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Beads of Courage Helps Tell the Stories of Cardiac ICU Patients

Monday, February 23, 2015

Every patient at Children’s National Health System has a story and sometimes they choose to animate them through the Beads of Courage® program.

Beads of Courage® was brought to the Cardiac Intensive Care Unit (ICU) at Children's National in 2009 by art therapist Heather Stemas, M Ed, ATR-BC, LCPAT, and is a collaboration with art therapy, social work, and child life.

“The beads appeal to everyone and when families start to learn more about the symbolism of the beads, they become a prized possession,” social worker Heather Langlois said. Langlois manages the Beads for Courage® program at Children’s National and is in charge of supplies and enrolling families.

Children in the Cardiac ICU endure many procedures and the beads help capture every visit, test, and milestone.

“It’s a beautiful way to capture the child’s experience. Every yellow bead was a night in the hospital, every black bead was a needle poke,” Langlois said. “Kids who are born with congenital heart disease have a lifelong condition, and some of our kids are so young that this is a way to remember and a tangible way to tell their story.”

The beads even help parents process the level of care their children receive.

“A lot of the time the congenital heart disease patients come over and have surgery soon after their birth and so it’s often the parent enrolling in the program for their infant. For the parents, it helps them to see what their baby has been through. As time goes on they can show their child what they’ve been through,” Heart, Lung, and Kidney Child Life Specialist Judith Ross said. “It touches their heart and means so much to them. It gives the parents something to do that’s concrete and share with others what it means.”

Ross and Langlois admitted that older patients in the program remind them when they’re behind on receiving beads for procedures.

“I think the kids, once they’re older and know they’re getting beads, it helps them own their treatment a little more and understand their condition a little more. And that owning and understanding what to expect is really important,” Langlois said.

The beads represent the strength, stamina, and courage of what each child has been through with their illness. One of the first beads a child receives is an acorn-shaped bead. The symbolism of the acorn is that it grows into a mighty oak tree and that represents a patient’s strength.

“There’s also THE bead of courage, and it’s a glass bead, chosen by the patient that represents something very difficult and it represents that they came through on the other end,” Ross said.

Beads of Courage® Meanings:

  • Black – needle poke
  • Yellow – overnight stay in the hospital
  • Blue – clinic visit
  • Red – transfusion
  • Light green – test, scans, etc.
  • Aqua – tube insertion
  • Tortoise and glass – cardiac catheterization
  • Glass star – Cardiac ICU admission
  • Glow in the dark – echocardiogram
  • Purple – infusions (antibiotics, pressor support, etc.)
  • White – learning new medications 
  • Handmade glass heart – heart transplant

Langlois said the beads help kids talk about their condition with others, and one patient even took her beads to show-and-tell at school.

“Owning your story is best way to become your own best advocate,” she said.

Beads of Courage®, Inc. was started by Jean Baruch, an Arizona nurse, in 2003 to help patients and families cope with serious illnesses.


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