Sunday, February 27, 2011


If you love Chipotle as much as me- you MUST click on the picture below:

Free Chipotle?! Yes please! :) Happy Sunday.

Thursday, February 24, 2011

Be Still

I'm not always so good about stopping and taking care of myself. Even when I do have down time I still am checking email/facebook/twitter, calling friends, reading books, crafting, watching tv, you name it. At my small group last night we discussed the need to take time to clear our schedules and simply rest. I mentioned that moving here was a good opportunity for me to reset; I was so incredibly busy in NC that I very rarely had time 'off' and when I did have a spare moment there were always stacks of assignments and papers to work on. When I moved here though I suddenly had nothing on the agenda (minus work) I started to lose my mind a bit. My natural inclination was to frantically search for activities to fill the dead space. I don't do well with free time.

The last two weeks have been crazy to say the least. In addition to working full time (closer to 45 or 50 hours than 40), I spent the previous weekend in Port Charlotte and this past weekend in Gainesville; multitudes of fun activities, but not much time to rest and recoup. I've been running on 5-6 hours of sleep a night and it finally came back to bite me. I went into work this morning, woke up with a bit of a sore throat but didn't think much of it, however suddenly realized during morning report that I was incredibly lightheaded. Over the next hours things progressed so much that my supervisor decided it would be best if I left for the day. I really didn't feel that sick, but when one works in the hospital, one has to be much more careful about infection control.

So I came home. I sat on the couch and practically haven't moved since. It's been glorious. I didn't realize how tired I was until I laid down to take a cat nap and ended up sleeping for 3 hours. I caught up on email, I watched the Ellen show, I even moved outside to watch the shuttle launch! (We're close enough that I could actually see the flames coming off the back of the shuttle). I've been able to watch Florida Basketball (Go Gators!), and catch up on assignments. Apparently God knew better than I that I would need a day of rest today, I just hope I am well enough to go back in tomorrow!

It's important no matter what our work might entail to make sure we are taking time for ourselves emotionally, spiritually, physically, etc. It's so easy to burnout and studies have shown that higher levels of stress are associated with increased risk for illness (Thank you psychoneuroimmunology!) As part of my thesis I included a survey asking people what types of self care strategies they find helpful in preventing emotional exhaustion. I thought I would include it here for you tonight. Read over it, think about your own self-care strategies, and maybe get some ideas of new techniques to try and keep your emotional health!

Self Care Assessment Worksheet
Source: Transforming the Pain: A Workbook on Vicarious Traumatization. Saakvitne, Pearlman & Staff of TSI/CAAP (Norton, 1996)
Physical Self-Care
___ Eat regularly (e.g. breakfast, lunch and dinner)
___ Eat healthy
___ Exercise
___ Get regular medical care for prevention
___ Get medical care when needed
___ Take time off when needed
___ Get massages
___ Dance, swim, walk, run, play sports, sing, or do some other physical activity that is fun
___ Take time to be sexual—with yourself, with a partner
___ Get enough sleep
___ Wear clothes you like
___ Take vacations
___ Take day trips or mini-vacations
___ Make time away from telephones

Psychological Self-Care
___ Make time for self-reflection
___ Have your own personal psychotherapy
___ Write in a journal
___ Read literature that is unrelated to work
___ Do something at which you are not expert or in charge
___ Decrease stress in your life
___ Let others know different aspects of you
___ Notice your inner experience—listen to your thoughts, judgments, beliefs, attitudes, and feelings
___ Engage your intelligence in a new area, e.g. go to an art museum, history exhibit, sports event, auction, theater performance
___ Practice receiving from others
___ Be curious
___ Say “no” to extra responsibilities sometimes

Emotional Self-Care
___ Spend time with others whose company you enjoy
___ Stay in contact with important people in your life
___ Give yourself affirmations, praise yourself
___ Love yourself
___ Re-read favorite books, re-view favorite movies
___ Identify comforting activities, objects, people, relationships, places and seek them out
___ Allow yourself to cry
___ Find things that make you laugh
___ Express your outrage in social action, letters and donations, marches, protests
___ Play with children

