Engaging Souls.

I often spend moments reflecting on the weeks events, of the things I have observed and listened to, of moments I have been part of.
Some of these things, stay with me for a while, and some impact on my practise, and on my very being.

I have shared with learned colleagues this week, the "small stuff" with the most "powerful punch", and how that challenges others.

How small droplets of attitude change- can become down pours of happiness and compassion.

From as early as I can remember - Kindness, Care, and Compassion where words that I felt I could be part of.

They were of the very essence of what I wanted to achieve in my working journey.

 How my working journey, actually defined who I am, and what I stand for, of how I want to be.

It is me, if I were a cake, and you took a slice, I would hope that you would see that for yourselves.

If we look at some of the words to define Compassion- it encompasses care, concern, benevolence- I want to share my definition.

To offer, time, care, understanding.
To be alongside someone on a journey, of the twists and turns that road may take
To provide a space, to be, to explore feelings, both positive and at times destructive- and to support that.
To celebrate the good, to acknowledge the tough stuff.

Others who go to work, do their tasks, and then leave at the end of the day- they struggle to appreciate or understand someone who - to some degree is always working, sharing skills, talking about their vocation, and it is just that a vocation, a way of life for me, its what I feel I am here for.

We all have experiences, that shape who we are, how we react, how we behave, so its really up to us to chose how this effects us as human beings- how we pass on the baton.
You may wonder - what does that have to do with Engaging Souls......

My soul has been filled with wonder, care, love, warmth and moments of laughter and light- but equally with trauma, sadness and darkness over time- but I choose to use all these elements to teach and to share- sometimes it is exhausting- but also excelerating.

I also want to acknowledge how difficult life can be.

This week I found my voice.

I was able to lead my very first- Engaging Souls Teaching Session- I call it this because I had hoped that it would have this effect- I was fortunate to meet a cohort of student nurses- over 60 of them!
I was unsure of how they would respond to my style of teaching, and sharing of experience and skills.
I spoke about a subject that has great meaning for me- it shapes me and underpins the type of Healthcare Practitioner I strive to be.

Specialised Play- the impact on the child.
How we as HCP's  can shape a hospital experience.
What can we do to support preparation of the hospital experience.
Specialised distraction techniques that we can.

The buzz in the room was electrifying.

The students were engaged and showed amazing skills- we talked and discussed hospital experiences, and together shared skills.

They also came along for the creative ride with energy and drive- and showed great respect and care for each other.

Feedback is so important for the trainer- Thank you.

An Engaged Soul HCP.

 

 

"Hunter" Patch Adams, always shapes the tone of the training, of always seeing the person, not the illness, or disease.
As HCP's sometimes we loose that essence ........ I am just trying to help and support us to find it, and for it to shape healthcare for children and families.

I talk about the Patient Experience all the time, about listening, about opportunities to seek feedback, and how this can in time change processes.
I feel very proud to have met the students this week, I thank them for their time and enthusiasm, their honesty and their engagement.
I feel empowered by the support of my managers- to deliver in the way that I do and for the opportunity to share.

Engaged Soul HCP's Feedback.

 

 

Just take a moment - look at the expression on the face of the next generation of HCP's, of how we can evoke those emotions, and how the "small stuff" packs the punch, effects change, and impacts on the experience for our patients.

 

Sian Spencer-Little.

Specialised Play and Activities Practitioner.

 

What fills you with Joy?- Impact and Feeling

This week I have thought about how we describe joy, the essence of it, how it makes us feel, and what impact that feeling has on us.
How do we ask C&YP about this?

Joy- A feeling of great pleasure, and happiness.

Does limited joy impact on how we feel each day, how we cope with things when they are tricky, does it allow us to take a breath, or do we struggle even if we think we have it- but it's so hidden that the struggle in finding it is to much.
For C&YP that have experienced loss or fear, to ask them what they do that gives them joy, perhaps is the hardest question to be asked, in fact some might think that it is wrong to ask such a question, because in some way you are not respecting or honouring the loss- I feel to honour and respect, you must listen and there must be hope, that through sadness and the darkest times, there were moments of joy, and that there will be again.

Flowers, colour, art, music, smells, food, texture, photographs- all evoke deep feelings- can joy be found in these?

Each day I do my best, and each day I strive to make a difference.
The following day I strive to do my best, again, and so on.
This week I had the privilege to support and work alongside a young person who was facing a challenge.
Several years of ill health and lots of tests had left a impact on this young person, the ability to identify happiness and joy was the challenge, the question had never been asked before.
Initially - I received some strange looks........... but I continued to support this pathway.

