and with power, comes strength and courage. Telling kids what will happen, how it will feel, what their job is going to be and helping give them the tools to perhaps have a more positive experience, is a privilege. I also think it’s important to sprinkle in a little well-timed humor (hmmm…a future blog topic?)…and a few smiles. For those who know me, I’m a bit of a silly heart...although if you ask the patients and families, they’ll just say I’m plain nuts. And I take that as a compliment.  :-)

Kids and families just don’t know how to react to this word, “cancer.”  I mean, really…what the heck… “I have cancer?” As you can imagine, this is extremely intense. It is sometimes a very delicate art; being able to balance caring, compassion and empathy, without going overboard on emotions. They have to hear what we are telling them, so sometimes it just takes a couple of repeats. But by inserting a little humor here and there, I’m able to relay that life is going to go on and they are going to be a part of it.  I want them to know that  it’s still okay to laugh (in fact it’s a great stress reliever), that our team is going to be by their side helping them navigate these unfamiliar waters, and we’re going to do it with strength, determination, humor and love. 

 Heck, sometimes I just get to play Skipbo with a patient, or build a rocket ship, or read a story…or just make them smile. Play is just as powerful as any other tool.  Really?  Play? Yes, play. In fact it was Plato who said, “You can learn more about a person in an hour of play than in a year of conversation.”  How true this is. Kids look forward to coming for their outpatient treatment and trying to beat me in a game of cards (but they rarely do!), or doing a craft, or blowing bubbles while they have their dressing changed. Wow…what an amazing job I have!  I get to touch kids’ lives every day...and I get to touch their hearts as well.  And….they touch mine.  

Do I still wish I had a bigger house? Yes. Do I still wish that it wasn’t messy? Yes. Do I still wish that I had someone to share life’s up and downs with? Yes. Do I wish I had more money? Yes. Am I thankful for all the wonderful gifts God has bestowed upon me? Yes! ABSOLUTELY!!

So when I get the “Wah wahs”, I recall these 44 words that really say it all….

“A hundred years from now....it will not matter what my bank account was, the sort of house I lived in, or the kind of car I drove...but the world may be different because I was important in the life of a child.”

Gee...I wish I could play all day...

If I've heard it once, I've heard it a million times.....YOU know what I'm talkin' 'bout...."Gee, I wish I could play all day."   My first inkling is always to say, "You could, you just picked the wrong career...haha".....but.....I don't. Of course, that statement and the ever-famous, "You went to school to learn how to play" are both capable of getting our hackles up...and absolutely free of charge!  But....what DO you say to that? Well, for me it depends...on the situation, who said it, the "personality" of who said it, and....my mood.  Often times, I'll just say the above statement; it usually gets a laugh.

I've found that people who make those comments, generally mean no harm.  It's often an expression of appreciation for what I'm doing, and a genuine desire to join in on the game of cards....or cooking activity....or playing Rock Band. However, these people are also not usually around when I'm trying to help kids cope through some medical procedure where they are terrified. Or when I'm making hand molds of a child who has died. Or when I'm telling a 7 year old girl that her daddy isn't going to get well and will probably die today, while her mommy is numb and sits quietly crying. I've never had anyone say to me, "Gee, I wish I got to tell that little girl her daddy was going to die."

So what exactly DO I say? Usually, not too much. Sometimes just something generic like, "You know, it's times like this, when I do get to sit and help a kid be a kid, that has the ability to wipe away all the other parts of the job that aren't so much fun." Face it, is it in front of a child or family that you want to say,  "Oh yeah, well....just 1/2 hour ago I was making hand molds for the family of one of my favorite patients who just died. It was horrible. They didn't deserve to die, and now I have to sit here and pretend like I'm not heartbroken."  Nope, this probably isn't the right time.  And it truly depends on who it is and how it is said. If it comes from a nurse who generally doesn't understand child life, and might truly believe what he/she is saying, then I might chalk it up as a teachable moment....later. If it's another patient who sees me playing cards with a pediatric patient while they're receiving chemo, I don't worry too much about it. I think that most visitors see the name badge and just know that the hospital probably isn't going to pay money to an employee JUST to sit and play cards.