Spiritual Self-Care
___ Make time for reflection
___ Spend time with nature
___ Find a spiritual connection or community
___ Be open to inspiration
___ Cherish your optimism and hope
___ Be aware of nonmaterial aspects of life
___ Try at times not to be in charge or the expert
___ Be open to not knowing
___ Identify what in meaningful to you and notice its place in your life
___ Meditate
___ Pray
___ Sing
___ Spend time with children
___ Have experiences of awe
___ Contribute to causes in which you believe
___ Read inspirational literature (talks, music, etc.)

Workplace or Professional Self-Care
___ Take a break during the workday (e.g. lunch)
___ Take time to chat with co-workers
___ Make quiet time to complete tasks
___ Identify projects or tasks that are exciting and rewarding
___ Set limits with your clients and colleagues
___ Balance your caseload so that no one day or part of a day is “too much”
___ Arrange your work space so it is comfortable and comforting
___ Get regular supervision or consultation
___ Negotiate for your needs (benefits, pay raise)
___ Have a peer support group
___ Develop a non-trauma area of professional interest

___ Strive for balance within your work-life and workday
___ Strive for balance among work, family, relationships, play and rest

Monday, February 21, 2011

Reasons I fail at life Part One

I do think about blogging, I really do. Quite regularly actually. Often as I am driving from Point A to B I start crafting an absolutely beautiful and verbose posting that is sure to simultaneously rock your world and alter your perceptions on faith, life and love.

And then I get home and I either A) pass out from exhaustion, B) get distracted by something really interesting on tv, C) get distracted by something totally worthless on tv, or D) forget. I can't promise I won't still have long lapses in between postings, but whenever I get that creative burst I will do my best to keep you updated on my daily life (Especially as several friends have given me grief in the last three days for not blogging regularly!) So in an attempt to make up for my silence I give you what promises to be a rather lengthy bit of reading  :)

This weekend was truly lovely and a great opportunity to take a step back and breathe. I feel like for the last three weeks I have been going non-stop. Work, papers, journaling, driving places, cleaning, 'reflecting', it takes a lot out of me. Yet, God seemed to know that I would need a chance to recharge, and the past three days have truly been a blessing.

I should start by saying that last week was a complete 180 from the previous one. I'm finally starting to find my footing in the hospital and really feel like I am making progress in the right direction. In fact, during my weekly evaluation on Friday my preceptor told me that I was doing a "wonderful job" and that I'm clearly taking all of her advice to heart. It meant a lot to hear that.

Quick recap of the clinical highlights of Week Three:

~Completing morning report entirely on my own (also know as a game of "Nurse Hunt" as I run throughout the unit trying to track down the various RNs to get report)
~ Facilitating my first one-on-one medical play activity (Very successfully might I add!)
~Helping bring a teenage patient outside into our play area after being stuck in his room on a ventilator for two months.
~Exporing storage to get prizes for Bingo (AP gets so many donations over the holidays we can literally fill three storage units even after giving away toys to every kid in the hospital, stocking the playroom, and setting aside prizes for clinical procedures).
~Helping facilitate a rather large game of Hospital Bingo with patients from all over the hospital
~Doing my first couple teaching/educations to patients (and might I add that after my last one my preceptor told me that i had done the education portion perfectly!)
~Watching the staff deal with grief after learning a former patient had passed away
~Attending a class taught by my supervisor and getting to talk with several college students interested in child life. It was neat to be seen a bit as an 'expert' on the student training process and DEFINITELY reassuring to hear her tell the students that I am doing a really good job in my position!
~Leading my first group art activity where we made various versions of these:

Overall it was a great week. I made a LOT of mistakes, but that is part of the learning process. I've realized I'm going to make mistakes and it's alright, that's how I develop and improve. I'm still nervous a lot and feel anxious walking into rooms for the first time, but slowly it's getting easier to focus more on the patient's needs instead of my own performance. I have two more weeks left on this unit before I move to my next rotation and this coming week I will take on responsibility for half the patients. It's a bit overwhelming, but I seriously make an effort to say a small prayer before I walk into each room- asking God to calm my nerves and help me say the right things. If nothing else I am truly trying to keep the focus off of myself because it is the only way I am going to become adept in this field.

