Time taken and given to C&YP in hospital is a rare commodity, I say this as in an ever changing and fast paced environment such as acute inpatient care- I believe it is, this is not to single out an individual , or team but an observation.
I have heard such conversations, they wished there was a little more time, to explain, adjust, prepare themselves as HCP's as well as their patients and families.
This is not always possible- what if it presents as an emergency?
I feel like I want to turn this on its head a little, so stay with me on this!
As a Specialised Play Practitioner I observe the impact a hospital admission or procedure has on C&YP when it is an acute admission or procedure.
All of a sudden they are informed that a procedure, operation or blood test needs to happen.
At that very moment- everything changes for them, their families and the HCP's caring for them.
As HCP's we don't always know significant history in terms of previous experience or trauma.
However I observe the fear, the apprehension, I listen to the questions, the slight adjustment in level of voices, pitch, volume- I watch intently to the change in size of their pupil reaction, the flushed colour in their cheeks, the silence that takes over them.
The body language, the breathing rate.
All this occurs immediately after they are told about the procedure- I call this the "golden 5 minutes"- in this time, whilst the HCP's are preparing themselves, as they too experience all or some of the above-the C&YP needs preparing- so how we manage this next episode of care is crucial for us as practitioners, and for the child or young person.
Simple language to explain "what happens next"
Words are so very important at this stage- how we describe things, there are some words that we should not use.
Key words are the only thing parents and C&YP remember, I discussed this during the week with a family, they shared with me " tube" " mask" " blood" " prick" being the most they remember in times of fear.
Tube, Mask, Blood, Prick.
This was a child who will have to come into hospital on a regular basis, for the rest of his life, and these are the words he will remember each time he prepares to visit the hospital.
What if words are not the medium- Photographs, drawings, signs, PECS (picture exchange communication system), Makaton , BSL and so on.
The "golden 5 minutes" should be for the need to know now information.
Why, What, When, How.
These are ideas, and a continual work in progress- because they can and should be adapted to each individual healthcare setting, and individual child or young person.
I should also say that I do observe, HCP's taking the time - and the results speak for themselves.
Change in practise, communication and preparation is always an adventure- it asks us to think differently, use words and language we may not have previously used ,or indeed how we would choose to describe events or actions, at times we might feel silly or self conscious, but we as adults can process that- C&YP cannot when fear and trauma takes over.
Recall what I said about turning this subject on its head........................ what would the outcomes be?
If we have a "golden 5 minutes" just imagine what impact that would have in "time" spent calming a child or young person down, when they refuse to allow HCP's to carry out observations, procedures, examinations?
Time spent encouraging a child to allow that process to happen.
If the "time" was there to prepare as HCP's then it should be there for the C&YP?
Health Play Specialists, Play Specialists, Play workers can be the time keepers.
We are also really good at sharing our skills and knowledge with the wider MDT.
Trauma in Children is a deep and ever evolving study and research experience, - when we meet C&YP and their families for the first time we do not know what trauma, if any they have experienced, or the family history, but research and studies show us that it impacts on their very being, and ability to cope with new experiences, and how we draw on those, the fight or flight we display.
There are many battles that our patients may have fought and won, there are also many that they are still fighting and living with on a daily and hourly basis when they reach us.
Play4C&YP will be taking a few weeks break, to recharge, to reconnect, and to read!
Recommended read................
Waking the Tiger= Healing Trauma
Peter A. Levine
Sian Spencer-Little
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