Rebecca Gordon, MA, CCLS
Norton Children’s Hospital, Louisville, KY
Imagine you are a student on the first day of your child life internship. You listen with eager ears, hanging onto every word your preceptor shares while trying to memorize every detail, thought-process, and theory behind it. You practice your introduction of services until the words are perfected, trial new diagnosis activities for every scenario you can think of, even speak out loud by yourself to make sure your IV preparation is flawless before you’re allowed to finally try with your first patient. From the moment an individual decides to pursue child life, a fire is lit from the passion it takes to become a child life specialist. This excitement and passion behind the practice of child life is what acts as a driving force of our field. For students, there is a continual effort that is exerted to keep this flame ignited and burning in the midst of foundational child life clinical experiences, even when considering the potential obstacles caused by the nature of the child life profession. For those educating students during their clinical training, we as professionals have to contemplate the question of what a preceptor’s role is in kindling that flame and preventing burnout for current students and future child life specialists.
Some of the most memorable words I can recall from my journey into the child life profession were from a previous internship student and current child life specialist who stated “at some point during your internship you are going to completely question if you even want to be a child life specialist, but that’s just the stress of internship talking.” While in that moment, those words gave a sense of relief and a feeling of connectedness, they now worry me as a child life specialist who has experienced the signs of burnout in my professional practice. The emotions that can often be identified as a warning sign for burnout as a professional (“overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment,”) are generally expected as a part of stress of being a student (Maslach & Leiter, 2016.) For many students, however, the normalization of these emotions, a fear of failure, and the competitive nature in the field of child life could prevent conversations that may shape the lifelong practice of incoming child life professionals.
Take a moment to consider the learned skills you acquired during your own clinical training. For many incoming child life specialists, their practice begins as a mirror image of their preceptors’ techniques and eventually evolves over time to become an individualized version of those learned skills. It is essential to remind ourselves as preceptors in clinical training that we are not merely educating a student, but rather a future clinical child life specialist, and early education on burnout could have a significant impact on the success of a student. For those working with child life students, it is crucial to recall that while diverse volunteer, work, educational, and healthcare experiences are entry-level requirements for students applying for clinical training experiences, a foundational knowledge of self-care practices to prevent burnout is not. For many students, feelings related to burnout can even be seen prior to entering clinical training experiences. When sharing about her personal experiences with burnout during the Child Life Wild Life podcast, Jess Cheung’s feelings of burnout were noticeable as early as during her practicum application period and heightened as she progressed throughout her clinical training (Lewin, 2021.) For non-clinical and clinical educators alike, when providing education on self-care and burnout, the goal is not to eliminate the inevitable stress from clinical training experiences, but rather provide students with lifelong tools to better manage that stress.
Research has shown that “a child life specialists' unique position within a complex health care system places them at high risk for experiencing burnout,” and that “over half of child life specialists are found to be at risk for developing burnout” (Hoelscher & Ravert, 2021.) Programs should consider methods that could potentially educate and foster self-care in clinical training environments. Self-care for child life students and specialists alike should be treated as a preventative system, rather than one that is utilized as a response to stress. Engaging in self-care practices goes beyond simply “taking a break” and reasonably emphasizes the feeling that it is openly acceptable to take time for yourself prior to and in the midst of stressful circumstances. To foster this mentality with students, preceptors should consider having thoughtful and honest conversations with students throughout their clinical training about burnout and self-care and should process interactions that may elicit strong emotional responses as an incoming professional.
As a professional, at times it can be difficult to recognize that taking 5 minutes after a stressful interaction or intervention to sit down, have a drink of water, breathe, and process is a necessary skill. However, students can gain greater insight into moments such as these in recognizing your own limits and how to cope with those emotions. Preceptors should consider intermittently asking students about which self-care activities they engaged in each week and reflect on the effectiveness of those activities in aiding in their stress. Consistent reinforcement of purposeful self-care habits offers a space for reflection and application of these skills in a controlled environment during clinical training. At a program level, coordinators should consider the value of building in additional flexibility in hours for students in circumstances when half or full self-care days may be beneficial to the mental health of a student. Furthermore, integrating prearranged 15-30 minute self-care activities with members of the child life team, or a student’s direct supervisor, throughout a student’s clinical experience, could also be an additional opportunity for truly integrating self-care into foundational practice. For students lacking established in-house peer support from fellow students, this can also serve as an opportunity for creating an early established network outside of a student’s immediate preceptor. This not only offers benefits for the student, but also preceptors, while giving respite, differing perspectives, and team comradery to all individuals involved with student education.
The factors that influence a student’s success in preventing burnout at an early stage are not just of those that take place within the hospital, but also the elements affecting a student’s life outside of it. Students can face a range of factors that may contribute to additional stress during their clinical training. These elements could include relocation, insufficient or unfamiliar social support, financial uncertainties caused by an inability to work, health concerns or disabilities, a lack in diversity represented within the child life or hospital environment, and an inability to adequately practice self-care due to clinical and non-clinical workloads. Preceptors should be aware of these factors and evaluate their own biases when students appear overwhelmed or are unable to take advantage of additional opportunities beyond scheduled hours.
As educators, preceptors, and role models, we have a duty to the students we encounter to provide a foundational education on the realities of the child life profession. While this article is primarily focused towards those educating future child life specialists, all of us have a responsibility to accurately present all aspects of the profession to those considering the field. Each of us within the child life profession are able to recognize that individuals have more opportunities to establish positive coping when they are fully informed, given time to process, and are introduced to positive coping strategies early on. Kindling a student’s flame through educating, implementing, and nurturing self-care and preventative burnout strategies works to offer long-term solutions, beyond the classroom, in realistic clinical environments. By doing so, students have the potential to utilize an essential skillset in their life-long child life practice and allow their passion to burn during and far beyond their clinical training period.
Hoelscher, L. R., & Ravert, R. D. (2021). Workplace relationships and professional burnout among Certified Child Life Specialists. Journal of Child Life: Psychosocial Theory and Practice, 2, 15–16.
Lewin, J. (2021, August). The wild life of burnout as a student and professional with Jess Cheung [Audio podcast episode]. In Child Life Wild Life Podcast.
Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry, 15 (2), 103–11.