This job has been so fulfilling but it is also requires a certain level of focus and commitment that can be absolutely draining. The plus side is I am certainly sleeping better than I have in a long time (although that is also partially thanks to a great combination of herbal medications and a new white noise machine). I've also started getting involved with a local church, and my roommate and I joined one of their small groups. I'm excited to have an opportunity to meet new people but I also have realized that once again God has a greater plan than I could even guess! During our first meeting last week we went around the table and all introduced ourselves, sharing a bit about who we are and what we do. When it was my turn I mentioned the fact that I am working as a child life intern and the girl next to me got very excited suddenly. Turns out she just quit nursing school 3 weeks ago, realizing it wasn't really the right path for her. She had at one point three years ago considered child life, but hadn't been in a position to really follow through with it, and I was the second person in 4 days that she had met who was working in that field. We got to talking and she shared that she's starting to think God is also calling her into this field and I was able to provide her with a lot of helpful information. 

Funny how he plans things sometimes huh? I had had a few doubts about whether or not I should attend this particular group, primarily because I knew they were aiming to meet for 12 months and were gearing for individuals age 25-40. Now I know being 24 doesn't necessarily mean anything, but when all is said and done I was a bit nervous. Clearly though, God had a plan and I have to admit sometimes it amazes me (And it really shouldn't) how perfectly he orchestrates events in my life to occur.

More than anything I've realized I HAVE to take time to take care of myself emotionally and spiritually if I am going to last in this field (let alone this internship!), which is an ironic realization considering that is the entire focus on my thesis. But regardless, this weekend was the perfect blend of exciting, fun activities while still having opportunities to rest and recharge.

This weekend marked the first time I have been able to return to Gainesville since I graduated almost two years ago. What started as a desire to attend a gymnastics meet turned into a fun three days of visiting with friends, attending sporting events, and eating great food! As soon as I get my pictures uploaded (read: as soon as I get my lazy butt in gear) I'll post a full update of that trip... because let's be honest, I take every opportunity possible to share my Gator Pride!

So that's it for now. I have to say, I've really been surprised at how many people have told me they've been reading here. I started this on a whim and figured there would be a handful of people *coughcoughBritaandAllisoncoughcough* who would be interested in reading about my endeavors, but over the last three weeks individuals I never would have guessed have mentioned my blog and how much a particular posting had meant to them. I thank you for taking the time to read my rambling thoughts and if nothing else I pray that God uses this blog to remind you as much as he reminds me that he is always working in our lives, sometimes we just have to be effortful at looking for his touch.

God bless!

Sunday, February 13, 2011

24- no, not the show!

So today was my birthday. I turned 24.

Nothing spectacular, nothing monumental-- there really isn't anything significantly special about the age of 24 in and of itself (Except if you're like me and loathe prime numbers- so moving to the age of 24 is awesome; always loved that number... I mean seriously, its divisble by 2, 3, 4, 6, 8, 12... how cool is that! Plus as my cousin pointed out, its twice 12 (the day of my birth) so that makes it like a double golden... ok I'm getting off track...)

Where was I? Right, I turned 24.

I had decided a week ago to go ahead and come back home for the occassion. I've only been away two weeks, so it seemed a bit quick- but at the time I figured it made sense because I really don't know anyone in Orlando, and I didn't want to the few people I did know to feel responsible for making something happen that day. Plus, what's lamer than sitting around alone on your birthday? So I made the decision to come home. Once again- God knew what he was doing.

I haven't posted a lot lately. I truly expected to make an effort to post something every day. I wanted to share my experiences and inform others about this awesome field. I don't think I expected how exhausted I was going to be. Working 8 hours a day is tiring in and of itself, but when you add in the approx. 90 minutes of travel time, having to wake up before 6:30, dealing with emotionally charged situations, and feeling constantly under pressure- it all adds up to a truly drained Bethany.

