Small Change- Big Impact

Sometimes during the busy weeks that we have as HCP's we forget to provide the care for ourselves, to take stock, to take time and to really look around at the environment we will spend a lot of time in.

I recall some conversations this week with colleagues and with patients, about the hospital environment- and the impact this has on wellbeing and recovery.
We have recently spent lots of time, and with the help of some charity funding, looking at ways we can improve the ward and cubicle areas.

In my experience and from feedback I have received from C&YP who have to spend time away from home  in such a strange and alien type environment as a hospital- have shared with me how  this impacts on mood, recovery, communication and over-all wellbeing.
Anxiety is already raised- however if C&YP face many days in a cubicle - with limited visitors, peer conversation and socialisation and colour- this has a direct effect to how they cope with procedures and interventions by clinical and medical staff.
Some C&YP have expressed feeling isolated, unsure of what's going on outside the door, is everything ok.
While we cannot eliminate all those feelings- we can help to enhance feelings that will encourage recovery, create distraction and conversation, and lift mood.
The environments for C&YP have changed dramatically over the last 10 years- with research and feedback studies to tell us and inform us of changes that could be made.

For some change can feel unsettling, but change can be powerful, enhancing and inspiring.

We have made themes from blank wall spaces, taken favourite books and extended some well known phrases - added a few pieces of art , to bring a white wall alive with colour, words, songs, and spark imagination, communication and elements of fun!
Small changes, some paint, laminated sheets- and lots of bluetac, wipeable vinyl stickers, and a bit of imagination.

This week has also reminded me of the very reason I chose this vocation- from a very early age I knew what and where I wanted to work, how I wanted to carry myself as a professional , who I wanted to take on this journey, and the changes I wanted to make in order to enhance and impact the hospital experience for C&YP and their families.

I am sure we all can think of that person or place we have worked that has given us that strength to continue, to believe in what we do, to carry on.
I have read many articles this week about inspiration, the power of the voice, the belief to speak, the support received.
I have many that have inspired me, and each day I find inspiration lands upon me, from the C&YP I am humbled to share stories and experiences with,  from the families I support and meet, to the  HCP's I share my working days with.

However "Hunter" Patch Adams- remains very high on my top 5 list!

His work in America, and across the world with the Gesundheit Institute- pushes me to be a better practitioner. 
" What would you do if you had the opportunity to help someone?
Run toward or away from the suffering"

Time to Talk #TT

Time to Talk and Listen #TTL

As this week begins, having just returned from some much needed annual leave- it gives you time to stop, think things through and make a mental list of the things that might be different if we just took time to talk and listen.
This is a very simple way of showing we are present, willing to engage and ready to listen.
Not just with our patients, and families.


Time to talk with our peers, and professional colleagues- then time to listen to what is being said, just by doing that we could impact on that persons day in a positive way, empower them, support them, be alongside them.
The best team approach is..
"what would you like to achieve, work on, explore, or ask today"
Our goals can be so small sometimes, but just as important.
 Because of this we miss making them, all health care professionals have the ability to wear red shoes!!

When working with children, young people and their families I always allow some moments to observe, by standing on the touchline if you like, to watch the relationships between the nursing and clinical staff and the families between each other evolve.
During this time I can look for the subtle differences, the fears that bubble to the surface and the questions that they need answering.
My opening introductions are " Hello my name is Sian, I am not a nurse or a doctor, I am a Play Specialist" Then I wait for a minute.
" Some of the doctors and nurses call me a funny name- so I will share it with you, and you can decide- Its NutNut or Nitty NuttyNora"

I sometimes change this dependant on the age of my patient- but mostly I am always called NutNut! a bit like a spikey hedgehog, cute to look at, and hair that is spikey

" My role is to support you while you are in hospital, listen to your questions, I am honest and I never lie, because its important you feel you can trust me"

In a hospital or clinical environment it is always so alien like, add to that the stress and emotive feelings, and then you have a situation that is so highly charged its somewhat like a firework.

I wanted to share my  #TTL tips. These are not new ideas- but ones that support the many roles we have.

• Chatting for that extra 5 minutes- allows trust to build, information to be gathered and works out ways forward and a plan= win win
• Where there are accessible platforms- engagement and honesty are key elements to encourage working together partnerships.
• C&YP need a supportive place to be healthy, so they can learn about there illness, and ways they can manage it and care for themselves.
• There are lots of questions that need asking during an admission- bringing in a Play specialist can allow this process to be less overpowering, I always like to know the following.
• Favourite colour, music, toy, words, place to go, activity, holiday,
• Least favourite things.

This way we can use that information as a means of providing conversation and language that is not clinically based - it shows we are interested in them as an individual and that we listened and we are present in that moment.

I am then able to use these elements in any prep play or distraction I need to do.
I spend a lot of my working week, supporting emotional wellbeing, I share with C&YP - its ok to be scared, its ok to know it might be sore, or painful, its NOT ok to NOT say this.
It takes courage to be different, to say these things, to reveal wounds.
We all strive to enhance the patient experience with positivity and honestly, and a willingness to learn, each day.
We all strive to support each other, with care and compassion, support and a listening ear.
Final thought................
Creating memories, supportive work, being upset as HCP's makes us who we are, how we care and nurse, how we lead, and how we effect change, and teach others to do this to.

