Therapeutic play – celebrating Play in Hospital week

Play has that power, through nonsense, to soften hard edges and warm the cold moments and offer a ‘what if…’ where previously only inevitability existed.

Play England’s new Trustee Laura Walsh is Head of Play Services at Great Ormond Street Hospital for Children NHS Foundation Trust. With Play in Hospital Week starting on Monday, here she talks about the professional development of therapeutic play and the crucial work of Health Play Specialists in the lives of children and their families.

Play in Hospital Week – now in its eighth year – is a celebration of the importance of play in hospitals. NAHPS (The National Association of Health Play Specialists) leads and coordinates this opportunity for Play Teams across the country to demonstrate the wonderful work they do. And it is wonderful work for sure. NAHPS exists to promote good quality and appropriate therapeutic play provision in healthcare, they administer a registration of professional qualifications and provide an annual conference as well as other learning opportunities.

Children receiving medical care back in 1930s or 1940s would have been treated as miniature versions of adults: parents were not welcome in the hospital setting and frequently children and adults were treated together without any consideration of the impact it might have on a child to see distressed or delirious adults receiving medical care. Children would often be left in isolation with nothing to relieve the boredom and anxiety of a long hospital stay, as Cath Hubbuck explains in her book all about the importance of play for sick children (‘Play for Sick Children,’ Hubbuck, 2009). Work done in the mid-1950 concluded that childhood should be recognised as distinct from adulthood and young patients should be considered differently. This has continued to be an area of growth in understanding and it is since been written into care standards. Now, children must have access to a) their primary carer while in hospital and b) play opportunities, as they would at home.

Why is play important in hospital?
In hospital (children’s hospital or paediatric ward) there are usually connotations of negativity towards illness: they’re generally places you go when something is wrong – albeit with the intention of making it better. Play is the thing that keeps children excited to go back to hospital for that unavoidable scan because they will be able to play with the member of the team they know well there. Moments of play and connection are able to persuade children to take the medicine or hold still for that blood test. That’s so important because when something is made fun it no longer seems so worrying or scary. Mary Poppins had the right idea when she said “Supercallifragilisticexpialidocious”. No, not that one! When she said…”in every job that must be done there is an element of fun”. Play also relieves the sensation of waiting, reduces the amount of perceived pain and speeds up healing times.

Currently there are a number of charitable organisations which align with and recognise the need to lighten the anxiety children and families can feel as a result of hospitalisation and medical procedures. There is clear synergy as Play Staff are able to focus on building meaningful relationships with children while the charitable organisations often support those aims, carrying out their own fundraising and supporting hospital staff to achieve the objective of bringing play opportunities, activities for diversion, characters and games to delight and enchant children while they are in hospital. The Starlight Children’s Foundation is one of these charities and they support Play in Hospital week.

Across the country hospitals will be participating in PIHW, celebrating every-day heroes and highlighting some of the typical playful moments and types of play activities that happen in the hospital. For instance, activities such as medical play – often a favourite choice of children’s – help them to feel a better sense of control over their situation through demystifying the materials that are used. This can be using syringes or cotton buds to paint with, or mimicking real acts with surgical gloves swabs, cotton balls and tongue depressor.  Playing  at taking bloods as doctor and patient allows children to take power away from the fear attached to those procedures in which they are powerless. We as sensitive adults have a responsibility to allow children to redraw the boundaries and play with these power relationships. Play has that power, through nonsense, to soften hard edges and warm the cold moments and offer a ‘what if…’ where previously only inevitability existed.

Playworkers were introduced into hospitals many years ago and eventually a specific qualification for a Health Play Specialist (the title later changed from Hospital Play Specialist) was created, validating the use of techniques which had play at their core and therapeutic effects. The qualification recognised and brought together the body of knowledge. It also standardised the delivery as well as enshrined a sense of value for it as a profession. Today the qualification is a foundation degree delivered by NESCOT (North East Surrey College of Technology) which supports students to learn the techniques of preparation for procedures and distraction (while procedures are happening) as well as techniques and theories of sense making after a procedure has happened. With all of these tools – a mixture of theoretical and practice-based learning in the workplace, and a mentor – they are ready to fly solo and continue the journey of growing and developing their practice which demands skills of critical self-reflection, empathy, sensitivity and wisdom.

This October 8th -14th keep your eyes peeled for signs of celebration of play in Hospitals and if you are lucky enough to know a play specialist – high five them today!

 

To find out more about Play in Hospital week visit https://www.nahps.org.uk/play-in-hospital-week/

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