Connections: March 2023 - 5

Q&
They've been an integral part of the care
teams at Dartmouth Health Children's since
1977. To commemorate National Child Life
Month, we talked to Torie Miele, one of 10
child life specialists at Children's Hospital at
Dartmouth Hitchcock Medical Center, about
this important role in the care of our kids.
Q: What is a child life specialist?
We support children and families in the
medical setting. We combine our knowledge
of medical concepts, child development
and family-centered care to provide evidencebased
interventions and support for all children,
no matter what their age or stage. We work
to help them cope with the stressors of the
hospital environment through preparation,
psychosocial support and age-appropriate
teaching on medical concepts. One of the
coolest things about child life is that there is no
billing involved. Every child has access to our
child life programs without cost to the patient.
Q: Describe the different aspects of your job.
I like to describe it as a puzzle piece that
fits many places. In our clinic setting, I provide
a lot of preparation for what the patients will
experience, like blood draws or X-rays, and
make a coping plan to give the child choice
and control.
A
with Torie Miele, MS, CCLS
Certified child life specialist, Dartmouth Health Children's
The work of a
child life specialist
I help manage the anxiety that can come
with doctor's visits. We talk through what to
expect during a visit and I may stay present
for the visit for support, explaining what the
doctor says in child-friendly ways, exploring
emotions and giving alternative activities. Play
is the language and the work of children, and
so I use a lot of medical play to help children
get control over the medical setting and tools.
In our intensive care nursery, my work is
a little bit different. These patients are very
vulnerable and need appropriate stimulation
and support. I sing, talk to and soothe the
babies whose families aren't able to be present.
Crying leads to more calorie burning and a
dysregulated system, so keeping these babies
comfortable is very important. When we have
older babies, I add in developmental play to try
and meet milestones as best we can.
Q: How important is play in your work?
By introducing different types of play-
medical, therapeutic, developmental-we are
able to present ourselves to our patients as
nonthreatening people and get a glimpse
inside their world. In medical play, we use both
real and toy medical equipment to give the
patients a sense of power over their medical
tools, and so they can explore and learn. For
instance, I use a doll with an IV, EKG stickers
and an NG tube to prepare a sibling before
seeing their baby in the ICN. Play can be
used to meet lots of goals, such as building
rapport, meeting treatment goals, distraction,
emotional expression and more.
Q: What is the ultimate goal of your work?
We're here to help children feel heard,
validated and understood. Our goal is to
diminish the trauma they may experience in
the hospital system, and to help normalize
feelings of sadness, disappointment and
anger, teaching the kids how to cope with
those feelings. In the end, we want to help kids
be kids, no matter what their situation.
Q: What do you find most rewarding?
I really love watching kids succeed and
grow. Working with chronic populations and in
our NICU, watching kids overcome obstacles
they never thought they could, and thrive
despite difficulties, never ceases to amaze
me. Getting to work with a patient over years
to help them overcome their fear of needle
sticks, helping a sibling hold their premature
sibling for the first time or watching their
understanding of their diabetes or cystic
fibrosis grow as they age, it's really rewarding
to know I have a small part in that journey.
Connections: March 2023

Table of Contents for the Digital Edition of Connections: March 2023
