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Beyond the Doll : Maximizing the effectiveness of Medical Play in the Pre-Operative Area

Beyond the Doll : Maximizing the effectiveness of Medical Play in the Pre-Operative Area. Jessica Oviatt, MA, MEd CCLS. Introduction . Outline CHOC Childrens Two surgery areas Surgical Short Stay Unit Outpatient Pavilion Anywhere from 15-35 patients a day Policies IV 8 years and above

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Beyond the Doll : Maximizing the effectiveness of Medical Play in the Pre-Operative Area

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  1. Beyond the Doll: Maximizing the effectiveness of Medical Play in the Pre-Operative Area Jessica Oviatt, MA, MEd CCLS

  2. Introduction • Outline • CHOC Childrens • Two surgery areas • Surgical Short Stay Unit • Outpatient Pavilion • Anywhere from 15-35 patients a day • Policies • IV 8 years and above • Mask induction 7 years and under • All heart caths and GI procedures get IV’s before • Limited parent presence in OR

  3. Traditional Medical Play • Types • Directed vs. Non-directed5 • Normative vs. Therapeutic • Symbolic • Familiarization vs. Dramatic4 • Uses • Normalization/Exploration • Education/Preparation • Information gathering • Reinforcement/Introduction of ideas

  4. Traditional Medical Play cont… • Influences on Medical Play • Gender3 • Past experience/exposure3,4 • Developmental level • Acuity4 • Research • Children have less anxiety2, less emotional distress1 and more cooperation1,2 when given chances for medical play

  5. Pre-Surgery Environment • Prioritization • Age • Anxiety level • Past experience • Pre-Medication • Pace • How many people does the CLS see in pre-op area • How early do they come • What steps are required from of the patient and family • How many patients are present • Policies • Parental presence during induction, IV vs. mask induction, use of pre-medication

  6. Limitations of Medical Play in Pre-op • Time • Space • Heightened anxiety • Acuity • Interruptions • Medications

  7. Modifying Medical Play • Ultimate goal: to incorporate the environmental factors and medical play influences while balancing the medical play and the limitations associated with the pre-op area. • Different play paradigms • Play as Flow6 • Play as Comfort6 • What to know… • Know the population • Gender, age, developmental level • Know the recovery • Bodily changes, bandages, procedures, pain, etc. • Know the doctors

  8. Accommodating Limitations • Environment • Minimize distractions • Set up a medical play zone • Plan ahead • Surgery schedule, nurse information • Common diagnosis bins • Post-op medical play • Desensitization, normalization • Other opportunities for play before day of surgery • Market child life in the surgery environment

  9. Opportunities for Medical Play in Advance • Tours • General vs. In-depth • Surgery Preparation Clinics • Hello hospital, teddy bear clinics, etc. • Inpatient • Medical play while preparing/educating • Scheduled surgeries

  10. Other Areas for Modified Medical Play • Emergency Department • Outpatient Clinics • Orthopedic Clinic

  11. Surgery related: Decorating face masks and hats Decorating anesthesia mask ID bracelet for stuffed animal/doll Getting to know me sheets Mask play IV play Surgery bag coloring sheet Body part coloring sheet Pre-op checklist Mask animals Appendix jar Examples of Pre-Op Medical Play

  12. Recovery related Cast glove art Casting Decorating crutches, halo, etc. Tension ball Ph probe on a doll Dressing change play Recovery ladder Group idea sharing….. Hospital Environment related: Medical coasters Band-aid art Collages Door hangers Hospital scrapbook Hospital Jewelry Mind in a bottle Examples of Pre-Op Medical Play cont…

  13. Questions?

  14. References • Chance, P. (1979) What is play? Learning Through Play. New York: Gardner Press, Inc. • Gaynard,L.; Wolfer, J.; Goldberger, J.; Thompson, R.; Reldburn, L. & Laidley, L. (1990) Psychosocial Care of Children in Hospitals: A Clinical Practice Manual. Rockville: Child Life Council, Inc. • Goleman, D. (1995) The Master Aptitude. Emotional Intelligence. New York: Bantam Books. • Lynch, M. (1994). Preparing Children for Day Surgery. Children’s Healthcare,23(2), 75-85. • Mahajan, L., Wyllie, R., Steffen, R., Kay, M., Kitaoka, G., Dettorre, J., Sarigol, S., and McCue, K. (1998). The Effects of a Psychological Preparation Program on Anxiety in Children and Adolescents Undergoing Gastrointestinal Endoscopy. Journal of Pediatric Gastroenterology & Nutrition vol 27(2), 161-165. • Pass, M. & Bolig, R. (1993) A Comparison of Play Behaviors in two Child Life Program Variations. Children’s Healthcare, 22(1), 5-17. • McGrath, P. & Huff, N. (2001). “What is it?”: Findings on preschoolers’ responses to play with medical equipment. Child: Care, Health, and Development 27(5), 451- 462. • Jessee, P., Wilson, H., & Morgan, D. (2000). Medical Play for Young Children. Childhood Education 76(4), 215-218. • Jessee, P. & Gaynard, L. (2009). Paradigms of Play.The Handbook of Child Life: A Guide for Pediatric Psychosocial Care. Springfield, IL: Charles C Thomas Publishers, LTD.

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