Cancer: Before This and After This

Each hospital unit does things very differently based on the unit’s patient population. Some staff are more involved with their patients due to the continuous care a patient may need, such as the Oncology Clinic that sees their patients on a weekly or monthly basis. Because staff may see the same patient week after week, staff can expect to become very involved and thus know patients’ likes, dislikes, school, exciting life moments (such as prom), as well as the struggles (such as losing a loved one).

It is important to have good boundaries while working on this unit and to not get overly involved in patients’ lives. As Certified Child Life Specialists, because we see so many patients in a given day, it’s imperative that we do for one what we would do for all. Especially in the Oncology Clinic. If you provide a patient with a really big prize, like an American Girl Doll, for going to surgery, but the patient next door that’s of similar age only gets a Barbie, that’s going to look unfair. It’s important to not “pick favorites.”

While keeping those good boundaries at work with the patients and families, it’s also important to not “bring the patients home with you”. Because you will be more involved with your patients and families than you would be in the ER or Radiology for quick outpatient procedures, you may know more deep problems/feelings that your patients could be facing such as a terminal illness, an unavoidable divorce for their parents, or depression and suicidal thoughts for patients or family members due to the weight of the patient’s illness. This can be difficult to lay at the door on your way out, but it’s so important for your self-care to leave what you deal with at work, at work. By bringing these concerns and frustrations home with you, can disrupt your life, friendships, and could even affect your dating relationships or marriage.

On a positive note for the Oncology Clinic – it’s also important as the child life specialist to create a fun and uplifting space for patients and families to find solace in a place that otherwise feels threatening, scary, and daunting.

Celebrating special holidays such as Easter, Halloween, and Christmas at the hospital helps the hospital feel more like home. Most of these patients will spend time in the clinic for their chemotherapy every week and some may even spend time on the Pediatric unit for weeks and months at a time receiving back-to-back chemotherapy. By giving patients special days and holidays to look forward to helps normalize the hospital experience for children. 

Taking special trips either annually or bi-annually and planning out-of-the-hospital get-togethers for patients and families allows for fellowship for those wrestling with the same devastating diagnosis.  This builds community and camaraderie for this patient population and allows for parents to not feel so isolated and alone.

Finally, our hospital has a Chemo Bell that every child that completes their last day of chemotherapy gets to ring. Since I was not stationed in the Oncology Clinic, I have only seen a handful of these moments and let me tell you, just writing this is making me tear up. It is one of the coolest experiences to see a child all the way through one of the toughest times of their life and to witness their final moment in the hospital where they get to ring that bell as a way to say, “I was brave, I did this, I am strong and capable.”

PRO TIP: Put the Chemo Bell up high and tie a long ribbon for patients who get to ring it so that not every day, will you randomly hear the bell ringing for the wrong reasons.

Sydney Children’s Hospital

For a video version of what a bell ringing looks like, check out this video from St. Louis Children’s Hospital 

Grab a box of tissues. Don’t say I didn’t warn you!

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