Emergency Department Rotation Reflection

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This past week was my final in my outpatient rotation in the emergency department! During my emergency department rotation, I focused on the following modules from the ACLP internship modules: psychosocial preparation, coping with pain & distress, lifespan development, and communication. These module activities were all completed and were done fluidly with my experiences, meaning it is not a week by week progression. During my final week, I was completely independent and I carried the Cisco phone and the trauma pager. The patient interaction that I wish to highlight from my final week was an IV placement with an 8 year-old female who partially degloved her thumb. While I had various meaningful patient interactions, this interaction …show more content…
However, we did discuss using developmentally appropriate language and soft language, which I observed and actively used in this patient interaction. Child life texts teach us how important it can be to prepare a child for a novel experience (i.e., IV placement, surgery, hospital admission, etc.) as well as the benefits from rehearsing steps to those procedures. Child life texts also teach us how it is important to empower and provide support to the patient, as well as assess each patient’s anxiety/fear/coping as an individual. Developmentally speaking, I assessed that this 8-year-old female had a developmental age that matched her chronological age. We are aware that school-age patients have developmental concerns involving fear of loss of control/mastery, fear of bodily harm/death, fear of the unknown, loss of routine, and forced dependence, and in turn that interventions (preparation/education) and play/activity sessions offering for feelings of choice/control/mastery, setting the patient up for success in activities, familiarizing the patient with common medical tools, clarifying misconceptions, and normalizing the environment through play can help to combat these potential stressors. Therefore, this is why I offered preparation to the patient and allowed her to decide …show more content…
This patient was a high priority for a multitude of reasons. For one, the RN requested my assistance. Secondly, the patient needed the IV quickly to be sedated to fix her thumb. Knowing the patient's developmental age also makes her a priority, because procedures can be difficult for this age group. My preceptor and I also discussed the theoretical foundations of child life in this intervention decision making through Piaget’s Cognitive Stages of Development and Erikson’s Psychosocial Stages of Development. For example, the patient is in Piaget’s concrete operational stage of cognitive development, where she is able to think with the understanding of reversibility. To account for this, I made sure to explain that this IV was not permanent and would be removed before she left the hospital. Additionally, the patient is in Erikson’s industry vs. inferiority stage of psychosocial development, where she is developing a sense of pride through social interactions and accomplishments. To account for this, I was able to engage her in social interactions and distraction/diversion, as well as provide verbal affirmations, which she displayed pride to both. Moreover, I offered choice and control opportunities with the items I brought for distraction/diversion to the patient so that she could feel that she had some say over what was happening
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