A Silent Wish.

When those around us need help

When those around us are in pain.

We should listen for the sounds , when they ask again,we should watch for the signs.

For we may have missed their silent call for care.

We may have missed the very essence of their need, and slowly they disappear.

They may be our patients, they may be our colleagues.

 It could be us, as we send a silent wish.

We all spend so much time - reaching out with kindness and care, that even in the deepest times of despair and discomfort - we miss the importance of what is being said.

I have spent many months this year calling to my colleagues, picking up the banton of patient first and experience-  waving it frantically at times.

Sometimes it is taken and great things have happened- and at times it has fallen to the floor.

Over this last year there have been huge strides, and there have been times for me that have been so difficult and distructive, that some days I have felt like I have carried the biggest of boulders in my bag.

Throughout the year I have grown, discovered a strength deep within,that I didn't think was there, have collaborated with inspiring peers- and have learnt that being true to what you believe and feel is both freeing and frightening in equal measure.

I recall a conversation with a family. 

"You see Sian it's easy to "act" like you are giving the best performance of your life, but really you want and need the permission to strip that costume and at times  feel naked and all consumed in order to let it all out"

I thought about how honest this family had been with me- how trust plays a huge part of patient care and support.

Then I reflected on my month, my year.

I thought about how do we really allow families to feel free enough to be able to strip away there performance - and allow us to see the core of need.

I haven't got all the answers- but I know that one way could be providing an environment that allows honesty and opportunities - that listens and that doesn't promise the magic wand action.

I have been reading lots and collaborating with great minds- I have also been listening - and taking time to explore authenticity- and how this impacts patient care.

My silent wish for the new year- to continue with planting those seeds- of providing them with food and fuel- of nurturing them and supporting the start of the growth.

Wishing you many moments of peace, joy and happiness in equal measure.

Sian.

Conversations that matter.

"Vulnerability is not a weakness, and the uncertainty, risk, and emotional exposure we face every day are not optional.
Our only choice is a question of engagement."
Brene Brown 2012.

When we work with and engage with children, young people and their families we are seeing them at there most exposed, raw, and vulnerable.
As health care professionals, we may walk alongside them, to offer a hand or to simply listen and to help carry that emotional suitcase that is at bursting point, but we do not have the power to make everything better- for it all to go away.

But we can impact the experience.

It is at this point we engage with them, and those first moments need to be as honest and kind as possible- however having walked alongside many I feel that as an individual I have to also be at my most exposed and at times vulnerable.

I don't know what they will ask me, or what they want help and support with?
I don't know what path we shall walk, and if there may be many twists and turns in it.
Brene Brown  talks about choices and Daring Greatly- I feel that as an individual I dare greatly most days, I also observe my colleagues do this sometimes on a hourly basis.
As health care professionals we have codes of conduct, pathways and policies to follow that are there not only to protect ourselves - but also to ensure the safety of patients and clients we work with.

But they do not mention over exposure or vulnerability as we would understand it- so we have to make sure we have pathways in place to support us as professionals. 

But sometimes we are thrown curveballs- and we don't see them coming,  however experienced we are.
Having conversations that matter are all exposing and engagement is the key, without it the most important elements are missed, and the family or individual you are caring for also gets lost in the unknown.

I recall some recent conversations with a family, the things that matter, the vulnerability of the conversation - the courage shown to talk - and to say the most emotively charged things, in a space that can be held- in the middle of a busy ward environment - it was not easy, but it was spontaneous, and organic in its content.
How do we know what to do and say in these moments?

I can only share my experiences- and over the past few weeks I have had to spend time looking at my vulnerability and to not be afraid of it, to have the courage to expose it to some of my colleagues.
It can sometimes be misread, it is can also at times become over consuming- and feels quite alien to me.
To feel in a vulnerable state, also throws up feelings of anxiety, being frightened, out of control, unsure, and can be exhausting.

Recalling tough conversations that matter with children and young people, and their families, these feelings are expressed in many different ways, but when striped back their sense of feeling exposed and vulnerable- translates into fear and anger as they are unable to control what happens next.

Conversations that matter can be minutes in length, seconds, it can be a comment as you engage in an activity , whilst doing observations, walking past- but the impact may be powerful.
Over the last 8 years- I have watched as large groups of doctors approach children and young people at bedside.
Those that decrease in size.
Say hello to the child/young person.
Ask how they feel.
 They are the ones who dare greatly, and have courage to hold the vulnerable - which equally transforms the relationship, the art of it.

The parents and families we work with are exposed to the very core.
 To have a sick child in hospital, and not know what's happening- or what day of the week it is.
 They have emotional suitcases that are bursting at the seams.

In order for us to support them, we need to be supported.

Vulnerability is not a weakness, it is a true strength, our children and families will feel a great sense of this when in hospital- so our conversations that matter will invite that strength to be exposed, and we will do our best to bring purpose and meaning to events for them- hearing the unheard, and being ok with that.


Sian Spencer-Little.

In Health, In Trauma, Play is essential.

Play is an essential component, it is instinctive and powerful- in the development of the whole child and must continue wherever possible in sickness and in ill health, trauma and both when there are long or short term issues.

