A trip to the emergency room can be a frightening experience for a kid, whether it’s for a serious injury or just a sore throat and fever. Physicians and nurses do what they can to calm nerves, but in the rushed world of modern medicine, they often don’t have much time as they hurry on to the next patient.
Benjamin Heilbrunn, MD, assistant professor of pediatric emergency medicine, thinks tending to children’s emotional well being in the ER can be crucial to communicating with them and their parents. To him, this starts with creating an overall environment geared toward reducing anxiety.
“With the way that medicine is now, especially in the peds emergency room, I don’t have the time, unfortunately, to do a great job of anxiety reduction and emotional healing,” he said. “You have to create an environment that’ll make kids comfortable and give you the best shot at getting the correct diagnosis, and not have this be a miserable experience for them.”
Child life specialists at the University of Chicago Medicine Comer Children’s Hospital are on hand during business hours to provide activities to help children manage stress and anxiety. For instance, they may play games or use art and music therapy to help children through their hospital experience. In the ER, they also use iPads and other gadgets to help kids relax while undergoing procedures. Heilbrunn thinks more hospitals should provide these services to all patients in the ER, full-time, not just those undergoing procedures.
This recommendation comes from personal experience. As a medical student, he spent time traveling with Patch Adams’ Gesundheit! Institute, performing as a clown at hospitals in Europe. Now, through a study recently published in the Journal of Emergency Medicine, he has the data to show that child life services and hospital clowning actually work to help reduce anxiety for kids in the ER.
In the study, conducted while he was at Children’s Hospital Los Angeles, Heilbrunn and his colleagues assigned patients in the pediatric ER to one of three groups: one that would spend time with a child life specialist before seeing a physician, one with a hospital clown, and a third control group. The children’s anxiety levels were scored on a standardized scale once they entered the exam room, after a brief 5-10 minute visit with the child life specialist or hospital clown, and during the physician exam.
Half of the children studied had heightened levels of anxiety. For these kids, playing games, coloring, music or other activities with the child life specialist reduced their anxiety by 22 percent. Those who saw a hospital clown did not show the same reduction in anxiety, but Heilbrunn says he thinks this effect could have been larger with a longer visit.
While Heilbrunn doesn’t have much time now to relive his days as a traveling hospital clown, he still tries to put his experience to good use, blowing bubbles or playing games to keep them distracted during an exam.
“The ER doesn’t have to be scary. It should be a little bit fun and interesting. That’s why I do it, to promote the idea that these services should be there all the time,” he said. “It’s changed my perspective on being a physician and how I care for patients.”