The doors to the brand-new Herman & Walter Samuelson Children's Hospital at Sinai, Baltimore, opened March 19, 2012. The new and improved space offers 26 private inpatient rooms equipped with a video game system, a 42'' flat screen television, a sleeper sofa bed for parents, locked storage and more.
But perhaps the most popular feature for both young and old alike is the live aquarium broadcast feed.
"As soon as they step off the elevator, patients and families are greeted by a large flat-screen television that displays a live feed to the Baltimore National Aquarium's beautiful, colorful fish," said Nancy Baker, BSN, RN, CPN, clinical leader.
In fact, channel four on any television in the facility will transport visitors to the aquarium's underwater oasis. While the fish certainly offer a soothing retreat from reality, they are not the only diversion for patients. Part of the expansion included a "distraction station" to avert children's attention during potentially uncomfortable procedures.
"It's a way to make children a part of the procedure and make them feel more comfortable," explained Baker.
Putting Patients in Control
As the name suggests, the distraction station is a multisensory machine used to distract children during procedures, such as IV starts, putting in NG tubes, blood draws, spinal taps, dressing changes, catheter insertions and any other type of exam where a child must remain still. The station is also used at times to calm children who are very agitated.
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HEALTHY FUN: Patient Kilah Sherman enjoys playing with the colorful lights that make up part of the distraction station at the Herman & Walter Samuelson Children's Hospital at Sinai. Bottom, Nancy Baker, BSN, RN, CPN (left) and Laura Cohen, BS, CCLS, share in the fun.
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The station is on wheels, allowing the machine to move freely from treatment rooms to a child's room. One of its unique features is a projector at the top that can project an underwater-themed View-Master type show on the wall. Other features include a CD player to play soothing music, a large color-changing bubble column, aromatherapy, and long twinkling fiber optic cables that children can hold and play with.
"All of these features are used to distract children and also to calm them," said Laura Cohen, BS, CCLS, coordinator of child life services.
Even before the distraction station, nurses were no stranger to shifting children's attention toward positive thoughts. Baker noted that nurses would ask children questions such as "Who is your favorite teacher?" and "What is your favorite game?" just to keep their minds off of the procedure taking place.
These days, the sensory machine is something the children can, at times, control themselves. For example, they can change the colors and lighting of the bubble column by squeezing a ball.
"Another thing that used to take place is multiple nurses would be necessary to prevent a child from moving their arm during an IV insertion," recalled Baker.
However, with the distraction station and the help of a child life specialist, it can now be done with only two nurses, which allows the additional nurses to be at the bedside of other patients.
"It not only makes it more comfortable and less traumatic for the patient, it makes the whole situation more positive," Baker said, noting that, when a child is in the hospital, nurses strive to provide him or her with a positive experience.
"You don't want them to be fearful every time they see a doctor or a nurse - and this is one way to make them feel more relaxed and more in control of a situation."
A Real Team Effort
Cohen observed that nurses should know how children are going to respond to the distraction station before they turn it on so that it doesn't overwhelm them.
"You have to know what's going to work for a particular child, and it may be that you have to try different techniques," she said.
Healthcare professionals, the child life specialist, the parents and even the patients themselves are all involved in making decisions regarding their care.
"It's a real team effort," said Cohen.
Baker remarked that she and other nurses at the hospital work very closely with the child life team and have a child life consult if they know far enough in advance of a painful procedure.
"Many times these specialists can educate with books and other educational tools about the procedure," Cohen said.
Baker provided an example of a 4-year-old patient who needed a 2-hour CT scan. After the child life specialist worked with the child, he knew what to expect and was able to stay still for the entire time. In fact, he was so relaxed that he fell asleep during the CT scan, which made it a positive and successful experience.
"If we know we're doing a procedure such as blood work on a child or an IV start, I reach out for a child life specialist and their professional expertise. They can work with the family and decide what would work best for their child that would result in a successful procedure. Child life can operate the distraction station while the nurse is doing what the nurse needs to do," she said.
A Positive Patient Experience
Studies have shown that pain as "benign" as an IV start can have both physical and psychological consequences in children.
The distraction provided by the new station is a unique approach to procedural pain in children and is largely used by RNs and child life specialists trying to provide the child with the best experience in terms of avoiding pain.
"Pain can make children scared of nurses when they come in the room," said Baker. "If it's a patient who might have a chronic illness and needs to be hospitalized fairly frequently, they might be scared every time they are admitted to the hospital."
With the help of the distraction station, many patients look forward to their visit to Herman & Walter Samuelson Children's Hospital at Sinai because they have fun.
"When that happens, it's not only a positive experience for the patient, but for the parent as well," said Baker. "As a parent, seeing your child going through IV blood draws and painful procedures is really heart-wrenching, but if we can make it a positive experience and a less traumatic experience for the child, it makes it so much easier for the family."
Cohen offered another example of a young mother who was afraid to get her blood taken because of an extreme needle phobia that stemmed from receiving numerous blood draws as a child and teenager; when she became pregnant, the woman avoided prenatal care, resulting in her baby having a condition that could have been avoided.
"The point is we don't want patients to feel too afraid to come back. So, if we make them feel comfortable and give them a positive experience, they won't come back traumatized," concluded Cohen.
Beth Puliti is a frequent contributor to ADVANCE.