As I have been reflecting about the role of child life in honor of Child Life Month, a word continues to come to my mind: advocacy. Advocating is what child life is all about.
We are a child’s advocate in the trauma bay. We are their advocate during a sexual assault screening. We are their advocate for the flu shot, the port access, the IV start. We are their advocate as they roll back to surgery. We are their advocate as they prepare to say goodbye to their baby sister, their grandmother, their father.
But, what is a CCLS supposed to be advocating for?
We advocate that children get to be children. We advocate for their voice to be heard. We advocate for celebrating the small things. We advocate for children to be informed. We advocate for honesty. We advocate for choices. We advocate for one voice. We advocate for parents and siblings. We advocate for inclusion. We advocate for interdisciplinary teamwork. We advocate for comfort measures. We advocate for patient empowerment.
Advocacy isn’t always easy, however. There can be surprising challenges to our advocacy whether that be policies or even people pleasing tendencies!
“We advocate that children get to be children. We advocate for their voice to be heard.”
I remember one such moment when advocacy was really challenging and uncomfortable for me.
I was called to support a 4-year-old for a voiding cystourethrogram (a VCUG…a.k.a. one of the worst procedures ever. Ranks right up there for NG tubes for me!) You can read more about the process of VCUG’s here and see why it definitely isn’t one of my favorites. With a test this invasive and uncomfortable, it essential that child life is present.
After building rapport with this nervous patient and mom in the waiting room, we headed back for the procedure. However, upon arriving to the fluoroscopy room, something became apparent: the tech overseeing things didn’t see my role as necessary.
As we walked in the tech abrasively introduced herself and explained that we were behind schedule and needed to go as quickly as possible. When I explained my role to her, she rolled her eyes and continued on in her flustered way. She seemed less than enthused that there was yet another person in the room to manage.
I started feeling threatened and intimated as the procedure began. The catheter was placed, much to the reluctance of the child, and it was then time where everyone remaining in the room must have a lead apron/vest. The tech began to distribute vests.
She handed one to mom. She handed one to the radiologist. I turned to the tech and reminded her that I needed one. She handed one to the nurse.
There were no more vests.
“Looks like you will need to step out, Allie. I don’t have any more vests.”
The patient cried and her mother looked at me in desperation. This test was still completely foreign to both of them. And, they recognized that it was only halfway done.
They needed an advocate.
Here were my obvious options:
- Back down out of insecurity because I certainly wouldn’t want to make the tech dislike me even further.
- Quickly and aggressively assert myself, disregarding the tech’s concerns.
OR perhaps, there was a third option: I could advocate AND seek unity with staff.
5 Ways for a CCLS to Advocate:
1. Stay focused on why you need to be the advocate and for who.
This wasn’t a case for me as a person. This was a case for the patient and her mom (and therefore a case for our profession). When I turn my glance to look at her—to see her fearful and helpless expression, I remember whose voice I am speaking up for.
2. Validate the concern/the opposition.
As opposed to me first asserting my own agenda, it is first important for me to help the person in opposition to me feel heard. I need to make sure I seek to understand why that person is against my services. Ex: “I understand that safety is of upmost importance and that everyone needs a vest.”
3. Unite in the common goal.
“I also understand that you are on a tight schedule and we need to move as quickly as possible. I completely support that sense of urgency and want this test to be completed quickly for this child as well.”
4. State how you can help.
“My role is to remain with the patient to help her remain calm and to help her cope well with all aspects of this test—including when she will be asked to void on the table. My role is to help this go as easy as possible for her to ensure that we can get this done quickly and without causing more agitation for her.”
5. Propose solutions.
“So, who can I call to find another lead vest or where can you direct me to go get one while we wait for the radiologist to begin?”
The choice was not if I stay in the room or not. As a professional and member of the interdisciplinary team, I WOULD remain in the room. But instead, offer possible solutions to help that opposing staff member be able to still exert some control in the situation as well (does this sound like a familiar strategy we also use with kids? 🙂
Advocacy can mean that someone is even more irritated with me. Advocacy may look like another eye roll, sigh or abrasive remark. And yet, it isn’t about me or my approval. I know my worth. It is instead about advocating for best practice, for teamwork, and ultimately for speaking on behalf of patient’s and families.
So be their voice. Embrace the discomfort. Advocate while seeking unity. And, celebrate those people that do happily work with you! Because we know there is a lot of them. Happy Child Life Month!