Laughter as part of the medicine: Why a play-specialist's job couldn't be more serious

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The Independent Online

Just a spoonful of sugar helps the medicine go down, said Mary Poppins. But, when children are hospitalised, persuading them to co-operate with their treatment isn't quite that simple...

As well as injecting some fun into their hospital stay, play specialists are trained to engage children in play that prepares them for medical procedures, and to distract them while treatment is being carried out.

"You're an advocate for the child," says Jenny Dyer, a play-specialist team leader at London's Great Ormond Street Hospital. "Play helps children to relax, so they're more likely to say how they're feeling and what's worrying them. We can then pass that information on to the medical staff."

Dyer is currently working with a child who is refusing to have injections. "We use real needles and syringes on specially adapted dolls and teddies so the child becomes familiar with the equipment. It helps us to find out if they like to watch or look away, or if they would prefer to have the injection in their leg rather than their arm."

Play specialists will often spend time building up a relationship with a child so they can identify the best strategy to help them. "I worked with a four-year-old boy who had to take a lot of thick, oily medicine," says Dyer. "Whenever it was mentioned, he would hide under his bed, and it had almost reached the point where they would have to put a tube into his tummy. I found out that he wanted to be a fireman when he grew up, so we explained that the medicine would build up his muscles and make him big and strong – it was something he could relate to. We also used role plays, got him involved in measuring out the medicine himself, and introduced a reward system. In a couple of weeks, he was taking it without any problem."

Large hospitals for children may employ as many as 40 play staff, and there are opportunities to specialise in play in children's wards of general hospitals – the Department of Health recommends one play specialist for every 10 beds. It's also possible to work in child-development centres and hospices, and supporting healthcare staff in the community.

"You have to be creative and imaginative," says Norma Jun-Tai, chair of the National Association of Hospital Play Staff. "Providing good-quality play for children means speaking their language and seeing things from their point of view."

But you also need to be able to build a rapport with adolescents. Play staff work with patients up to the age of 18, so the job may also involve using psychological approaches to help teen-agers come to terms with, say, operation scars, or hair loss after chemotherapy.

Being a confident communicator is also important, adds Jun-Tai, as you will be working as part of a multidiscipline team and liaising with staff of different levels. And a degree of emotional resilience is needed for situations such as preparing a child to have a limb amputated, or working with one who is terminally ill.

The medicine may not always go down in a delightful way, but, says Dyer, "it's rewarding to know that you've helped a child through a difficult time, and that their stay in hospital has been as positive an experience as possible."

The lowdown

Voluntary work on a children's ward is a good way to get a feel for the job, after which you could apply for a post as an unqualified play assistant.

The BTEC Professional Diploma in Specialised Play for Sick Children and Young People is a one-year, part-time Level 4 qualification involving study and work experience. It leads to registration with the Hospital Play Staff Education Trust (HPSET). If done while working as a play assistant, the hospital may provide funding and study leave. Minimum entry requirements are a Level 3 childcare qualification and three years' experience of working with children.

See www.hpset.org.uk for a list of colleges offering the course, and the website of the National Association of Hospital Play Staff (www.nahps.org.uk).

The starting salary for a play assistant is around £16,000 a year, rising to £28,000 for a qualified, experienced specialist.

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