To Play or not to Play

    To Play or not to Play?

So here is the article that was published by Archives of Disease in Childhood (ADC) via twitter and the main website, and is what started this whole journey.
I have along the way made some amazing Twitter Buddies, and had support from the wider professional community, who continue to support, advise and champion the role of Specialised Play for Children and Young People within acute paediatrics.
Grateful Thanks go to ADC and Dr Hannah Baynes and Kath Evans for this opportunity and for highlighting positive patient experience and the importance of it within acute care.

        

Play in its most intimate of forms allows for free expression, exploration, joy, and excitement . For others it’s a welcome distraction. What makes play become a tool, a balance barometer, a universal subject, is when it is introduced or offered to a child/young person (CYP) who requires an intervention, treatment or one who is in the midst of trauma or a long term diagnosis.

Clinical settings are strange, sterile environments, where your senses are overloaded, where you become overwhelmed by people, sounds, smells and sights – it’s a wonder that play has a place in such a frantic space or moment in time, but it does. For the hospitalised child enhanced information of their condition can lower a child’s fear and the pain they experience.

We have a small window of opportunity to introduce, assess, build trust and explain our roles to a CYP and their family, this is about the patient experience, how I can improve this as a service, and what tools I can provide to enable a CYP to feel listened to during this meeting, and how we can do this as healthcare professionals (HCPs) in a way that is honest and in the present? As HCPs in acute settings this should be part of the treatment plan and process of supporting CYP and their families, the recovery and coping strategies put in place would mean “Whole Being Care”.

There are “Moments of Specialised Play” these can be mini sessions of introductory play in order to build and gain trust, to allow contact within a CYP’s private space, or there can be short nuggets of contact – for one off procedures. There are the “Journeys of Specialised Play” – when the child or young person lives with a chronic condition that requires multiple admissions/procedures – perhaps it’s at this point we introduce a long term procedure plan to support future admissions.

As HCPs the challenge now is to look at our approach to CYP. What do we need to do to gain skills in specialised play, how can it be done in a way that promotes and provides a more balanced approach to health care impacting positively on patient experience, through a CYP’s eyes, and are these methods and processes accessible?.

So next time you have contact with a CYP think about how you can introduce play into the encounter, access the Health Play Specialists, ask them to share their knowledge. The use of a friendly head made from a glove, a well-rehearsed joke or the latest App on your phone is a great way of showing that you are present, and that the experience matters to you, and that you are engaged and ready to listen. You may sing, laugh, or pull a funny face, have hidden in your pocket the most amazing stickers, or you may sit alongside a young person on the floor, and acknowledge that right now it is tough.
In answer to the question “To Play or not to Play?” Why not, simply “to play”.

Sian Spencer-Little
NNEB, Dip in Care, Cert in Therapeutic Play, Cert in Bereavement Counselling for Play Specialists.
Specialised Play and Activities Practitioner.
Children's Ward
Kings College Hospital NHS Foundation Trust

Dr Hannah Baynes
Consultant Paediatrician
The Hillingdon Hospital NHS Foundation Trust

What if?

C&YP- I wonder..

Just some thoughts- what if for every C&YP who becomes an inpatient we were to ask just one question, a question that would allow us some level of insight of the here and now- and a question that may show them we are present and engaged and interested in them.

I am not for a minute saying that the vast majority of us don't do this- but we are all so busy in participating in so many different levels of our job roles- that sometimes taking a moment is tricky.

So the question- What do you do that makes you happy and gives you joy?

As a PlaySpecialist this is something I ask quite early on in my introductions- it allows me to breakdown clinical walls, creating a non- threatening approach, in turn I can start to build trust, listen, observe and assess.

This may last just a few minutes- sometimes that's all you need to begin active and open lines of communication and listening. 

Play for Health

Sharing of Skills.

#Hellomynameis.... Sian, I am a Specialised Play and Activities Practitioner.
Having worked with  children, young people and their families for a few years now ( nearly 15yrs!) it always amazes me how much I learn each and everyday.
I am also very fortunate to have worked with, and work alongside the most dedicated Hospital Play Specialists, Nurses, Doctors and Consultants, as well as the amazing team that provide support and care for those patient's and their families.
The list is endless.
One of the reason's I am beginning this new phase of my work journey is to share ideas, thoughts and themes within my field of experience, to develop ways of working with and supporting children and young people during the hospital process.
Impacting on the patient experience, promoting working practises that highlight the importance of communication, clarity, working together and sharing that with the clinical teams, both in Paediatrics and Nursing- getting to the key issues that face children and young people.
What is important to them, what do they need from us, how does it feel to be in hospital.
These are the most important questions.
Along the way I hope to share ideas,  different ways of working, of asking the questions, of getting feedback and how this impacts what I do.
Taking my lead from those C&YP I have the privilege to care for and work alongside.

I do not know everything, I learn new ideas, communication methods and ways of working each day.
Together we may laugh, cry, share and teach, but ultimately we will empower and help shape and develop C&YP care and their hospital journey's.
#Hellomynameis..... is the most important way to start.

 

 

 

 

Well this is the beginning!! Not sure where we will travel, but lets do it togther, safely and more importantly think about how we as HCP can make a difference, create opportunities and above all enhance the C&YP patient expereince within acute paediatrics