Interview with a play specialist
Jenny Dyer is play specialist team leader at Great Ormond Street Hospital
Jenny Dyer is play specialist team leader at Great Ormond Street Hospital (GOSH), London. She qualified as a nursery nurse from Princess Christian College, Manchester in 1984. She worked as a children’s nanny before going to GOSH. She qualified as a play specialist in 1994 and became a play team leader in 1999.
What made you decide to become a play specialist?
When I came to GOSH I worked as a nursery nurse, carrying out basic nursing duties, but part of my role was also providing play activities, particularly for the long stay patients. My interest in the play role came from there. I wanted to concentrate on the play aspect rather than the nursing side of the role, so I became part of the play team in 1993.
Can you explain what the play team does?
Within the play department, play specialists and play workers provide a play service with a holistic approach to the children and families who come to Great Ormond Street. The patients we help are aged between 0 and 18-19 years
Play workers provide normal and diversional play so that children can use it as a way of switching off from what’s happening to them and so that they know that play can continue when they come into hospital. Play specialists support children through difficult tricky procedures. We will assess the child when he or she comes here, and depending on the reason for their admission, we will work out what techniques we should use to support them through whatever treatment or procedure that they are going to have.
It’s important for children to have an understanding of why they’re in hospital and what’s going to happen to them. When they come in, they’ll be anxious even if they’ve been here before, and so will their families. As well providing them with normal play, we will provide them with “play preparation.”
This play is to prepare them for what’s going to happen to them in hospital. For example, if they’re going to have an MRI [magnetic resonance imaging] scan we use different play techniques to show them what’s going to happen. It allows them to understand something of the procedure, express their concerns/worries, and make some choices around how they would like the procedure to happen—giving them just enough control, but not total control, so that they can manage their anxiety and have their treatment or procedure
Using an MRI scan as an example again—if a child has had one before, found it stressful, and he or she may be anxious about having another scan, then we would invite them in to meet us [the play specialists]. We would do an assessment during which we would try to find out what it is about the procedure that the child is worried about. Some children have to be given contrast via a cannula. It could be fear of the needle that is making them worry, or it could be going into the MRI scanner, or having a general anaesthetic.
Once we find out what the worry is, and depending on the age of the child and their level of development and understanding, we would decide which method of play preparation to use. In a younger child who is not going to have a general anaesthetic, we might use a “play tunnel” so that the child can practise lying still in the scanner. For an older child we might use a model of the scanner room and equipment made with Lego to allow them to play out what is going to happen. We can also use real equipment to act out what is going to happen during a procedure and take the child into the scanner room to practise lying on the bed and going into the scanner. The child can also choose which films to watch during the scan. We involve parents and family as much as possible during these sessions.
When do you find your job the most rewarding?
For me, the most rewarding part of the job is when I’ve been able to use the skills and techniques that I have developed over the years to give an anxious child the ability to develop coping strategies so that he or she can undergo a procedure without undue fear. We can’t take away all the anxiety, but the work that I’m able to do with children allows them to reduce that fear. It’s all about providing a positive experience for the child and their family.
Do you have any tips for medical students or doctors when they meet younger patients?
Make sure that children are treated in a child friendly environment. For example, in the emergency department there should be paediatric facilities that are separate from adult patients.
Acknowledging that children are not mini adults, and that a child is an individual are important things. With children you need to build trust, say hello and introduce yourself and have a little conversation with the child before jumping into the treatment side of things. Also, listen to the child and their worries. Involve the parents or carers as much as possible because they know their child the best.Sally Carter, technical editor, The BMJ
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.