It is critical and crucial in helping to support children and young people - to provide coping strategies and opportunities to explore, to find out

the mechanisms of why we each react differently to environments and procedures.

All members of the team whether that be in healthcare, support work, overseas volunteering are involved in the wrap around care elements of children and young people within health/aid settings they can utilise play and it's components.

Members of the Specialised Health Play Team hold enhanced responsibilities, experience and rich knowledge to share and promote essential skills.

Judy Walker shared with us that essential functions of play are built into the fabric of the child and young persons journey through the hospital and health experience.

Normalising Play is at the very centre of a child's world- to have it removed - to have been part of a traumatic experience or for play to be unobtainable means to deprive and remove the ability to explore, engage and experience.

Children and Young People accessing hospital and health care often feel disjointed from the experience- when I talk about this I also want to include the following.

Recent world challenges throws up questions.

I wonder how children and young people feel ,who have had to leave the place they know, the people they know, where they play, to be led away to travel, on such a long and at times frightening journey- How do they feel?

To leave their homes without the adults whom they love and trust who provide a safe loving feeling.

They may have lost the ability to play and in turn are not able to express or play out their worries?

They may have become so shut down and withdrawn that to experience joy, have fun, or smile- is lost.

This will have a huge impact on the way they develop, grow and for their stories to be told- we have to listen, sometimes to the unheard- and sometimes this takes a long time.

Listening to the unheard is often difficult - for the HCP's involved - but how difficult and frightening for the child or young person and their families to tell it- to let us into their inner world.

We have to do this within healthcare too- to assist the healing journey of trauma - to past experiences and look at how it impacts the future of their care.

It's important when working with children, young people and their families that we look at how long a hospital stay will be, will they need regular input within a clinical environment .

Individual Play Programmes are a way of listening to what they have to say- how treatments make them feel- what works well for them to support preparation and distraction- likes and dislikes.

A lengthy stay in hospital or repeated hospital admissions may lead to a decline in reaching developmental milestones - Developmental Play Programmes can help and support to address this.

 They are formulated to ensure delelopmental progress is maintained, and opportunities to explore,have fun and maximise learning in a non- threatening way.

The Art of the Relationship

                                            

 

 

In many walks of life we come across and meet interesting and amazing characters, in my working life I have met such wonderful, bright and strong children, young people and their families.

 

They have brought so much joy and meaning to the work I love, they spur me on each day- to try and create a safe haven, a ripple of understanding, a place to be.

They have also given me a deeper understanding of their pain, and at times sorrow and despair, they have shone a small light on how it is for them, right now in this moment. 

 

With this in mind it felt natural to take a walk along the  therapeutic road and commence a journey of my own, of deeper understanding of ways to offer that safe "just being" place within my role as a Specialised Play and Activities Practitioner within a healthcare setting.

Its not always easy, and sometimes I see children and young people for such a short time, that I wanted that time to be solely for them, to choose and explore in a safe way, and if anything allowing a little of their story to be heard.

 

Stories are talked about as having such powerful meanings to those telling- but also to those receiving.

This weekend I have been sharing my story , and learning about using different creative techniques- ways a child or young person might choose to share a little of themselves or what matters to them.

The over riding theme this weekend- has been be curious, don't make assumptions about how a child or young person feels.

Learn how to play as adults so we learn through a child's eyes.

Take time to really imagine how or what story we are being shown.

I have also be able to share a little of myself with a group of equally amazing Health Care Professionals and colleagues who work in education.

 

Our core aim appeared to be the same, yet I was very aware we had all come together as strangers, and at times it felt uncomfortable, a little frightening and raw, then taking a step back- these are just some of the feelings a child or young person might have-so  how can we extend the listening ear, how can we support and help children and young people explore their emotions, in a way that is unassuming and safe?

We were about to find out.

 

Any relationship takes time, 

understanding, to grow meaning.

 

To be secure, to have your own sense of self- for some that is asking the impossible. -  there are so many external forces asking us to change, to be something we are not, impacting on our learning and growth, and so our sense of self gets distorted and lost.

For children and young people they have to have the opportunity to explore their own sense of self, of identity, and for some facing unimaginable trauma and ill health this is just to painful and to difficult.

 

I wanted to share some of the key points I have had time to process from this weekend- these are just a few! 

They may assist or resonate with some of you during your working week, or any long term work you are doing-

 

• Be present with the child or young person- the relationship, the quality of this, be curious.
• Keep shining a light on the process- wonder what its like to be that child or young person.
• How are we seen by children and young people- are we number 10 in a long line of adults that have been in their lives?
• To grow the depth of understanding- and the relationship , always check in with yourself- how does it feel.
• The use of image and the arts allows us to be alongside a child or young person using metaphor.
• Use the creative process to allow a child or young person to express what they feel, their story.
• Allow that to be heard with reflective listening.
• Be playful- it allows more freedom, this in turn makes the experience richer.
• Don't make assumptions.

 

We always have room to learn and develop...................take the moment.

 

 

 

Sian Spencer-Little

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Play4C&YP in Health.: Making a Difference.

