Progressnotes - October/November 2012
- About MUSC Health
For children with severe burns, their world seems to have spun out of control. They have endured the trauma of the injury itself, been ripped from their familiar surroundings and placed in an unknown environment where they must undergo sometimes painful procedures (eg, debridements, dressing changes) associated with burn care.
Even after recovery, they bear physical and emotional scars that impair self-esteem, complicate family life and make social interactions challenging. They can no longer trust that the world is a safe place. Adults might cope by talking through their feelings of helplessness and isolation. Young children are less likely to do so. Play offers them a way to reassert control over their environment and vent their pent- up feelings.
MUSC’s Child Life Services, which is staffed by a dozen child life specialists, tends to the emotional needs of children as they receive medical care, offering support to families and opportunities for play to children. Betsy McMillan, MA, a senior child life specialist at MUSC who has worked with pediatric burn patients for almost 16 years, believes that play can bolster the spirits of a child recovering from a trauma because “play is normal and natural to a child in an environment where nothing else is.”
To encourage recovering children to play, a light and colorful atrium near the inpatient pediatric units at MUSC Children’s Hospital has been turned into a play area, complete with a wealth of age-appropriate toys, board and video games, DVDs and reading materials. The atrium offers a safe haven for children, a place of fun and relaxation where medical procedures never occur. According to McMillan, play has an almost magical effect upon the children, whose injuries may have left them emotionally withdrawn: “When children start to play, their personalities come back really quickly.”
Play can also be used to help children make sense of their injuries and teach them about the medical procedures they must undergo. Their injuries can be reproduced on simple stuffed dolls by putting bandages where the child’s bandages are. Betsy McMillan regularly puts tracheostomies in these dolls and even has tiny pressure garments for them, identical to those that children must wear for up to a year after skin grafting is complete.
Children should be allowed to play freely with the dolls because, according to Betsy McMillan, “Children can be very exact at recreating their experiences when they are in the driver’s seat.” They may use the doll to represent how their own injury occurred or reproduce a recent blood stick or dressing change.
Above all, open-ended play allows children to reassert a sense of control.
While he lay in bed recovering from his burn wounds at MUSC, his fingers splinted to help prevent contractures, Dortez Gordon relished the remote control car that Child Life Services brought to his room.
With one touch of his finger, the car spun out of control and then went whirling out of his room into the hall outside. For Dortez, this was the first step in reclaiming a life that had itself momentarily spun out of control, the first sign that good times would once again return.
Once they leave the hospital, children face a different set of emotional challenges. Anxious over their scars and with a sometimes impaired self-esteem, they must return to school, where stares, teasing and a constant barrage of questions likely await them.
Camp Can Do instills in them the confidence that they “can” meet these challenges and lead a fulfilling life.
Cosponsored by MUSC’s Pediatric Burn Center and the Burned Children’s Fund, the weeklong camp designed especially for burn survivors is held each summer at Camp St. Christopher on Seabrook Island, South Carolina. The Burned Children’s Fund is a collaboration of MUSC Children’s Hospital and South Carolina Firefighters, and most of its monies come from the collection and recycling of aluminum cans by firefighters statewide.
Jill Evans, R.N., M.S.N., a burn nurse with more than 20 years of experience, is the Coordinator of Pediatric Burn Services for MUSC Children’s Hospital and the Burned Children’s Fund and is the Administrative Director of Camp Can Do. According to Evans, the camp has a “a very comfortable, accepting atmosphere” and provides kids a break, a place where “they get to feel accepted and know no one’s going to be asking them a lot of questions.”
Camp Can Do offers pediatric burn survivors all the fun of a regular summer camp. They can swim in the ocean, play on the beach, fish, play in the mud, dance, do arts and crafts, play basketball and eat grilled food. They can do so in a protected environment, with peers who have experiences similar to their own. They can share their stories easily with others who truly understand what they have been through. They can let their guards down and be kids again.
Campers return year after year, building strong friendships. They also build confidence, as they realize they are not alone. The kids say it best themselves: “Whenever I go to camp, I can always count on not getting teased and not feeling left out about anything and just fitting in. I build confidence in myself. It’s a good feeling.”