Meet Rachel: Certified Child Life Specialist
Speak Now for Kids honors child life professionals who are dedicated to helping children with difficult health circumstances. The following testimonial is courtesy of the Association of Child Life Professionals (ACLP).
Rachel Kinsinger of Loma Linda University Children's Hospital is an example of a Certified Child Life Specialist (CCLS) who thought outside the box (in this case, an MRI machine) to create an innovative approach to procedural preparation that resulted in reduced risk, cost, and wait time.
Rachel was completing a fellowship at Loma Linda University Children's Hospital when the Child Life department was contacted by an MRI physicist about long wait lists for scans. All children under the age of 12 were automatically scheduled for scans using general anesthesia, and the wait time was at least three months.
Rachel thought she could help by reviewing the records of the children on the wait list and determining if they would be good candidates for a scheduled practice MRI session, and potentially a non-anesthesia MRI. Appropriate patients were over the age of six and did not have sensory issues or developmental disorders. In addition, the MRI scan had to be a single study no longer than 25-40 minutes.
Using a decommissioned MRI housed in a building across the street, Rachel set up a practice area with a gurney and slide board and offered free appointments to eligible patients. She used images and recorded sounds to imitate a real scan experience and talked to children about contrast scans (if needed) and their individual fears.
Some children are scared of the dark environment while others are startled by the loud noises. After preparing children for the practice session and working through their specific concerns, Rachel observed them in the scanner. Children who could stay still in the scanner for two minutes were cleared to schedule an appointment without anesthesia.
Rachel tailors her procedural support to the patient and uses a variety of techniques to reduce anxiety and promote cooperation. Patients can squeeze balls when they have an urge to move, and some enjoy picturing the bravery they receive from squeezing their “bravery balls.” She also demystifies the process by encouraging kids to wear comfortable clothes without zippers so they can avoid changing into hospital gowns.
Since May 2017, 37 patients avoided anesthesia for an MRI scan. Rachel’s success rate is around 93 percent, and she’s even had success coaching four-year-old patients through the scan.
After Rachel’s successful trial run during her fellowship, the child life team proposed starting a child life position in MRI/radiology. The position was created, and Rachel has been working full time in radiology since October 2017. Her results are so promising that the hospital’s Radiology Engineering department is building a customized practice MRI machine with fun colors and stickers as well as an accompanying doll-sized MRI.
One of Rachel’s patients was a seven-year-old boy with a gait abnormality. After successfully completing a non-anesthesia brain scan, his doctor ordered another scan—this time of his entire spine. The spine scan would take more than an hour and was scheduled with anesthesia.
The soonest appointment was in seven months, and the family contacted Rachel to see if she could help. Rachel confirmed there was no medical reason for the scheduling delay and then worked with the child to practice a longer non-anesthesia scan. The scan, which was scheduled for two rather than seven months out, was completed successfully.
It’s hard to overstate the impact of Rachel’s innovation and the benefit to patients, families, the healthcare team, and the hospital. The hospital saves time and money every time a child scheduled for an MRI with anesthesia manages to complete one without. Parents are relieved that their child didn’t need general anesthesia, which always involves a level of risk, and grateful that the medical team can diagnose and begin treatment sooner that anticipated.
To learn more about how Certified Child Life Professionals help children facing acute and chronic illness, injury, trauma, disability, loss and bereavement, see the Association of Child Life Professionals (ACLP) website.