The reason I asked - I wanted to empower this young person to draw on joy, happiness and the feelings these evoked, to celebrate these "moments of joy" and use them to support energy levels, pain management and relief and strength to ask for support.
We spent several "bite sized sessions" together, talking through what was joy, and how each person found it.
I was asked if there was such a thing, and how could it possibly help me, "I have been living with this illness for 8 years".
During these "bite sized sessions" I listened, I was present, I never once interrupted, there were moments of silence, they did not need filling, and slowly I built trust, I showed understanding and I shared my "moments of joy"

I was able to do this- as I too understand the world of living with a disability, of challenges, of changes a person has to make.
It is not very often that you feel as a HCP you are able to share such intimate parts of your life with a patient, but when you work alongside C&YP it becomes who you are and how you work.
As we know C&YP are honest, they ask questions, and I am always honest- no matter what the outcome or impact.

We discussed happiness, the feeling this gave, the colours used to describe happiness, how did our facial expressions change when you had a "happy thought".
Slowly together with family members we begun to build a "Tower of Joyful Jenga" , music, activities, food- all things that created happiness and a feeling of joy.
It all sounds so simple- and yet so difficult all at the same time, to plug into a C&YP's deep emotions and feelings is not easy, but then again, how easy is it for them to share that with HCP's.

I ask a simple question to open up conversations with C&YP
" what do you do, watch, listen to, or experience to give you a deep sense of joy"
As HCP's we need to be ready for the answer- to support the journey, and not always want an outcome, but to have the conversation- as this will be the start of their journey.

This week I have read many things, some joyous, some remarkable, some uplifting, powerful and upsetting.
I have been amazed at strength and astonished at bravery. 
I thank them for their honesty, and for the impact sharing their story has had.

I have also been asked to share my work, and how I ask those difficult questions, I feel at times overwhelmed, but also joy in the fact that I may just share a little joy with someone else.

My shares for this week..... Thank You for your honesty and for sharing- the impact you have is priceless.

Mefirst.org.uk- brilliant resource for HCP's - and a platform for C&YP.

The Brandon Trust- visited an amazing photography exhibition in London celebrating the trusts work and promotion of positive and freeing change in disability.

Headspace-perspective.com - Raising awareness of birth trauma, and premature babies, and of life and loss.

Towers of Strength- Jenga Style.

So having spent a day yesterday sharing and listening to real time feedback from children and young people on the subject of communication- from other HCP's and the fantastic mefirst.org.uk 

I am re-posting the Jenga Blog as it resonated well with the subject matter.

Please take the time to visit mefirst it's a fantastic resource and a way of opening up conversations - good meaningful conversations with C&YP - involving them in their healthcare, their journey,

Time this week has been also working alongside both clinical and therapy teams.

We have been discussing particularly what it's like being a young person now, the many stresses and worries we see presented to us- and the ability to be able to sign post and offer support.

Our "Bucket of Well Being" wall has had some really positive feedback and I have observed many young people as well as parents - spending time looking at the display, without worrying if any of the team were suddenly going to ask them any questions.

We chose the place on the ward which had privacy and wasn't overlooked that way time could be spent.

 

When I offer support,and work alongside a young person, I always share with them that I work honestly and with permission from them I will share information with the clinical team to assist them in working together to a good outcome- a shared working group with the YP and the team.

I often talk about a "Jenga Tower"- when C&YP are struggling to share worries or anxiety so I thought I would share it with you.

• Sometimes in our lives we carry a few pieces, our support networks help share the load and add a few pieces so we build a tower that is strong, supportive.

• Then an event, or need to deal with an significant issue, or a worry happens.
• Sometimes we feel it's coming, other times it sneaks up on us.

• Our "coping tower" stands tall, it may wobble, but people around us bring re-enforced blocks, that may be family, or friends.

• But sometimes we don't acknowledge worries, especially if we feel they are small and perhaps insignificant, or that we do not know where to take them.

• Those small worries are like a little seed, and they grow, they grow under the "coping tower". 

• They get bigger, even though they started off small- and with this the worry builds and the "Coping tower" wobbles.

• The worry now starts to remove some of the blocks - and you carry on a little unsteady- but ok.

• Then for example- you have an exam and have to study- or you have a disagreement and you worry a bit about that.

