What Am I Good At? Building Self Esteem through Play at Camp Klicek in the Czech Republic

Time to Explore:

The long days of summer, with the sun rising at 6:30 AM and setting close to 10:00 PM, lend themselves to unhurried, lengthy swatches of time. These hours can hold many opportunities for children and adults to engage in unfamiliar activities and discover new skills. Time for free play and exploration is a commodity during our workaday, technology-filled lives, but Camp Klicek in Malejovice, Czech Republic provides exactly this to children and families affected by illness and loss.

In the photo above, two seven-year-old boys get their hands on a saw, as they break down a tree branch in preparation for the campfire that all the campers will enjoy. Besides being fun, the boys are building their muscles and coordination, getting some great proprioceptive feedback, practicing cooperation and self regulation, not to mention problem solving. Their self esteem gets a healthy boost as they accomplish something new and contribute the the camp community. These are some of the attributes of spontaneous play that adults should take note of as we consider the developmental, social and emotional needs of all children

Structured Games

Sometimes structured games can lend themselves to learning through play that is so much fun that kids forget that they are learning. On this day, the campers were divided into three teams, and each team had four tasks to compete. They had to find a way to measure a liter of liquid, a kilo of sand, the length of a meter, and the span of a minute, all without the use of measuring devices. The camp was alive with children gathering sticks, pouring water, scooping sand into sacks and counting out loud and in their heads, as the teams competed to see who could get the closest to the actual measurement.

Group Play

On another day, volunteers from the Accace Corporation brought a day of activities to the campers. In the morning, they set up tables in the summer garden and mess tent, including paper arts and crafts, flower pot decorating, a drink mixing table with great recipes for virgin mojitos, margaritas and pina coladas, and a beauty salon station with face, body, and nail painting. Kids explored their artistic sides and wore their art with pride.

In the afternoon, the company volunteers set up an activity course in the forest, replicating what is entailed in working for a big company. My favorite station was the accounting department, where the employee had to take a fist-full of invoices and chase after the client to whack them with the papers to make them pay their bills!

And the other one I loved was a station where kids were taught the art of communication. They were told that communication is the lynchpin of success, and in order to practice communication skills, they had to stand on one side of an easel and describe a picture to their coworker on the other side, who had to paint of draw what that person was describing. It was a tough but very fun challenge for the kids.

In yet another station, the children ran through the forrest balancing cups of coffee they had made for their boss, trying to get to their boss’s office to sign power of attorney documents without spilling a drop.

Sharing Skills With Others

Many of the campers had their own skills to share and teach. Here are several of them, starting with an 18-year-old who made up a rap song on the spot.

One 14-year-old camper had a lot of skills, including bugle playing, fire breathing (So sad I didn’t get that on film!!), and archery. Here he is teaching another teen how to shoot a bow and arrow.

This young magician taught us all how to get a 100 Crown bill out from under a beer bottle without touching the money or the beer.

This artist created a virtual masterpiece depicting several scenes on one ceramic pot.

And even the youngest of the campers showed their talents. Whether it was my lunch-mate practicing his English, or a shy kid joining in on a new ly introduced American game of “Happy Salmon”, the kids never ceased to amaze me with their willingness to take risks, learn and share. I watched with admiration as this 6-year-old moved with the utmost patience and precision in a game of pick up sticks.

Nothing raises kids up to their potential the way play does. You can see the pride glowing as their self esteem grows by the second. And I feel so blessed to witness and participate in this play at Camp Klicek! Happy Summer!

Klicek Hospice Summer Camp: Kinderspiel Czech Style

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drawing by Markéta Královcová

A Diverse Community

My second stint as a volunteer at Camp Klicek in Malejovice, Czech Republic was as joyful and soul-filling as my time there last year.  The camp is special in many ways, but there are several unique facets that really stand out in my mind.  First, campers are encouraged to invite family and friends, and most campers have at least one sibling, parent, cousin or grandparent accompanying them. Most participants have been affected by an illness, developmental delay, death of a family member, poverty, racism, or incarceration. The campers range in age from one year to twenty-one (higher if you count the adults!) and come from such diverse backgrounds and situations that they form a very unlikely community of intersectionality.  This two-week summer camp brings together these widely varied individuals to partake in an environment steeped in nature, nutrition, community, and simplicity.

