Jamie Wright is an RN at Temple University Hospital in Philadelphia, Pa. At the time this article was written, she was a nursing student at Holy Family University in Philadelphia, Pa.
The author has disclosed that she has no financial relationships related to this article.
CLINICAL IS A TIME for nursing students to apply the material they learn in class to real-life scenarios. Although we students may feel overloaded with information, we often come across situations for which we're utterly unprepared. I vividly remember one such experience from my junior year of nursing school. This article describes that experience.
It takes a team
During my clinical at a large children's hospital, a patient, 7-year-old JL, was fighting a bacterial infection. His healthcare provider (HCP) prescribed antibiotics via an oral suspension, which caused an array of problems for JL's primary care nurse and me.
JL disliked the medication's taste and refused to take it. His nurse and I tried mixing the medication with juice, but that didn't help. The HCP then prescribed the antibiotic in tablet form, but JL had never swallowed a pill and refused to do so now. Running out of options, JL's nurse suggested that we consult a child life specialist (CLS). I had no experience with child life therapy or CLSs, so I was curious to see what the job entailed.
The CLS arrived and invited me to join her in JL's room for, what she called “pill therapy.” I agreed, and introduced her to JL and his mother. We explained that we understood the suspension liquid tasted awful, but we could try something else—it would just take a little practice. JL willingly accepted the challenge.
The CLS and I set up several cups on the bedside table and filled each one with different-sized candy. The first cup contained the smallest candy. Each cup after contained a candy that was just a bit larger than the last.1
The CLS reached for the smallest candy and explained two ways to swallow it. “You can set it on the back of your tongue toward your throat, drink water through a straw, and swallow; or you can set the pill on the tip of your tongue, drink water without a straw, and swallow.” JL chose to set the candy on the back of his tongue, and he swallowed it on his first try.
He was so excited about swallowing the candy that he wanted to move onto the next size. He placed the larger candy on the back of his tongue and was successful again. Moving on to the largest candy, however, his anxiety began to rise and he said he wasn't sure if he could do this anymore. The CLS and I both reassured him that this candy wasn't much bigger than the last and that if he really put his mind to it, he could swallow the candy. He reluctantly agreed to try, and placed the candy on the back of his tongue. This time, he couldn't swallow it.
Not so sweet
Upset that her son was getting anxious, his mother told him that he didn't have to do this anymore, and that she could ask us to leave if he wanted. The CLS respectfully interrupted, stating that it was extremely important for JL to learn how to swallow a pill. She politely asked JL's mother to leave the room so we could talk to her son. Although frustrated, his mother agreed and left.
After she left, the CLS calmly explained to JL that practice makes perfect and asked him to try again. He hesitantly placed the candy on the back of his tongue, swallowed—and grinned ear to ear when he realized the candy had gone down.
This experience helped me realize that many healthcare workers knit the pieces of hospitalization together. In an appropriate pediatric situation, a CLS can be a great resource for nurses because nurses don't always have the time to tend to more child-focused needs, such as play time or pill therapy. A CLS is educated to understand a child's physical, mental, emotional, and medical needs in order to help the child transition from the hospital back home.2
Every nursing student will experience a time when he or she doesn't know what to do, where to go, or whom to ask for help. It's important to remember that there's always a go-to person. When professionals from various specialties utilize one another for information and support, they can work toward greater patient satisfaction and healing.