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

Calico Dolls – A process of play – resource


by Maree Matthews and Gerry Silk 
Kiwanis International, 1994.

 

What are calico dolls and who makes them?
Calico dolls are simple in shape and made with plain fabric. The dolls are without features and they are plumply stuffed with polyester fibrefill, so they are lightweight. They are made in a range of skin tones. Children draw with textas or felt tip pens on plain calico giving personality and so each doll is unique. Since 1993 over 60,000 dolls have been made for children in hospital. Most of the dolls are made by volunteers and in the past Girl Guides have made calico dolls for AWCH in Sydney.
Where and how are they used?
Calico dolls are used to help children in healthcaresettings: in hospital emergency departments, radiology departments, routine healthcare admissions and when children are transported between healthcare settings. Calico dolls are also used in community settings by psychologists and child life therapists.

Health professionals such as child life therapists and nurses use the dolls with role play to help children, particularly younger children who are not abstract thinkers.  The dolls help prepare children for common medical procedures such as IV insertion, suturing, blood tests, insertion of naso-gastic tubes, changing dressings, manipulation and plastering of fractures under local anaesthetic and  X-rays

Calico dolls have been used to help transition children to hospital and medical procedures. The play is therapeutic because it gives children permission to express themselves. The role play helps children by providing them with emotional support when they are in unfamiliar healthcare places and having unfamiliar experiences.  

 

She coloured in the doll, giving it a happy face and a red line down its right leg which she explained as “the dolly’s sore leg”.

The dolls are also known as trauma dolls and can provide a positive way of coping, reducing stress and trauma. Children become empowered because through doll play they know more about what will happen to them and they can express themselves. Through parallel play they can tell family, friends and health professionals about what is happening to them and how they feel. How the doll is used is up to each child, their personality and developmental stage. Some children will focus on the doll as a means of gathering information and other children will use the doll as a tool for self-expression as well as understanding.
Calico dolls : a process of play is a great book for introducing health professionals and students to the value of calico dolls and their uses. Vignettes illustrate some of the uses, such as for diversion from pain, discomfort, anxiety and boredom. Other uses are for expression of feelings, as preparation for painful procedures, when working with siblings, for children who do not speak English, in bereavement care and for parent involvement. The book also explains how health professionals can make doll play a successful experience as well as how to talk to children in health care settings.
Calico dolls: a process of play is available for loan from the AWCH Library. The AWCH office also has a doll pattern for people who would like to make one.
Reviewed by:
Jillian Rattray
AWCH Librarian
February 2015

Therapeutic activities for children and teens coping with health issues

Therapeutic activities for children and teens coping with health issues
By Robyn Hart and Judy Rollins.
John Wiley & Sons, Hoboken, New Jersey, 2011, 379 p. ISBN 9780470555002.
Bibliography, pp  339-364. Includes CD-ROM.

“Therapeutic activities for children and teens coping with health issues” is a book richly filled with activities to assist health professionals, child life therapists, counsellors and social workers in their work with families. Activities and related information promote adaptation and coping for children, adolescents and their families in hospital or living with health issues. It is great to see so many ideas presented in an easily readable format, with over 200 practical activities to choose from.

Chapters focus on promoting understanding and coping for adolescents and children through different aspects of their healthcare experiences. Topics of the 16 chapters include separation and anxiety, self expression, socialization and help with many aspects of coping with illness. Set out in a clear way, each topic covers an overview, special considerations and coping interventions. The theoretical framework behind each topic is outlined. Activities are set out using an easy-to-read table which includes: therapeutic goals, age group, adult/child ratio, required time, restrictions and precautions and materials. You will also find an extensive bibliography (pp  339-364) as well as black and white illustrations and photographs. The accompanying CD has activity sheets and templates that can be customised.

With a great mix of theory and hands on, this book is sure to be a helpful reference tool and provide both information and inspiration. In fact I think I’ll gather up my supplies and try my hand at making a volcano.

About the authors
Robyn Hart, director of Child Life at Rush University Medical Center in Chicago. Judy Rollins, coordinator of the Studio G Artist in Residence Program at Georgetown University Hospital and Adjunct Professor at Georgetown University School of Medicine. This is the second  book they have worked together on, the previous award winning book is entitled, Therapeutic play activities for hospitalized children.

Keywords: Activities; Adaptation, psychology; Adolescent psychology; Bereavement; Body image; Child life; Child, hospitalised; Child psychology; Culture; Death; Families; Group work; Hospitalization; Medical art; Medical equipment; Mental health; Pain; Patients; Play therapy; Self-esteem; Self-expression; Therapeutic activities; Therapy

Awards
Winner of the American Journal of Nursing Book of the Year 2011
(Category: Maternal And Child Health)

Other titles also by Judy Rollins available for loan from the AWCH collection:
Meeting children’s psychosocial needs: across the health-care continuum / Judy A. Rollins, Rosemary Bolig and Carmel C. Mahan. Austin, Texas: Pro-ed, 2005. xv, 551 p.: Includes bibliographical references and index. Call number: 618.92 ROL 1
Core curriculum for the nursing care of children and their families / Marion E. Broome, Judy A. Rollins, Editors. Pitman, New Jersey: Jannetti Publications Inc., 1999. Call number: 610.7362 BRO 2

Review By:
Jillian Rattray
AWCH Librarian
March, 2013