‘Honey, you’re going to theatre tomorrow.’ Ben’s mother told him.
Ben looked at his Mum and remained calm. He didn’t seem concerned about what lay ahead of him. His parents sighed with relief. This was going well.
The next day, they arrived at the hospital. Ben was ‘prepped’ for surgery by his nurse who reminded him he was going to the theatre soon. To everyone’s surprise, he remained calm.
As they wheeled him into the operating theatre, the cold air hit him. People with masks over their faces were talking at him with muffled voices. Ben began to scream with terror. He had thought he was going to the musical theatre to watch a show. As he lay down on the cold, hard bed, the anaesthetist pressed a black mask over his face while telling him, ‘You’re alright.’ He certainly didn’t feel alright.
He drifted off to sleep still fighting, and his mother began to cry as she was lead out to the waiting area.
Have you ever had a healthcare experience with a child, or your own, where it did not go well? Was the child terrified and uncooperative resulting in restraint? Or, have you had a child tell you about a procedure only to realise that they don’t understand?
Ben had thought he was going to a show, not an operating room and as a result, his anxious parents were left distraught watching him as he drifted off to sleep screaming.
Children benefit from medical play far more than any explanation of a procedure could provide. Play is their language. It’s how they learn and make sense of their world.
So… what is medical play?
In medical play, the child has the chance to explore equipment, process emotions that may be brought to the surface and demonstrate their understanding of the medical procedure. Play offers the opportunity for an attentive adult to clarify and correct any misunderstandings before or after the event.
The child can participate in medical play in a group setting or on a 1:1 basis. The play can be directive (where the adult leads the play) or non-directive (where the child leads the play). It all depends on the goals and your time-frame.
How can I do this at home?
One of the first things you can do is get a medical play kit and allow the child to play with it at their pace (this is non-directive). Just having the play kit around enables them to play out previous experiences or just to familiarise themselves with medical equipment. When we know equipment well, our fears of it are lessened.
You can also practice play listening which can be initiated by you but lead by your child. An example of this is to set up a play scenario where you can play out a particular procedure. It may be an upcoming procedure or an experience your child has already experienced. You can start by saying, ‘Hey! Let’s play a game where I am coming to the doctor to have a needle and you are the doctor.’ Kids love it when we play with them. Lawrence Cohen has written a great book called, Playful Parenting where he talks about playing with your child. He explains how to set it up, direct the play or follow their lead.
But I’m a nurse! How does this apply to me?
Medical Play can be incorporated into your care quickly and easily. I work in Emergency, so my kids don’t always have the opportunity to prepare at home but they certainly can benefit from some play therapy. When I have a child headed for an operation, and it isn’t an immediate emergency, I will get an oxygen mask and make a game with it. For older kids, I have been known to attempt a Darth Vader voice through the mask. I am terrible at it, but it does the job, and generally, this is all they need to start placing it over their faces. By the time they get to the operating room, they are comfortable with the anaesthetic mask over their face.
Another example, for the younger child, is to dress up in a theatre hat and mask. Younger children are often frightened by the masks and muffled voices. Playing peek-a-boo with the mask helps the child to realise there is a caring person behind that mask. They also have the opportunity to touch and explore the mask to desensitise them to it.
My experience of medical play with my own children
My daughter, Miss M, had to go to the dentist for her first check up, and there was every chance she wasn’t going to enjoy lying on her back while someone poked around in her mouth with scary, noisy equipment. I didn’t have a lot of equipment back then, but I pulled together some gloves, a mask and a dental mirror. She loved checking me over and giving me orders to ‘brush more’ and ‘eat fewer sweets’.
When the time came to see the dentist, the dentist also played with her before she got her into the chair! It was a great experience, and she can’t wait to go back again. My daughter is very touch sensitive so it made all of this preparation even more important. It helped her feel safe in an environment that without preparation, feels very unsafe.
Do you have any experiences with medical play in the lead up to a procedure or hospitalisation? Please tell us all about it in the comments below and don’t forget to subscribe so you never miss out on a post from The Paed(iatric) Nurse!
Until Next time…