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Celebrating National Play in Hospital Week - A Health Play Specialist talks about her role with children in the Emergency Department

Ever wondered what the role of a Health Play Specialist entails? To celebrate National Play in Hospital week (28th September - 4th October), Sarah Nield, HPS in Royal Manchester Children's Hospital's Paediatric Emergency Department has told the story of what her role means to the children she looks after.

"Responding and meeting the needs of sick children and families is both challenging and humbling. In some of the most devastating circumstances children and families demonstrate unbelievable strength and courage. I have been and continue to be lucky enough to meet and get to know amazing real life super heroes. Working in healthcare allows for the realities and perspectives of life and death to be realised and respected. We all go through many, various and unique life experiences, illness does not discriminate. We are all going to be affected by life changing events and bereavement. The way we cope is primarily determined by individual resilience and the support network available to the person.

"Contributions from Therapeutic and Specialised Play Services are developing extensively at Royal Manchester Children's Hospital (RMCH). Recognition from the multi-disciplinary team regarding the value of play is fundamental to successful collaborative practice. The work of Health Play Specialists leading psychological preparation, instigating distraction techniques for clinical interventions and post-procedural play are necessary and interwoven with the excellence of clinical practice. Health Play Specialists are experts in child development theory and competent in observing behaviours, documenting, planning and delivering interventions and individual play programmes for children and recreational activities for young people.

National Play in Hospital Week 2

"The role of the Health Play Specialist (HPS) is largely determined by the environment the HPS is working in. The atmosphere in Paediatric Emergency Department (PED) alters considerably during a shift. The hospital is a major trauma centre therefore serious incidents frequently occur in this setting. Children arrive in the department by ambulance or walk/are carried in by parents/carers that have used their own or other modes of transport. Children that have suffered a trauma such as a road traffic collision or a fall arrive by ambulance and are seen immediately. Children that are unconscious, sepsis, having respiratory difficulties, having seizures, have a visible skin rash and allergic reactions are prioritised, therefore seen quickly.

"Front line staff, from the receptionists (they obtain identification details of patients attending PED), the Triage Nurse (for the initial assessment -the child is seen and reviewed) and the HPS to the Staff Nurses, Sisters, Doctors and Consultants in the Department, all are collectively involved in each child's care. The PED team through observations and collaborative practice are ensuring abrupt identification of deteriorating or critically unwell patients. The work in PED is frequently relentless. Working as a multi-disciplinary team and relying on the interconnected relationships, valuing and complimenting each other's abilities. Ultimately we are concerned with improving the patients and families hospital journey.

"A HPS is required to communicate effectively, explain information at appropriate developmental levels, whilst being compassionate and sensitive in her/his approaches to children and families. Possessing an inclusive outlook, respecting and having an awareness of cultural differences and persistently safeguarding children and young people are of paramount importance in the HPS role. The HPS must ensure that appropriate play and recreation activities are available and accessible to all children and young people -meeting the specific needs of the individual is very important. Awareness and sensitivity regarding the impact of illness, injury, health conditions and hospitalisation to the child and his/her family is an on-going learning journey. Empathy, compassion, care, honesty is crucial to understanding and supporting the patient experience. Holistic care is very important to ensuring quality provisions for children and their families. Holistic care is realising all aspects that make a person who he or she is, their emotional, social, economic, spiritual and physical needs are considered -the care given is person centred. Best practice is about approaching everyday practice in a positive, creative and responsive manner which enables the child and family to cope with their hospital experience.

"Team work is fundamental to striving towards best practice - as a team more can be accomplished. Play practitioners work and play hard. Play Leaders assess the needs of patients to determine suitable play provisions, ensure a safe play environment. Play practitioners advocate on behalf of children and families. Inclusive activities for patients and siblings are facilitated, alleviating boredom through play activities. Occupying time and having other goals -focusing on the personality of an individual rather than her/his illness.

"Play practitioners promote important health messages -hand hygiene, healthier behaviours, eating habits, dental hygiene, road safety and hazard perception awareness (keeping hot drinks and hair straighteners out of reach, supervision to prevent drowning, choking, suffocation). Play Leaders liaise with us regarding evaluating specific needs -children with autism, children with aversion to needles, fear and anxiety issues. We welcome and encourage patients' feedback. The Children's Hospital Youth Forum group meet monthly."

The play department provides diagnostic, therapeutic, developmental and specialised play for all children/young people and families from all cultures and background.

For more information about the team, please contact Susan Fairclough on susan.fairclough@cmft.nhs.uk or ext. 15652.