• The "coping tower" now leans a bit- and the first worry is growing- a few of the blocks are very loose.

• Now you are feeling unsure of all the worries that seem to be getting bigger.

                                      Who can you share this with?

• Then the "coping tower" looses a block, and you find yourself unable to make it stable, and your strong blocks - well they just don't know how to help-  and you suddenly find that you are alone- and have lots of feelings and thoughts.

                This may be the reason you find yourself at the hospital as things have almost  become impossible, and you react in a way that frightens you and your friends and family.

As health care professionals we can support the "coping tower" to build strength, and signpost C&YP to others who can help.

I use this over a period of time during relaxed creative sessions sometimes in the playroom or school room, or at bedside.
Our C&YP have to deal with so many influences many positive, some negative, some confusing and some they just are unable to deal with alone, as HCP's we have an amazing opportunity and honour to walk beside them during this part of their journey.

This week has seen much "Twitter Power" sharing the #CYPexp, with young people using their voices,sharing artwork and feedback with HCP's.
It has been amazing to watch from the wings at all the positive energy support from many HCP's including Head of Patient Experience for Children, and Maternity Services at NHS England, @kathevans2 and @_common_room with an amazing resource-  
mefirst.org.uk - which is dedicated to improving communication between HCP's and C&YP.

It has also been  a week of kindness, care, compassion and engagement, and professional friendship,building these are the values we all hold dear and support us in our work, Thank you  @johnwalsh88 and all the HCP's I have been chatting with.
 

I look forward to the next few months.
 

Final thoughts........

The imagination of two 8yr olds.

Mr Jelly the Jellyfish 

Doug the Dragon

Bob the snail

The fish with no face called Plaice!

Childhood, Compassion, Care, Resilience #CCCR

Many words would describe a environment that supports development, encourages growth and learning, listens, shares, and celebrates achievements.
The idea that a health environment should incorporate these, enabled me and directed me to a career in care, in compassion- to offer support when C&YP and their families needed it the most.
It began in acute nursing, and took in early years, primary health, child protection, and paediatric palliative care.
I have been a care giver and received care, and had the opportunity to make a difference at the very beginning of life and at the very end- and feel humbled and honoured to have done so.
This week I have thought a lot about Person Centred Care, about compassion, the roles I have worked within and the teams and fellow colleagues I have worked alongside.
I was thrilled to attend my first debate at London's South Bank University, with fellow colleagues and professionals working in and interested in the NHS, and posed the question "Is Health and Social Care person centred?" , it was also a huge pleasure to meet Kath Evans, and John Walsh.
I wanted to share my views, the experiences of care, and what I felt PCC ( person centred care) was.
I listened intently, to both sides of the debate, I acknowledge the need for changes, and that this should be recognised, the impact a reduction in services and staff can have on PCC, but more importantly the impact on the child, the young person and their families.

It was an impassioned debate.
So I came away thinking about a PCC 10 point Care List, which can easily be added to-this is with C&YP and their families in mind, but is multi patient use.
Its like the 6C's- a extension of it.
These are some of the things I think about when I approach and work alongside C&YP.

• Being present in the moment.
• Listening to the thoughts of C&YP and those they may share.
• Observing behaviour and the reaction you give, how you communicate your reaction.
• Individual needs
• Support
• Care
• Respect
• Plan
• Sharing
• Recognition

It was also an important week on the ward.
 For some time we have wanted to acknowledge some of the issues raised by C&YP - some of the issues they find the most difficult to cope with during the sometimes bumpy road through adolescence, the things important to them.
It is difficult sometimes to imagine the impact a loss of confidence can have, a lost friend, isolation and workload.
With the help of literature from Young Minds UK, and PAPYRUS, and a much better artist then me! ( Lucy U ROCK!)
Here is our Resilience display- with our very own "Bucket of Well-Being"
We adapted this - so it highlighted key elements shared with us.

 

This is collaborative working at its best, Specialised Play and Education.
Supporting new ideas, ways to communicate and support new ideas, just because we have always done it, does not mean things cannot change and be developed.
This week- Things I have learnt...................

1. Kindness
2. Trainable Triangle of Care.
3. The need to change and recognise the change.
4. Sharing and celebrating achievements.
5. Listen to patients voices, and experiences.

My word of the week.... Communication 
My share forward resource........ www.mefirst.org.uk
My thought......... How quickly we forget the magic of Childhood.

Sian Spencer-Little
with thanks to Lucy Haslam.

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