E - Early days of play for children in hospital

Recently, I dipped back into the 1970s archives and looked at early work on play for children in hospital. Information unearthed was about the importance of play, the role of play workers/leaders and why play workers needed to be established as a paid profession as well as allocation of space for play.  Silvia Nash outlined a 1970s view of the role of play workers who have a primary concern for the emotional needs and development of the child. The play worker helps and encourages parents and families to support and participate in the care of their child acting as a buffer. Play workers explain treatments to children to fit their understanding and support nursing and medical staff. In the UK, the National Association of Hospital Play Staff has documented milestones celebrating 50 years of work.

In Canada and North America child life programs were designed to meet the social, emotional and physical activity needs of children in hospital and to help children and their parents adjust and cope with illness. Hospitalized children need the continuing presence of someone important to them, as well as a rich and stimulating environment and opportunities for exploratory behaviour and play. The Child Life Council has produced a timeline and history of the profession.

In 1976 AWCH held a seminar Play in Hospital, a first in Australia. AWCH was instrumental in bringing together a wide range of people, making recommendations for unified guidelines and including roles and training. AWCH went on to write a Policy relating to the provision of play for children in hospitals in 1986.

A new beginning for the profession in Australia took place in 2015. The evolution of the hospital play profession in Australia was celebrated during Child Life Therapy week including the launch of a new name and website. Look to the Association of Child Life Therapists Australia as the peak body of health care professionals specialising in child development, who utilize their knowledge and skills to work with children in the hospital…. ACLTA has produced a short history of hospital play in Australia.

Early days and resources at the AWCH Child Health Library

AWCH Child Health Library holds foundational resources including:

• Working with children in hospital by Emma Plank, referred to as the mother of the profession
• Child life: an overview & Child life activities: an overview published by ACCH
• The under fives in hospital: a report on their emotional well-being published by AWCH
• Hospital: a deprived environment for children? : The case for hospital play schemes, by Save the Children
• To help prepare children for hospital, the 1972 Paul in hospital, shows photos of a child in an oxygen tent

Important resources that identify the needs of children in hospital

• Platt report, which includes information on the importance of play
• A two year old goes to hospital, DVD
• Marking the 50th anniversary of the Platt Report: from exclusion, to toleration and parental participation in the care of the hospitalized child.

Recent resources available for loan include:

• In sickness and in play: children coping with chronic illness
• Therapeutic activities for children and teens coping with health issues
• Richard Thompson’s Handbook of child life and the Child Life Council bulletin

 Related resources can be borrowed on preparation for hospital, relaxation, mindfulness, coping with grief and living with serious illness.


Jillian Rattray
AWCH librarian
http://Library.awch.org.au
May 2015

F is for Feelings - from fear to resiliency

It can be hard for a teenager when her peers move from the excitement of “can I sign your cast” to “it’s really going to hurt when they take it off”?

Fresh out of a visit to hospital with my daughter yesterday, I’m reminded of the importance of feelings. It seems all too obvious, that a trip to hospital will result in feelings of anxiety and fear.

Photo from: http://www.clipartpanda.com

Yet my thirteen year old had shown stoicism from the outset of breaking her arm. She picked herself up and trudged across the sporting field asking for her water bottle. Meanwhile I hastened to keep up, asking her to slow down. Over the weeks she coped with waits at two hospital emergency departments, an adult’s hospital and a children’s hospital, then repeated waiting at orthopaedic and x-ray clinic queues. She had it down pat and knew where to go and what to do, seeing herself as one of the many other children waiting for treatment.

There were certainly challenges along the way, worst being no food or drink and for me watching the pain under gas as her arm was manipulated and put back into shape. Once again I had to hasten to keep up as she jumped up after the procedure to head off to make an appointment at the orthopaedic clinic. The only sign of something being wrong was the cast from wrist and over bent elbow.

Later that night the pain and challenge of sleeping with a heavy bent elbow came. This was followed by challenges of dressing, washing, undertaking school work with her weak arm and carrying a heavy  bag which included books and a laptop. Transport on the bus with kids pushing and pulling also led to pain and concern. Despite all this she managed to walk, run and dance her way through the weeks.

Photo from:
http://www.kleurplaten.nl/kleurplaten/12308.gif

So where in all this resiliency do fearful feelings occur? It can be hard for a teenager when her peers move from the excitement of “can I sign your cast” to “it’s really going to hurt when they take it off” and so the stories begin.

I wasn’t prepared for my daughter’s sleepless night that preceded the day when the cast came off or for the impact of some of the “kid-fabricated” stories.  As we waited one last time in the waiting room she was distracted by the funny things around her, a parent talking to their young child about what was on TV, “look there’s a penguin with a rainbow coloured beak”, no it’s a puffin she thought! Just when things weren’t looking good she was called up. One boy had cheered earlier when his name was called, adults chuckled, a moment of relief.

Photo from:
http://www.123rf.com/clipart-vector/zombie_arm.html

What made the difference to my daughter’s trepidation were the explanations health professionals gave. Speaking to her and demonstrating the procedure of having the cast taken off made all the difference. Phrases like “what you can expect”, “what you might expect” were really helpful. She even smiled as the cast came off. She was glad her arm was not green.

Being “armed” with information makes all the difference. The first test of this was as she reluctantly passed by the swings on our way to the car. It was great to know that she understood and can resist the temptation to hop on a swing, bike or other moving object.

How can books and resources help?

As parents, we won’t always know what our children are feeling. The AWCH library holds books to help adolescents and children understand what they are feeling. There are books written to help children identify and manage how they are feeling so they can develop self-esteem and coping skills.

 A book to help adolescents is the Stress reduction workbook for teens: mindfulness skills to help you deal with stress. Teenagers can use this easy to read workbook with activities to develop an understanding of what stress is and how to live in the present moment, “mindfulness”. They will gain a sense of control over stressful situations and develop resilience. 

 

There are books too for school children such as Relax, which teaches relaxation techniques or Be the boss of your stress : self-care for kids and Be the boss of your pain: self-care for kids.  

Nowadays there are plenty of online resources to help children and families prepare for hospital experiences, an example for young children is the child-friendly free app Okee in medical imaging. This fun app will help young children learn all about medical imaging and feel relaxed and supported.

Help! My Child’s in Hospital has practical advice for parents on preparing their child for hospital. Visit the website to find out about other families experiences.

Everybody stay calm: how to support your young child through medical tests and procedures will also help families prepare. These books will help parents with practical skills to support their children through stressful times, so they gain confidence and better health.

So I invite you to borrow a book and be well prepared for that next encounter with the doctor, dentist or hospital.

Jillian Rattray

AWCH librarian

http://Library.awch.org.au

April 2015