Erikson Child Life Alumni Lead Hospital Teams in COVID-19 Pandemic

Anna Akers-Pecht is an Erikson alumna and member of the Institutional Advancement team. This article is part of a series of interviews she’s conducted over the past few weeks with Erikson alumni exploring how COVID-19 has impacted their work. Read her other interview here.

Rebecca Meyers, MS Child Development with Infancy specialization ’04, Infant Mental Health Certificate ’13, is the Manager of Children’s Services at Ann & Robert H. Lurie Children’s Hospital of Chicago. Shira Miller, MS Child Development with Child Life specialization ’06, is the Manager of Child Life and Creative Arts Therapy at Rush University Children’s Hospital. Rebecca and Shira took the time to discuss with me their experiences as Erikson alumni in hospital settings during the COVID-19 pandemic. Some of their responses have been edited.

Akers-Pecht: What has it been like at Lurie and Rush during the pandemic?

Meyers: There have been phases. At the beginning, there was a lot of fear and uncertainty that we—the whole world—were trying to figure out, then also us specifically in the microcosm of the hospital where there’s even more potential to be exposed. A lot of my staff in the ED [emergency department] had anxiety—not knowing what the right PPE [personal protective equipment] to be wearing was. We implemented decreased schedules where we had people working from home to support social distancing since we had decreased volumes. There were a lot of feelings around that, especially people living alone, people who are introverts versus extroverts.

“We’ve all been in the pandemic long enough at this point that now it’s baseline stress versus crisis stress that everyone is experiencing, so we’ve had lots of conversations this week responding to that and what the hospital can do.”

And what we can encourage people to figure out on their own a little bit, in an individualized way. Everyone is navigating what’s happening in their homes with parents and kids and childcare.

Miller: I would agree with this similar trajectory. Being a children’s hospital within a larger medical center, seeing both pediatric and adult patients, we’ve had some different experiences. As our pediatric volumes were decreasing somewhat, we were still having patients come in for various needs, especially in the adult units. As has been reflected in the news, Rush was built for something like this, so units were able to be converted to meet patient needs. This started to pose a new challenge to navigate in Child Life: we always say it’s not about us, but we’re all dealing with our own stress and fear—considering the changes and the unknown, trying to focus on pediatric patient needs, ourselves, the team—all while  these COVID-related changes are happening around us.

Simultaneously, I was managing the same idea of people’s own personal fears and anxieties about the unknown. We had a conversation as a team about what to do about staffing. The team asked if we could go to a rotation schedule for their own safety and security, so we now have this balance. A lot of our team also lives alone—they’re from out of state, so their support systems are far away. In the beginning, we had daily and sometimes hourly debriefings, and found our rhythm: “For now this is the new normal, whatever normal means, and our volumes have been down, but there’s still a lot of psychosocial work to be done.”

We are being asked by physicians, “Can you please get into PPE and be there for this child?” We’re cognizant of material usage, but when we are asked by a doctor to provide interventions, it reminds us that we are seen as essential in this time. There’s a lot of stress right now, but that we’re being seen as essential and valued is a silver lining. We’ve been doing morale-boosting—we chalked the driveways and sidewalks with inspirational messages for staff and did a gift exchange among the team. Each of the pediatric units has adopted an adult unit. As Child Life specialists, we also work with adults who are separated from their kids, spouses, loved ones. We are there to help the adults navigate the separation, questions, and potential grief for children in the family, so we’re not just working in pediatrics. Maybe there’s not going to be a funeral, maybe they’re just going to FaceTime their dad for the last time.

“As Child Life specialists, we also work with adults who are separated from their kids, spouses, loved ones. We are there to help the adults navigate the separation, questions, and potential grief for children in the family, so we’re not just working in pediatrics.”

Akers-Pecht: I cannot imagine. You’ve both said your volumes have been down. Can you explain what that means for folks not in hospital settings?

Miller: Anything not emergency, life-threatening, limb altering is being taken care of in a virtual capacity as much as possible. Elective surgeries have been delayed.

Meyers: We saw a decrease by 70 percent in our areas. We haven’t needed the full support of our four surgery Child Life specialists. There have been times where there were only eight kids in the ED and normally, we have 40 beds and a waiting room full of kids. We’ve hypothesized about a lot of that—kids aren’t at school, they’re not at playgrounds. So many people use EDs for primary care reasons that they’ve decided to manage at home now.

