J is for Joking Around in Hospital

Mention the word “hospital” to a child and chances are thoughts of fun won’t spring to mind. This is with good reason. Infants, children and teenagers in hospital or facing repeated hospital stays understand about pain and fearfulness. Sick children see hospital differently from adults. Children’s thoughts about hospital also differ depending on their age. Young children may want more than anything to have their family close and sometimes this isn’t possible. They also want lots of play and toys. School children often have many questions and need answers about what is happening. Adolescents value privacy and social and educational spaces. Young patients surveyed in a recent report Admitted children and young patients survey results 2014 indicated there was room for improvement in what is available to do in hospital (more books, games, toys).

Hospital, a friendly and healing environment?
For children and young people the hospital environment is not just about clinical care. Human needs count. An interactive, engaging and aesthetically pleasing environment and a friendly, caring welcome from the hospital community is important. Children find ways to connect with their environment, such as creating a personal bedside with pictures, photos, decorations and cards.  Children’s hospitals make their environments more child-friendly through bright colour, plants, toys, artworks, arts and craft, books, a visit to the hospital playroom, games room, multi-sensory room, healing garden, natural space or playground. Child-friendly places where family can gather, play and be together make all the difference.

Children and young people’s social and emotional needs
One study looked at the views of young children and found that children between five and seven years like “funny”, “friendly” and “happy” doctors and nurses. Being in hospital and a strange environment is challenging, particularly when children aren’t prepared for the experience.

Clown Doctors
How can “joking around” help children in hospital? Clown Doctors™ are amongst the people in hospital who help kids cope. If you have met one you will know they simply ooze fun. Their tools include a “goody bag” of gags and a fine appreciation for quirky antics and silliness. Perhaps Clown Doctors are the antithesis of all things serious in hospital but they do play a serious role. Clown Doctors take therapeutic play and art forms, such as drama, music and song, jokes and gags to hospital bedsides, emergency, preoperative rooms, wards, playrooms and other hospital spaces.

Clown Doctors understand about the feelings of sick children, their families and health professionals who they meet. Sick children have a changed body image and find themselves in a passive patient role. Clown Doctors turn things upside down using humour. The Clown Doctor, has a white doctor’s coat, with bright collar, maybe a tie and “medical equipment” but that’s where the resemblance stops. The rest is very much “clown”.


 Clown Doctors dose sick children in hospital with fun and laughter!

Clown Doctors unique dress mode suits their unique task. Using a toolbox of skills and understandings, they modify and interpret play and activities to fit with a child and family’s needs and responses. Clown Doctors help reduce anxiety and emotional responses in preoperative rooms where children and parents wait before minor operations. In some hospitals, Clown Doctors work in Emergency helping children by distracting them during painful procedures. The positive impact lasts beyond their interaction. Clown Doctors bring joy to children with serious illness, who experience extended and repeated hospital stays. Children are transported out of the medical, into the magical with humour and laughter.

Who is joking around now?
A sick child may swap roles and “become” the doctor who practises with medical play. This contrast leads a child into a stronger place. With the positive benefits of laughter children relax, have reduced muscle tension and pain and stress are taken away.  They cope with sad and hurt feelings and feel good and in control. Clown Doctors also bring humour and laughter to parents, siblings and carers as well as healthcare professionals. Happier and less anxious families and health professionals journey with children towards better health.

Clown Doctors™ is run by the Humour Foundation and does not receive government or hospital funding. They rely on community support to fund programs, visit their website to find out more.

Thank you Clown Doctors™ for contributing photographs.


Jillian Rattray
AWCH librarian
January 2016

Painful paediatric practice

I was out to dinner with my girlfriends last night and at dinner the topic of pain relief in hospital came up. One of my girlfriend’s children had broken his arm and to fix the fracture pins had been placed in his humerus. To have pins removed, my friend took her son to the local paediatric hospital. Before Bob had his pins removed he was offered no pain relief and this is where the story really starts…..

To remove his pins Bob was placed in a chair. His mother was asked to sit next to him.  A clown doctor was there to distract the child whilst the pin was being removed. To remove the pin the doctor used pliers, which slipped as the pin did not come out easily. This process caused Bob a great amount of distress…. However, as this was happening, the clown doctor was attempting to put a red nose on the mother – impeding her ability to comfort Bob. In addition, there was still one more pin to be removed. Yet by this time the child was hysterical and distraught.

A comedy of errors, or a sheer lack of planning and consideration for the needs of Bob and his mother?

The reason I wish to share this story is that this type of situation exemplifies why AWCH is still relevant in 2014. In our 40 year history we have made lots of progress in advocating for children and their families as they navigate the health care system. However stories like Bob’s and Betty’s still exist.

Betty is an intelligent and articulate woman. She told me that she placed her trust in the medical staff and that if they said that this procedure did not require any pain relief then Bob would be fine. Once Bob became distressed she felt she had no control over the situation and that all she could do was comfort Bob to the best of her ability at that time.

This happened two weeks ago, and prior to the pin removal Bob was always a happy go lucky child with a ready smile and a cheeky sense of humour. Since the procedure he has been having nightmares, being argumentative at school and is scared to play footy or use him arm too much.

For me this story shows that AWCH is still very relevant today and the work we do is still needed.

Ally Hutton
AWCH President

Thanks to Bob and Betty for sharing their story (real names not used)