And here's what I've learned in my 20+ years of child life practice...I can do some of the "meatiest" child life interventions with a patient....I mean....REAL child life stuff....and what the kids always tell their friends is, "This is Debbie. We used to play video games together." I had one patient, a 17 year old, diagnosed with osteosarcoma at the age of 15. He spent weeks at the hospital right after diagnosis and had chemo every three weeks for a year. His tumor was above his knee, and in the middle of treatment, he had a rotationplasty (might need to google that one).  Essentially, this is an operation where the surgeon amputates mid-thigh. Then the surgeon makes another cut just below the knee. The portion of the leg from mid-thigh to below the knee, is discarded. Then the surgeon takes the lower portion of the leg (the calf and foot), turns it around 180 degrees, and reattaches it to the femur....mid-thigh. Sound freaky? Yup. Google it. What the patient now has, is a leg, with a backwards foot and calf, attached at his thigh. Why would they do that? The backwards foot then serves as the patient's knee joint and gives MUCH more flexibility than any standard prosthesis could ever give. They have a much more functional knee joint and can do things that they might be able to do as easily with a standard prosthesis. So what's my point? I don't remember....what was it? Oh...that was just a little background on my patient....we had been through a LOT together. We talked a LOT about that upcoming surgery, how he was going to look like a freak, no one would ever love him, etc. Then he got a life threatening infection at one point. As I sat in the PICU with him, holding his hand, with tears in his eyes he said, "Debbie, I'm not ready to die yet." Yeah, heavy stuff. This is the kind of stuff I'm talking about...the stuff not everyone sees. My point is, I had a really great working relationship with this patient....I'd been by his side through a lot of rough times. On the rare occasion when I'd meet someone in his family or a friend (he lived two hours away), how do you think he introduced me to them? "This is Debbie. She taught me about what it's going to be like after surgery. She held my hand when I thought I was gonna die. She told me that despite my physical appearance, there would someday be one VERY lucky girl (probably several) who would fall in love with me because of me." Nope. Guess again. He said, "This is Debbie. She tries to beat me in NCAA Football on the PS2." Yep, that's right. And for the record....I usually DID beat him...usually. Not so much because of my great PS2 skills, or because I understand the game of football and all its plays. More so because I had absolutely NO idea what I was doing. Oh...I'm pretty convincing. I squint while looking through the plays, look like I'm really evaluating my options...trying to outsmart whatever my opponent is doing. What I'm really doing is looking at the pretty patterns of the plays, planning dinner, wondering if my son got his homework done, and whether or not the gallon of milk at home smells funny?  Ahhhh....the wicked ways of the child life specialist.

So that's my point. See....I did have one. A "play lady" isn't the worst thing I could be called. There are a lot worse things I could be called....in fact....I've been called a few of ém. I used to get all bent out of shape about it. Now I see it as harmless banter or as a teaching moment....at the appropriate time. I always try to keep everything pretty lighthearted....don't want to be getting all visibly flustered...that won't do anyone any good. Keeping a cool head, using a sharp mind and NOT a sharp tongue is the way to go!!!

"Sit, Ubu, sit! Good boy!" Woof!

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!)

A nearly perfect ONE VOICE experience.....

Don't you just love when people actually let you do your job?? I don't really mean to be critical, but it's just so refreshing when people understand not only YOUR role, but also THEIR role!
I had a near perfect ONE VOICE experience on Friday....just thought I'd share it.
I work in an outpatient treatment center that services primarily oncology and solid organ transplant patients. If you need outpatient chemo, you come to us.(Now, I also cover the peds Hem/Onc clinic and radation oncology, but they're not the focus of my story today.) If you need a PICC line placed and you're outpatient, you come to us. If you need IVIG, lab draws from your port or line, outpatient antibiotics...you come to us. In our treament center there tends to be a core group of nurses who like to take the pedi patients, the others...not so much because"kids are harder." Friday we had a little 2 1/2 year boy who came in for IV antibiotics. He is a liver/small bowel/pancreas transplant recipient that I've met on a couple of occasions. He is in the custody of his grandma and she takes really good care of him.
Since a majority of our patients have lines or ports, I didn't even think about his possibly needing an IV...I was prepared with the toys to keep him busy for his 2 hour infusion. His primary nurse (nurse #1) was a nurse who doesn't often take care of our peds kids. She started to put "little dude" into the crib while another nurse (nurse #2....see how I name them so cleverly? It's a gift.) came in. Nurse #2  generally does take care of our pedi kids. I assumed they were doing their "checking the wristband" duty, but quickly realized they were going to start an IV.  Now...we all know that you sometimes have to tread lightly around staff you don't know quite as well, and since I didn't know nurse #1 my brain immediately went into the "Hey...hold on, I've got a better way to do this" mode.  All of a sudden, "Tra la la la"....nurse #2 said, "Why don't we do one of those 'sitting on the lap' holds you were showing us?" (Immediate internal heavy sigh of relief...we've got ourselves a believer!!)  Nurse #1, on the other hand, didn't have any idea what we were talking about but was willing to try. ANYTHING to make it easier was her motto. BEFORE I worked in the treatment center, I had done some inservicing with the treatment center staff about ONE VOICE. About this time last year, we were able to add a child life specialist to the treatment center; they've only been accustomed to someone bringing them toys in an emergency. It's been exciting to provide child life services to this area and define what that looks like. I've done a couple "quick inservices" about positioning and distraction for some of the staff and most of the staff have been very receptive to "trying something new."
At this point, I backed up the turnip truck and started where we should have started at the beginning, by asking G-ma what works with "little dude." She told us that he does really well sitting on her lap. Ding, ding, ding...we have a winner!!
From here on out, it was ONE VOICE heaven. Little dude sat on G-ma's lap, nurse #1 did the IV, nurse #2 assisted and I blew bubbles....the PERFECT scenario. G-ma knew exactly what her role was, she kept his other hand away. The nurses knew their job, to get the IV done and let child life do the distraction. Now...I've always had no problem producing hot air at a moments notice...talking is one of my greatest strengths (and weaknesses), so blowing bubbles is NOT a problem for me. (I can even do it with saliva. Oops...tmi)
Picture this: Little dude sitting side saddle on G-ma's lap, G-ma keeping little dude's hands away from the IV start, nurse #1 squatting down doing the IV, nurse #2 assisting, child life blowing bubbles, little dude popping bubbles and smiling. The only "oops" of this scenario was lack of EMLA. However, our transplant kids have such limited vein access, you'd literally have to slather them in EMLA...head to toe. Sadly for this little guy, he'd been poked enough in his short little life, that he didn't really fight a whole lot. He started to fuss...and then....the bubbles took him to his happy place. It was just a great situation...everything worked beautifully. Not only did this make it better for "little dude" and G-ma (who said the bubbles really made a difference...he usually resists), it also demonstrated the power of positioning, play, and not a lot of chatter going on. Nurse #1 and #2 got a dose, first hand, of creating a less threatening environment and how distraction can make a positive difference. Sometimes this is all it takes to get things started in the right direction....one positive encounter at a time....and I didn't even need to throw a shoe!