Many surgeries that are elective are all scheduled to come back next week, starting Monday [May 4]. We are hopeful that that will drive our volumes. Some of the things we’re putting in place: we’re taking chairs out of waiting rooms, we only allow one caregiver in with a child anywhere in the hospital. I think this last part is especially hard for our families and then staff. You think about going to the hospital with your child and then not having your support person with you. Typically, we allow some parents to go back into surgery ’til children fall asleep, and that’s been hard for the kids, as that’s a good part of their coping plan. When a parent sends their child off with the anesthesiologist and, hopefully, a Child Life specialist, that can be hard, and then even harder if there isn’t another caregiver there for support.

Akers-Pecht: What have you been doing to support your Child Life team?

Meyers: Some people on the team, such as education liaisons supporting patient learning goals at home, are working exclusively at home and doing all virtual visits. It’s been different for each of the teams. It’s been interesting to watch the evolution. Like Shira said, at the beginning, we were meeting every single day. People just needed information. What we were seeing on CNN was a little different from what our children’s hospital reality was. It became important to have reliable, consistent, frequent check-ins that people could count on. Reflective supervision is also so important! It can depend on the reflective capacity of a group makeup; some people may need the group supervision model and others benefit more from one-on-one supports. Additionally, there are lots of groups who are providing therapy to health care workers for free and just overall support, which is so wonderful. I have tried to help people figure out where their resources are.

Miller: In the beginning, leadership was doing a lot of debriefings. I was trying to give to my team as much accurate information as they could take in and what they wanted at the time. On the news, people were already running out of PPE—but thankfully that was not the experience we were having in our space. As we moved into a model where we weren’t all working together, I was worried about what that would do to our team dynamic, but we’ve done a lot of team-building and collaborating in new ways. I was watching their anxiety decrease and positivity increase.

Professionally, watching them get excited about projects and having them feel this sense of purpose was helpful. Our hospital was sending out daily updates. The more people felt like they had real information, I was watching some of that anxiety go down. Most of us have friends in other hospitals. I’m navigating that stress of the team coming to me asking about job security.

“There’s a fear of, is there something still to come for us? Or are we really moving forward the way things have been, with the adjustments that we already put into place?”

Meyers: I think the unknown nature of our economy has been hard for staff and something that causes worry and stress.  Staff are concerned about how our decreased volumes will affect our staffing in the long run. I have definitely lost a lot of sleep trying to figure out the right staffing patterns, the right places to step in to be an advocate for my teams and how to ensure that staff have the right information and overall support.

Miller: Things look different in each place, even though we’re all doing the same job, and a lot of us come from the same framework, foundation, schools, etc. There’s fear of the unknown.

Meyers: Everybody has good days and bad days, right? I talk about that with the team, everyone has stuff going on at home—as a leader, you carry a lot. Because you have to think about everyone, you have to think about all of the units, not just yours. I’m carrying a lot of the individual stresses people come to me with.

Miller: There’s the day to day, but you’re also still trying to manage a department, responsibilities and expectations from donors, outside people, organizations you’ve worked with forever. There’s a lot to shoulder when you’re leading a team.

Meyers: It is quite an exercise in patience and flexibility.

Miller: Always as Child Life specialists we ask, “What’s a new way to do this?” How are we going to make it happen?” Some days it’s amazing and people execute, and other days you’re having to manage expectations. It’s a unique dance.

Akers-Pecht: What gives you hope?

Meyers: To go back to what Shira said—I am definitely a positive person. What’s a silver lining here? Some of the ways we’ve figured out to do some virtual work—we’ve just yesterday launched a COVID-19 support line. Mental health and psychosocial care keeps being raised up. Child Life is such an integral part of that in health care. We’re being called upon in more of a primary way. It has felt so impactful to talk through the developmental pieces of what we think about for different kids in different stages and how to creatively make connections.

“How do you create connections when people can’t physically be there?”

Miller: It’s interesting to see someone else say it—I’m generally a positive person, too. Everyone has this heightened level of stress and anxiety. Am I being a little tone-deaf when I’m trying to find these silver linings? I don’t think so. It’s about balance. Leaning in to the reality but also finding the bright spots when we can, especially for others.  From a leadership standpoint, and it’s also in our natures, to acknowledge the hard parts, yet also think what’s going to come out of this. We have taken this time to really collaborate—with a mask on or virtually—and some of what’s coming out of that are these connections to a bigger hospital system, [whereas before] you may never have crossed paths with that person, or you may never have been pulled into that conversation. What will come out of it will be very unique.

