Sian Spencer-Little. All work and no play…, Don't Forget the Bubbles, 2017. Available at:
In hospital it is the team that makes the difference. Many specialities interact to make what could be a horrendous time a much happier one. In this occasional series we hear from those unsung heroes.
#hellomynameis Sian, I am thrilled to share with you a little of the role of the Health Play Specialist, and what that means and why I do it.
I have always been driven with a passion to work with children, young people and their families, especially within a healthcare setting. I wanted to make a positive impact, and work on the way we care for, support and deliver healthcare. A huge part of my role is observing, listening, and sharing.
I began as a nanny in a remarkable family of three children – two of whom had a rare genetic condition. They taught me so much more than a textbook could about the human spirit, determination, struggle, and the impact of caring for children with a long term health need. This felt like where I should be and what I should be doing.
Creating a non-threatening environment is at the very top of my agenda.
Play is an essential component in healthcare. It is instinctive and a powerful driver in the development of the child. I spend many hours sharing skills and ways of working, with student doctors and nurses, as well as with families. I love the energy they bring, a different viewpoint and new ideas.
A typical morning for me may consist of preparing children and young people for surgery, sitting alongside a child and listening to their story, how they come to be in hospital. It may then take the form of supporting a family who are dealing with a new serious diagnosis, holding a hand, and providing a safe space to explore raw emotions. Then I might be in fancy dress and leading a sing-a-long story session. Perhaps I then offer a 1-1 creative arts session to a young person who is struggling with the clinical environment and needs some space just to be. After 23 years of doing this my gut instinct is still very strong and I never ignore it.
Joining the board round at lunchtime with my clinical colleagues I ask if there are any bloods or cannulas to do? Which children need prep for this or distraction therapy? Interwoven in this busy morning there may also be emergency admissions, planned electives and ward attendees.
Being able to think on your feet, fuelled by tea, is essential.
Utilising play, all members of the team, be they in healthcare, support work, or overseas volunteering, are involved in the wrap around care of children.
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. As a Specialised Play Practitioner I observe the impact a hospital admission or procedure has on children. Without warning they are informed that a procedure or operation needs to happen. At that moment everything changes for them. I call this the “golden 5 minutes“. How we manage this episode of care is crucial for us and for the patient.
Use simple language to explain what happens next
Words are so very important at this stage – how we describe things and there are some words that we should not use. Key words are the only thing parents and children remember. I talked about this during the week with a family. They shared with me that tube, mask, blood, prick are the ones they most remember in times of fear. This was a child who will have to come into hospital on a regular basis, for the rest of his life. Tube, mask, blood, prick. These are the words he will remember each time he prepares to visit the hospital.
Trauma in children is a deep and evolving study and research experience. When we meet patients and their families for the first time we do not know what trauma they have experienced. Studies show us that it impacts on their very being, and ability to cope with new experiences.
The challenge is to look at our approach to children and young people. 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? How can we impact positively on the patient experience? Are these methods and processes accessible?.
So next time you have contact with a young patient think about how you can introduce play into the encounter, access the Health Play Specialists and 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, that the experience matters to you, and that you are 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.