No one seems to be listening....can I throw my shoe??!

When I set out in 1996 to create an acronym that would teach people how to provide a less threatening environment for children undergoing medical procedures, I never dreamed I'd be blogging...probably because I didn't even know how to turn on a computer, and blogging wasn't even a word back then.  Honestly, during my senior year of college, Iowa State University decided it was about time to computerize the library. I never went back.

Here it is, 15 years later and people have been talking about "that ONE VOICE thing I heard about."  Did I dream 15 years ago that I would apply for a copyright on ONE VOICE, start my own website, present on ONE VOICE at the National Child Life Conference, create a PowerPoint to sell as well as other merchandise? Um....heck no!! Am I glad that I have and that I am??!! Heck yes!! What an exciting journey this has been!!  My main goal has been to empower other child life specialists to help health care professionals create a less threatening environment for our pediatric patients. I hope you enjoy the ride as much as I am!! Well....as much as I am now that I'm over the "I have so much to figure out but don't have any money and don't have a clue what I'm doing" phase. I still don't have it all figured out, but hey, it's definitely getting better!!

If you stumbled onto this blog by accident, click on the following link to see what the buzz is all about...http://www.onevoice4kids.com/

Probably the one question I get asked the most is, "How do I implement ONE VOICE? I totally believe in it, but I'm not sure the nurses will buy into it?"  That's a great question...and unfortunately, not one that has an easy answer.  (What?! This ONE VOICE lady doesn't have all the answers?!! Well as a matter of fact I do, but I can't always get everyone to listen either!!) This is what I've learned in my 20+ years as a child life specialist...contrary to popular belief, we can't always perform miracles. We don't always have our magic bubble wand, pop up book or iPad that is going to make everything all okay. What we DO have though, is a working knowledge that the elements of ONE VOICE will absolutely make a difference to the children we serve! We just have to get the staff to listen....not always the easiest of tasks.
My best advice is this; start with the ONE VOICE PowerPoint Presentation. There is enough information in this presentation to back up what we're saying. It gives the components and the rationale. Not only is it a great tool to teach child life students about creating a less threatening environment, it also has a lot of information geared toward the medical staff who "just don't think like a child life specialist." Do you have staff that need to have research behind it in order to believe it? The PowerPoint has it.

What I've found is that usually, each person attending the PowerPoint presentation will identify with at least one element of the ONE VOICE philosophy; there will be at least one thing will make sense to them.  (What??!! Won't they just take my word for it that it all works? Um...no. If they do, then call me...I'll want to meet them!)  If you stop to think about it, getting a staff member to buy into one element of ONE VOICE is probably better that what you had when you woke up this morning, right? But what happens if another nurse doesn't buy into the same component?  What if he or she actually makes sense out of a different component? Ahhh....this is the beauty of it all. What inevitably will happen is that they will convince each other that the component they believe in, makes sense. Now instead of having staff that might have only believed in one component, you may now have staff that believe in two components...and you didn't even have to call in back up!! Once you've got them talking, you just need to make good examples of what you see them practicing, "Wow. It really made a difference when you let that little girl sit on her mom's lap. I know she still cried, but it really made a difference to both the patient and her mom!"  See where I'm going with this? Chances are, different components will speak to different people so hopefully this will work to your advantage!

From here, now you just keep it fresh in everyone's minds by talking about it, making good examples out of those practicing the ONE VOICE components, and with the ONE VOICE posters and ID name badge cards.  (All ONE VOICE merchandise is available from http://www.onevoice4kids.com/) The posters work really well when placed in break rooms, staff bathrooms and when tattooed to staff foreheads!!! (Remember...if you DO decide to go the "tattooed foreheads" route...make sure you practice ONE VOICE!)