How specialist team is helping to make a hospital visit child's play for little ones

A hospital stay, whether emergency, routine or long-term can be a distressing time for children and parents alike. Jenny Lee discovers how hospital play specialists are making a visit to hospital a little less overwhelming for all concerned

Gillian Knox, hospital play specialist at the Royal Belfast Hospital for Sick Children Picture: Mal McCann

PLAY isn't the first thing you associate with a hospital visit but a recent visit to Craigavon Area Hospital with my four-year-old daughter for a day procedure opened my eyes to the power of play for distraction and putting nerves at ease.

I came armed with a backpack of books, dolls, toys and an iPad – but I didn't really need any of it. The first thing my daughter was given when she arrived was a box of crayons and a choice of pictures to colour in and happily got to work on her poster of Disney's Queen Elsa. Jigsaws and games followed, while blood tests, pulse and blood pressure were taken half hourly. Then, before discharge, she enjoyed an hour playing in the toy room under observation.

The need for play is now widely recognised as being particularly important in a hospital environment where the child is exposed to strange sights, sounds and smells and children are dealing with emotions of fear and anxiety.

The Royal Belfast Hospital for Sick Children, which has 107 beds and last year treated just over 33,000 outpatients, has a team of 15 hospital play specialists, assisting the team of doctors and nurses.

I visited the hospital to meet some of those involved and was amused to discover they all carried around a bottle of bubbles in their pocket. Bubbles are one of the most important tools in this vital role because as well as being a fun distraction, the blowing controls a child's breathing and regulates their heart beat.

"We believe children have the same right to play in sickness as in health. We want the children not to be anxious and to make their memories of hospital a positive one," says Jenne McDonald is paediatric services manager.

As well as normalising the environment, play is vital for development and learning for long-term patients, for distraction purposes, particularly in A&E and in preparing children for surgical procedures.

"If you do not prepare children in an age-appropriate way, they imagine all kinds of things are going to happen," adds Jenne. The hospital use various tools for this including role play on adapted toys, photo books and even a virtual reality app designed to ease patients' fears ahead of MRI machine scans.

Some children are regular visitors to the hospital, such as those who attend four afternoons a week for kidney dialysis and, as well as static toys, there is a constantly evolving art and craft programme with even jewellery making and iPad animation workshops.

With Christmas coming, there will be visits from pantomime cast members and, of course, Santa, with special first Christmas photos taken of the sickest babies who will be spending their first Christmas in hospital.

Many of these children are in Clark Clinic, where they spend on average eight months before being well enough to be transferred to Birmingham of London for life-saving heart surgery. Gillian Knox is hospital play specialist on the cardiac ward and she highlights how parents also benefit from their work.

"Because our patients here are so sick, parents often focus on the condition and medicines and forget about their child being a child. Play brings back the normality.

"Stimulation is limited with babies who need to put on weight in order to be fit for their operation. It's a long day sitting for parents sitting at an incubator and we offer a friendly face to chat to and to help them when talking to other professionals such as social workers or physiotherapists."

Gillian also runs a new clinic, in association with the Heartbeat Trust, for children preparing for a hospital admission. The clinic is run jointly with with a specialist nurse; Gillian plays games and does art projects with a child, helping to alleviate any anxiety, while the nurse explains in layman's terms the child's forthcoming operation.

Another specialist clinic, held by outpatient hospital play specialist Paulette Martin, is for needle-phobic patients aged between four and 18, and is the only service of its kind in Ireland. Patients who are referred and can be so fearful of needles that it causes extreme sweating and increased heart rates.

Such phobias can effect many aspects of young patients' lives.

"I've had patients that have had a bad experience at 10 months and being held in a certain way can trigger bad memories and severe reactions, to the extent they can't get their hair cut or shoes fitted," explains Paulette.

The clinic involves the child attending three one-hour play therapy sessions. Each child is given an individual programme, where they go through their past experiences and are desensitised to the materials used.

Play specialists are especially important in preparing a child for surgery. Sonya Quail Mease is one of two working in children's theatre.

"We will see patients on admission and follow their journey through to theatre. We use play as a means of developing trust with the child and then prep them for surgery."

This is done through picture books and by using a specially tailored tablet on which the children can watch an interactive cartoon character journeying to theatre – and even by decorating the mask they will use for anaesthetic with stickers.

"I give them coping strategies, such as blowing bubbles through the mask. In theatre you are not in control of the situation, but if I can make a child feel part of the process, it helps them manage the situation better," adds Sonya.

Before entering the operating theatre, the children spend about 15 minutes quiet time with their parents in the theatre play room. This area has a variety of toys form a table football, farm set and princess castle, through to a sensory light tube, a dark den and images being projected onto the ceiling, particularly designed for children confined to a bed trolley.

"Parents enjoy the sensory experience of the room as they are apprehensive themselves and it gives them quality time to spend alone with their child," adds Sonya, who accompanies the child for anaesthetic and occupies them by playing games on an iPad.

And the perfect games to play during the 50 seconds it takes the anaesthetic to work?

"Free flow or Lego Quest for the younger ones."

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