This week was a struggle in many ways.

In some respects it was incredible. I LOVE my job. I typically call my mother as I leave the hospital every day just to check in and to make the travel time go a bit faster, and I think pretty much every day this week I've opened with the comment "I LOVE my job!" I've been exposed to so many different things, met so many people, gotten so many opportunities it's incredible. For example, yesterday morning we had a guest entertainer for the children. This lady works at Epcot in the Japan section and makes pulled sugar candy animals
She is truly incredible. With just a ball of 'dough' she can create almost any animal possible, and she catered to each child's wishes. Our children who were healthy enough came down to watch and make their own requests; for the others we brought some back to the units for them. The woman is a true artist, and the children were thrilled to watch her work. Earlier this week Disney's Animal Kingdom came in and did a big exhibit for the children. They had centers for the patients to learn about animals, a few games, a stage area where they showcased a few 'exotics' (owls, hedgehogs, snakes, etc), and then chip and dale came for a meet and greet. Did I mention I  love my job?

But it's also been difficult. my preceptor was sick so I've had three different supervisors, plus some expectations were not communicated to me properly so I've been a bit confused about my role with the staff. My evaluation yesterday went differently then I expected when my preceptor expressed a concern that I was letting myself get so caught up in the pressure that I was sort of playing a role and coming off as very tightly wound and forced. That hurt a bit, but at the same time I was glad to hear her reassure me that she has no doubt I'm going to be a great child life specialist- I just need to try to relax and not worry so much. I don't have anything to prove to them, they know I'm well trained, they know I'm prepared. Instead of worrying about trying to show them I'm ready to do this, I should just let myself experience it.

It's been an adjustment that's for sure; I'm learning so much about myself and who I am. Trying to get my priorities in order. Coming home and spending time with my family has been crucial. I am definitely a very touchy, feely, lovey dovey, emotionally laden individual- and although I am starting to make friends in the area, it's hard feeling so alone a lot of the time. I know its a natural byproduct of moving and will go away with time, yet God knew that this weekend I was going to need to be surrounded by people who love me. I'm so glad I had the opportunity to come back and recharge before I face the coming week. I appreciate all the prayers and support I've been recieving- Lord knows I need it! I just continue to trust that he has a plan for me and I know that growth is going to be painful. Yet that pain is necessary to truly prune away that which is holding me back and to emerge better and stronger on the other side.

Saturday, February 5, 2011

One week down= thirteen to go

Things I've learned during my first week of Internship

1) It's always good to make sure you have quarters in your car BEFORE getting on a toll road access- you never know when you'll find a booth with no cashier.

2) Admitting you love college football is the fastest way to bond with male patients of any age. However, admitting you're a Florida Gator fan doesn't always work as effectively.

3) Always double check (and triple check) your alarm clock to make sure it will actually go off

3b) It's amazing how quickly you can get ready in the morning when under a time crunch

4) Packing lunch the night before is a great way to save money AND time in the morning

5) Granny Smith Woodchuck is NOT as satisfying as Amber Woodchuck

6) Being surrounded by Disney figures all the time is super great for my mood, so is walking under a two story castle to get to the elevators

6b) Its very easy to forget in the midst of all the exciting activities and environments that tragic events do occur in the hospital. Children get sick, painful and uncomfortable procedures still occur, some patients will die. Tragedy is all around, our job is not to erase or eliminate that fact, but to make it more bearable.

7) Cute kids tug at the emotional heartstrings- its important to take care of yourself to keep from burning out

7b) Drinking wine with the roommate over home-cooked dinner is a GREAT way to do this.

8) No matter how early you go to bed, 6:15 will ALWAYS feel early.

9) Good friends send you 'good luck' wishes and tell you they will pray for you. GREAT friends call and text you constantly on your first week to make sure you know they are thinking about you, and tell you they can't wait til you come home.

