Last Monday I hit the ground running with two procedures right in a row: toddler 1, followed by toddler 2.
Both toddlers were in the waiting room when I walked in. I saw as one toddler was clinging to her mom and was already whimpering and quietly crying while the other threw his cup on the ground and looked directly at his mom, “No! I don’t want it!” he shouted.
Now, some of you toddler whisperers might say, “Toddlers are the best and my favorite age!”
But my response is: "That is awesome. Teach me your magic!"
Because for me, I have the tendency to immediately feel insecure, incompetent and just plain socially awkward at times when I have worked with toddlers. Let me paint you a picture of a few times I have worked with toddlers so you can see what I mean (and yes, these stories are for real):
Story #1– An 18-month-old is about to get IV. So, I swoop in and immediately get on the child’s level, eager to provide preparation and education. I start carefully explaining each step using as much detail and sensory descriptions as I can. “And then, the nurse will look for your blue lines, called veins. Veins carry the blood in your body and–ohhhhh wait. You are 18-months-old and have very limited vocabulary at your developmental stage. Right. Let me try this whole thing again.” The parent pauses and says, “so, how many child development classes did you have to take to become a child life specialist?”
Story #2– That time when all of a sudden I realized that I am blowing bubbles for solely my own entertainment in the corner. Little two-year-old Billy is still sitting there screaming during his procedure and isn’t even looking my general direction, nonetheless noticing nor appreciating my beautiful bubble blowing work. Bubbles sure are fun, aren’t they?
Story #3– In order to help a toddler hold still when she was getting a cast on both feet, I found that she became grossly entertained ONLY when I would bump into every piece of furniture on “accident” and then take my face and pretend-slam it in the door repeatedly. “Don’t worry,” I told the horrified yet humored staff members present, “I am a professional. I went to school for this.”
As I reflect on these three toddler stories, I can quickly buy into the false belief that “child life is of value only if the toddler doesn’t shed a tear and complies perfectly with the difficult tasks required of them in the hospital.” But one can quickly see, this is a completely unfair and ridiculous metric to use given the developmental stage of a toddler!
No matter the insecurity that may come when I believed I have “failed with a toddler”, I have to remind myself of a few critical things in order to move forward with confidence, and dare I say, even my dignity after all the “professional interventions” I tried.
“My success and my worth are not measured by how the patient reacts.”
The first consideration being: when working with a challenging patient population, perspective matters.
When working with toddlers (or any patient), focus on evaluating yourself rather than on solely the patient’s response. Ask yourself these questions: Did you try every creative intervention that seemed appropriate? Did you incorporate developmental considerations into your practice? (example: offering appropriate choices to promote their autonomy) Are you reflecting and debriefing afterwards, so that you can learn new approaches for the next time?
If so…then, good job. You did your best as a child life specialist and that is all that is in your circle of control. I don’t know how many times I have to remind myself of this truth: my success and my worth are not measured by how the patient reacts.
And second of all, have grace for yourself! Perfection isn’t the goal. Sure, I probably shouldn’t have assumed that a 18-month-old is ready to learn about the complexities of veins. Doy. And sure, ideally I’d love to be able to nail every interaction with a child and feel like an all-star child life specialist. But instead, we need to recognize that striving for excellence, integrity and growth in everything we do is where success is found. Nearly every child life specialist that I meet says that they have chosen this field because they care about patients and families. That care will show even in the learning moments. So when you mess up, take a breath, learn from it, and keep on caring and looking like an idiot if you have to in order to get that little tike to crack a smile!