I just finished a recording for the Association of Child Life Professionals virtual Annual Conference this year. I said that we’re so uniquely poised as leaders in our field to be able to talk to other professionals and organizations about how we do this kind of work. For example, with the adult patient population, being able to use our knowledge of development, psychosocial support, and creativity to help work with other disciplines to support patients in situations that they may not have encountered or considered before this.

Akers-Pecht: Rebecca, you mentioned reflective supervision. Are there other ways your Erikson education has prepared or supported you both during this time?

Miller: No question. Before, I very rarely thought about my adult education and supervision class, but I have never thought more about it now—the idea that we’re all different in terms of how we lead. I’ve thought a lot of about that idea of individualizing things.

Meyers: Yes!

Miller: I said to someone the other day “We’re not asking that person about this project today because we don’t know what space they’re in.” I was having to really think about how to help each other feel supported and individualizing my approach. I also find myself saying a thousand times, “It depends.” I think not always having the answers and embracing that and helping others be OK with that—there’s an inherent undercurrent of that at Erikson. There’s always other factors. It’s the same thing right now. Each person has different spheres around them, which you always think about when you manage people, but in this moment specifically, I’m thinking about how each person’s other spheres impact what’s happening.

“I think not always having the answers and embracing that and helping others be OK with that—there’s an inherent undercurrent of that at Erikson.”

Akers-Pecht: Very Bronfenbrenner.

Meyers: Individualized care that you were talking about really resonates with me because everyone is unique. We know that, but I think Child Life specialists are very self motivated, innovative self starters. I think about it now as how I am supporting them to do their job in the same way we support a child or family or to be able to navigate the medical field successfully. What are their coping mechanisms? It’s not for me to fix by myself; it’s about me empowering them to eventually not need me in the same way. Everyone needs such support now because we’re baseline operating at this stressful level.

Akers-Pecht: What are you doing for yourself? Your families?

Meyers: That part is probably the part that’s hardest for me right now. I have a six year-old, and she’s really struggling today specifically. My boss is so wonderful, and I’ve been working from home for a few days a week. The thing is, when I work from home, I’m there, but I’m not there because I end up on a lot of phone calls that then need email follow-up. You feel all that guilt. I’ve been very adamant about very little screen-time her entire life up until now and now wrestle with how many screens we put her in front of for education, recreation and connection. Navigating those things have been very hard. It all bleeds together instead of being a little more compartmentalized. For me, exercise has been crucial. It helps me clear my head. Talking to other people in the field about what’s been going on and getting some support has been helpful. I have really good leadership support here.

Miller: I’m in a very different situation because I live by myself. When I’m at home, I’m not trying to manage anyone else. Bu there’s no [work-life] boundary anymore. I’ve always liked to cook. I try to make sure I’m cooking and meal planning and stuff I’d typically do. Some friends and I have book club that we’ve turned into movie club for the next couple of months—people were using the library—I’ve had friends get super creative. Somebody ran an art class online.

Akers-Pecht: What can others do to help their communities?

Miller: Staying connected, doing something for someone, getting outside of ourselves.

Meyers: I think it can be overwhelming—people have lost jobs and gotten pay cuts. I think there are so many ways to find just one person in your community—whether an elderly person who needs groceries in your building—or just connecting and talking. Just so we have human connections—it doesn’t have to be a monetary thing. The signs in windows are so inspiring. A big heart and “Hope” created out of post-its in a window. Little things like that. We started a quarantine email sharing recipes and baking. People send in things that are inspiring in their communities. There’s a district in Beverly where the teachers did a parade through the community and past student homes. Things like that bring tears to my eyes.

Miller: People are becoming more socially connected even though we’re physically apart. Finding those little moments that you think might not be big, but where thoughtfulness is really coming through.

Meyers: If somebody identifies an organization they want to help, it can be important to reach out and ask them what they need versus coming and just giving. Our community has been so generous in working with us to identify helpful ways to recognize the healthcare workers through food and other donations.

“I just feel so grateful for my Erikson education—I serendipitously fell in to [the Child Life] tract, and I didn’t realize the long-term impact it would have for me both in terms of relationships and opportunities. I never dreamed that I would be leading a team, and I’m pulling on that foundation of understanding relationships and their power.”

Miller: I’ll echo that, but I couldn’t say it better.