10) There is nothing more exhilarating than feeling overwhelmed and underqualified- but also knowing that you are living out God's will for your life.


So I'm through with the first week, and Friday I spent a few hours shadowing the inpatient acute pediatrics floor that I will be working on for the next four weeks. Acute peds means that the patients typically have less severe diagnoses and do not need the same types of constant monitoring that those in Pediatric Special Care or the Pediatric ICU require. Examples of things we might see on these floors include asthma, short gut (part of the bowel removed), Appendix removals, new diabetes diagnoses, etc. Length of stays are typically 2-4 days on these floors (although they can certainly be MUCH longer). I would wager a guess that the majority of child life internships start their students off in an acute setting (or something similar) because it is less emotionally and physically strenuous than some of the more critical care units, and it is a great place to start to develop a craft. Our acute pediatric floors (AP has 2) have very large playrooms, and a lot of our children can come down when we are open.

However child life's mission is to provide services to children regardless of their limitations. For example, even if we had a patient who had a ventilator (meaning they can't talk very well) and was in complete traction, we are still responsible for helping them cope. In these cases we might use vicarious play where we work on art projects and have the patient decide what colors and materials are used, even though the specialist is the one actually making the project. Or perhaps we might build with blocks, but the patient chooses what shapes to make, and where to place particular blocks.

Child life is more than simply 'playing', we work with the purpose of helping children deal with the traumatic stress of hospitalization and try to facilitate normal coping and development. Its easy to get caught up in the 'fun' aspects of what we do (like Friday when I got to work with a pet therapy dog and a character (Clifford the big red dog) visit) and forget that more importantly we are there as advocates and support for children during their stay.

Because of confidentiality, privacy and HIPAA laws, the amount of information I share about my experiences will be very very limited. So instead of describing particular situations I find myself in, I figured it might be more appropriate to describe the general medical problem or procedure that I observed and talk about what role child life plays in those circumstances.

For example, on Friday I was given the opportunity to observe an NG tube placement. NG stands for nasogastric- and it involves running a tube up an individual's nose, through their esophagus, into the stomach. The NG tube is used for feeding purposes but also for the administration of chemicals and medications that can not be taken orally. For instance, a patient I observed on Friday had to ingest a chemical for contrast purposes during an X-ray that was so disgusting it would be impossible to take by mouth. NG tubes are also used for suction in the case of bowel obstructions.
borrowed from

Placement is difficult for children because it is not a procedure that we can sedate for, or even use distraction,, because the patient must be sitting up right and is asked to swallow constantly to assess the placement of the tube. When all goes well the tube can be placed in as little as 10 seconds, however when a patient is uncooperative it can take a lot longer.

As I mentioned before, Child Life Specialists can not always use distraction in these cases because the procedure is done in the line of vision of the patient. For procedures like IV starts, we can help the patient direct his or her gaze away from the doctors and instead focus on video games, picture books, i spy games, etc. For NG placement our interventions usually deal with preparation. My preceptor talked to the child and explained what the doctors would be doing. She described the procedure in terms that he could understand and then answered any questions he had. She was honest when he asked if it would hurt  and told him that some children say it hurts a little bit, but that once it was placed, he would forget it was there, and then it wouldn't hurt coming out.

During placement we serve as emotional and procedural support. Child Life Specialists NEVER serve as restrainers (in fact we try to discourage restraint all together and typically work with children to try and increase cooperation). Instead we sit by the child and help talk them through things, enact any coping strategies that were put into place, and support the parents during the experience. Afterwards we talk with the child, provide rewards and prizes for dealing with such an invasive procedure, talk with them to get their take on what happened, clarify any misconceptions, and then design activities to try and help them regain mastery over the environment.

Watching the NG procedure was a good reminder for me. I've been getting so caught up in all the fun exciting elements of my placement that I think I was forgetting a bit that the hospital is NOT a fun place. Even though we try to decrease the negative experience, we can never make it GOOD we can only  make it a little bit easier.