Play4C&YP in Health.: Making a Difference.:                                              I am a strong believer in positive thoughts, words, deeds and actions. Like the most h...

Making a Difference.

                                          

 

I am a strong believer in positive thoughts, words, deeds and actions.

Like the most humblest of people Mahatma Gandhi's very core was about values, beliefs and truth.

I believe that these values have an ability to impact on a situation, to offer a supportive hand, to simplify overwhelming episodes and experiences and support the learning process.

Equally I believe that I am honoured to work in a profession that allows me a small but intimate window into family life, sometimes during immeasurable heartache and pain, but equally at times of joy and relief.

 

During this last week, I have been what some might call a "steady hand" both for my colleagues at work, but also some families I have been fortunate enough to have met and supported ,but not necessarily for myself.

 

At times I have had to process lots of information and emotion in a very short time and with little breaks in-between to work with another family, child and young person.

I realise that we all do this on a daily basis- in many walks of life and work- so I wondered

- if I am struggling with this, if I take a few steps back, how much of a struggle and difficult road must it be to walk when you are a child, or young person, family member or student nurse?

The 6C's of nursing are...... Care, Compassion ,Competence, Communication, Courage, Commitment.

So as I try to make a difference, and be a supportive presence, I never forget why I do what I do and how, I thought about some of the words I have used this week, of the moments in time when I have sat with a child, or a nurse, a family member, a colleague, and how could I share this on a larger platform.

Time, support, care, understanding, respect, journey, process, courage- just some of the words I have said and heard this week.

 

A note to myself- I should never under-estimate the impact this work has on you, the individual, and the experiences of a family, how they share, how they educate, and how they touch your inner core.

As HCP's we are not in a position to call on a superhero with a protective shield when the going gets tough.( even though we might like to- but equally those superhero's are not always there for families either)

 

So here are my Top 6 ~ #SSC ( Sian's steps to self care)

 

 

1. Take a moment to regulate your breathing- this will help you deal with the next part of the journey you take with a child, young person and their family.

2. Give yourself a break- you are human- and in order to support and show empathy and compassion standing back for 5 or 10 min's will allow you to recognise sometimes the enormity of the situation in front of you- and seek advice from your peers.

 

3. Please don't feel you are alone in this journey.

 

4. A process diary is a really good way of getting all of the "tough stuff" we deal with out and down on paper- it can help to make things clearer- and can be helpful in understanding this complicated episode, and enhance your learning and impact your experiences- if this is to difficult, find someone who can sit alongside you.

 

5. Try and see some daylight/sunshine each day- even if it means walking the long way round to the car/ toilet/restaurant/shop/path lab/pharmacy - you get the idea!

 

6. Remind your colleagues and peers to do steps 1-6!!

 

 

 

Sian Spencer-Little

 

 

 

 

  

 

 

 

 

 

 

 

 

 

 

Bubbles for Joe

This week  I wanted to share with you a story..

A story about loss, and of honouring, of memories and of new beginnings- it formed part of my work previously with loss and hospice care.


Bubbles for Joe.


"This is me, my name is Phillip, and it may seem quite strange to you that I am sharing this photograph with you, especially as I am blowing bubbles.

Why, you may ask?

Well this is my best friends garden, I come here a lot you know, here I can shout, stamp my feet, think, here I can remember.

Molly helped me find this place, I call it my safe place, she lets me call her Molly Moo.

I am 11 years old, my best friend, was, is 10, and I come to this garden to remember him, because he is not here anymore, he has died and it took me a long time to say the D word.

The bubbles you see, are for him, in each one is a message, sometimes I tell him about what I am doing at school, or about the horrible school dinners, or maybe I might just tell him I have a new football, or that I ate loads of popcorn at the Cinema.

Today I am sending him a message about the summer, how hot it has been, that I went to the beach and ate ice cream, and how much I miss him and wish he was here.

I have blown 8 bubbles, but if you look carefully you can see or imagine that there is 2 bubbles together , it looks like an upside down snowman.

That is a special one, that's only meant for me and Joe.



After these bubbles fly towards the sky, I am going to have a water fight in his garden with his brother, we are going to get soaked, so he will be able to see, even though he is not here with me.

I do feel sad sometimes, and cross, very cross, and I miss him.
Molly Moo says it is ok to feel those things, but I still like to laugh sometimes too, just like Joe and I did together.

Sometimes my tummy used to make really strange noises when I was sad, and it felt like a washing machine, with lots of things going round and round, but when I blow the bubbles, and send Joe the messages it helps to make me not so sad, and then things start to calm down.

Soon I am going to be moving house, and I wont be able to come to Joe's garden anymore.

But there are lots of hills where my new house will be, and I will always have the photograph to remind me of my safe place in my head.

My new garden is on top of the highest hill, and you can see for miles and miles across all the tree tops.



So I can go, and blow bubbles.

Bubbles for my best friend Joe, and I can remember all the times we laughed.

On days when I feel sad I can climb to the top of the hill, and a little part of me will always remember Joe's garden and the fantastic summers we had".

The End



Sian Spencer-Little