The Context of Nature

Children sleep in towering teepees and smaller tents constructed in a field behind the main house, a 100-year-old converted schoolhouse equipped with wheelchair access, hospital beds, and three working kitchens. The field harbors an orchard and several gardens that produce fruit and vegetables for meals and flowers that adorn each table in the mess tent. At breakfast, preserves made from this year’s crop of strawberries smother daily fresh bread from the bakery, accompanying homemade porridge with gingerbread crumble. Every meal is taken outside, and all campers gather several times a day for large group activities.

Real Play

The lengthy summer days, temperate climate, and loose structure of the day leave ample opportunity for the simple kinds of play that seem to be disappearing in today’s wave of technology. Campers are asked to turn in their cellphones each day, and are encouraged to find what they enjoy and make the most of each day. Whenever I offered to help out in the kitchen, I was instead encouraged to “Go play with the children. That is a better use of your time.” And so I too was free to enjoy the spontaneous kind of play that forms the building blocks of childhood.

Here are some examples:

Hand Games

I taught the kids how to play “Butcher Make the Meat Red”, a hand game where one player attempts to slap his opponent’s hands while the other player evades pain. They taught me how to play a finger counting game. Thumb wrestling and criss cross (patty cake) needed no translation.

Rough & Tumble Play

Kids don’t always get a chance to engage in gross motor rough housing play. Here they had plenty of opportunities for this without adult interference.

Feats of endurance:

Kids spontaneously tested their own strength and cheered one another on. Football (Soccer in America) and a Camp Klicek version of baseball (involving knocking over cans and running bases) are also popular.

Loose Parts Play

The children chose names for their teams (there were three teams for chores and competitions), and then found loose parts in nature to depict their team name. The foundation has an ocean theme running through it, which is hard to explain for a land-locked country. But the teams were encouraged to include this theme of being at sea in their chosen names. Here are the results.

“Rats from Below the Deck”

Mussel and Green Psychodogs

Nails on the Sea”

Forrests and Fields

There were many opportunities to walk and play in the neighboring forrest and fields, gathering campfire wood, building fairy houses, and searching for buried treasure.

Imaginative Play

Last but not least, the younger children explored toys, dressed up in princess garb, and played with music.

This smörgåsbord of play is a perfect real world representation of the lovely parting gift I received from Jiri and Marketa Kralovec upon my last day at camp: a print of Pieter Bruegel’s 16th century painting of Kinderspiele.

I came home filled to the brim with fresh air, incredible food, and most of all, play and excellent company. Thank you Camp Klicek!

Stay tuned for my next blog, where I continue to share camp photos and stories.

Cooperative Play in Nature at Camp Klicek, Czech Republic

the volunteers!

Photo credit: Jiří Královec

(Thanks to Jiří Královec for many of the photos! The best ones are his and noted beneath each photo. The rest are my amateur work.)

At Camp Klicek in the Czech Republic, a place where children and adults affected by illness and loss gather, activities run the gamut from a tiddlywinks tournament to bussing campers to a Shakespearean play.  The Accace Corporation provides tax advice to the foundation during the year, but they look forward to visiting the camp in person to have fun with the children and families each summer. This July, a fabulous group of volunteers  arrived with a day full of activities to engage us all. Their choices promoted creativity and cooperation amongst the campers, and nature threaded its way through the day’s activities. The volunteers brought their A game to the endeavor – with wonderful materials and activities – but more than anything, they brought their hearts. Continue reading

Making Hospitals More Hospitable with The Tongue Depressor Challenge

 

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My colleague, child life specialist Jon Luongo, is one of the most playful professionals that I have the pleasure of knowing. He taught me all about the “tongue depressor challenge”, which is described in detail in our co-authored chapter in the Handbook of Medical Play Therapy and Child Life.  Below is a brief introduction to the activity by Jon:

I encourage the doctors to tap into their imaginative playfulness to complete what I call the ‘tongue depressor challenge.’ The task is to co-construct a teaching tool alongside a patient to explain a part of the body, a particular medical condition, or piece of medical hardware. The challenge for doctor and patient is to use at least one tongue depressor in their design; like a single LEGO brick in a set of construction toys, the tongue depressor represents a humble piece of medical paraphernalia with limitless creative building potential.