It's going to be an interesting three months, that's for sure. I'm continually praying and asking for support, and I know that will just increase as I get farther into this experience. I'm so thankful for all the support I've received from family and friends; that support is the only thing getting me through.

Now if I can just figure out how to guarantee my alarm goes off in the morning, life would be good!

Tuesday, February 1, 2011

First days

Life has been crazy. Can I just say that?!  I fully intended to make myself blog each and every night, but last night I just couldn't seen to find time in between the EIGHTY pages of reading, academic journaling, self-evaluation and discussion board posting I had to do. Ok, let's be honest, I didn't have the energy to deal with it! So to make up for my total and utter laziness, I'm not only going to recap my first two days for you, I'm going to give you PICTURES!

First and foremost, I would like to begin our little venture with a discussion of the wonder known as Orlando traffic. For those of you not in the know- it sucks. Majorly. One of the most populated areas in the world, and an out-dated, insufficient infrastructure do not go well together. Although the townhouse in which I am residing is actually only about 13 miles from the hospital, it takes me about 30-45 minutes to get to the hospital (Even using the toll roads). However, after some major hiccups with the toll system, getting lost downtown, and a non-working GPS I finally arrived here:

Arnold Palmer and Winnie Palmer Hospitals (His and Her Hospitals? That's a new one!)

Ok so the REALLY cool looking building is not mine- it's the Winnie Palmer Hospital for Women and Babies (the second largest volume of babies born in the world...), but still, its a pretty awesome sight to see!  I quickly made my way to the parking garage, proceeded to get lost trying to find my way out of it, and then proceeded through the hospital to meet with my supervisor and the other intern (who is incredibly sweet and I am SO excited to work with!).

We then proceeded to our electronic documentation training- where for three hours we learned how to access patient medical records, submit and check orders, input documentation, and add assessments. Maybe not the most exciting thing ever, but definitely will come in handy soon! We ended up finishing Sunshine training early and headed back to the child life secretary office where we were given.... our beepers!

Ok, I know most of your are rolling your eyes right about now- but you have to understand, having your own pager in a hospital is a sign of importance. It signals that you are someone that somebody may need to get a hold of, its a signal that we are a step up from merely students or volunteers. We are, in fact, professionals in training.

Lunch with the staff was great- the entire department is incredibly welcoming and excited to have us. Their enthusiasm is contagious! After lunch we were given the "$10 tour" as my supervisor labeled it. Let me tell you... the hospital is a true conglomeration of buildings. Four different building phases have contributed to the current floor plan- which is counterintuitive in many ways, and difficult to navigate in others. So far Sara and I have managed not to get lost, but I have a feeling it's just a matter of time! After lunch we completed a few online and written trainings and received our binders! We each have two, and let me tell you, at three inches thick a piece they are intimidating! Luckily, I realized that a good number of articles in the 'required reading/resource' book I had already read for my thesis. All I can think is that by the end of this internship we are both going to have very nicely toned arm muscles!
Resource and Internship Binders- oh joy!

Super excited for our binders!

Today was filled with more orientation items- including walking through the entire internship binder from cover to cover. I feel a lot better knowing that all of the expectations for me are written out and set before me. We received our rotation assignments, and started reviewing hospital policies and procedures. Our supervisor also gave us a selection of items to add to our 'distraction tool kit'. Not going to lie, I'm pretty psyched.
Awesome child life resources! (I know I'm hopelessly dorky!).

Today also entailed 'scavenger hunts' learning where various resources and offices are, reviewing safety procedures, and learning about the various codes. Although I am grateful for this extended period of time for getting my feet wet and adjusting to the hospital, I am also getting antsy to actually get out on the floors and start learning. It's intimidating to know that in less than two weeks I will be the child life specialist responsible for the care of several children on the acute peds floor. There's no doubt that I will have plenty of support and resources at my disposal, but it is still slightly frightening to realize that it's finally here. All I can do is take it one day at a time and give my best to each and every patient I encounter.

Now if I can just manage to handle downtown traffic life will be great!