 

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As with many great ideas, I borrowed Jon’s and tweaked it a bit. This past July, I brought the activity with me to the Klicek Foundation Summer Camp in Malejovice, Czech Republic. Camp directors Jiri and Marketa Královcovi graciously allowed me to lead the campers in a slight variation on Jon’s theme. Continue reading

Children Ponder Good & Evil at Camp Klicek

 

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We are all capable of good and evil.  People do bad things – sometimes they make mistakes that cause harm unwittingly. Sometimes they hurt others purposefully. Sometimes, doing nothing causes more pain for others than we can possibly imagine. At Camp Klicek in Malejovice, Czech Republic, founders Jiri and Marketa Královcovi make room for children to discuss and think about tough issues. They want kids in their care to be more than followers and simplistic thinkers, to see the humanity in everyone and the possibility that although conflict might be inevitable when a large group of people gather, people can make mistakes and still not be bad people.

And so, on one bright summer morning, following a hearty breakfast of porridge, bread, tomatoes, peppers, tea and hot carob with milk, the adults at camp led the children in an activity that reverberated throughout the week. The children gathered in small groups by age bracket. Some sat in the meadow, some under the mess tent, others in the courtyard. With adult guidance, they contemplated these questions:

  • What are bad or evils things?
  • Why do people do them?
  • What can be done about it?

The children took the assignment seriously, taking notes and including the voices of all. I moved amongst the groups, catching a snippet here and there from a kind translator. The children mentioned everything from the past and present atrocities of the world to the more mundane, including genocide, torture, terrorism and bullying on their lists. The youngest camper, when asked why people do bad things, answered, “Because they don’t love each other.”

At the end of the small group conversations, each group reported out to the whole camp, as we sat in the shade of the mess tent and processed together. The discussions were the scaffolding for the real fun. The next step of this activity involved each group choosing one of their examples, writing a play script to demonstrate the concept, and videotaping the enactment. The kids were deeply involved in this process throughout the day, and that night, they set up an outdoor theater in the courtyard, complete with a movie screen, the moon shining down upon us, and homemade apple strudel made from the summer apples, the Klicek version of popcorn. We smacked our lips and licked our fingers as we watched the completed movies, along with some movies created in past years.

My favorite play depicted two different families heading off to summer camp.  One family had no luggage or sleeping bags, just the clothes on their backs. The mother handed her children 10 crowns apiece and kissed them goodbye. The other family stood in front of a Mercedes Benz with their fancy clothes, belongings, cell phones, and the mother dolling out hundreds of crowns to each child. The scenario played out with the rich kids arriving at camp, immediately making fun of the poor kids, an act of kindness when one of them falls down and the other helps them up, and all of the kids ending up playing a game of football (soccer in the US) together.

A simple message, but one not lost on any of us. The campers did indeed come from a variety of backgrounds, and would probably not be interacting at school or in social circles outside of this camp environment. When I think of acts of evil, I think about how we create separation by dehumanizing people who we label as “other.” It is harder to keep these stereotypes and misconceptions in place when we wake, sing, break bread, play, and rest our heads together in the same teepee. I saw many acts of kindness each day between campers, whether it was an older child helping another child navigate steep steps, the hard work of the volunteers in our kitchen, or folks pitching in to help a teen search for her lost eyeglasses.

The thoughtful planning applied to activities that built community astounded me. Along with a mess kit and clothes, the camp packing list asked each child and adult to bring a glass jar with a lid to camp. The campers decorated these jars with their names and artwork, and hung them by ribbons on the branch of a low tree in the meadow behind the house. They left messages of appreciation in each jar, to adults and kids alike throughout the weeks. At the end of camp, they each took their jar with them, with strict instructions to hold off on opening it until they had arrived home. Marketa said that this is a concrete way to further the bonds created at camp. “Some of these children are isolated because of their illnesses. These jars and their notes are a lifeline for them throughout the year.”

My jar sits on my desk at home and reminds me of the generosity of spirit that children share so willingly. I can see why these campers return year after year to the meadow, the tree and the love.

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Camp Klicek: A Dose of Nature and the Universal Language of Play

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I remember the endless swath of time that summer brought when I was a young child. Unstructured free time in nature, with neighborhood kids, and my family. I also played alone, exploring the back roads on my bike and the woods on foot. At the age of seven, I would be gone for hours, playing in brooks, creating forts under the shelter of giant boulders, climbing trees, making up stories in my head, and writing poetry.

These days, we are hard put to find children at play in this kind of open-ended, unsupervised milieu. Their play is planned, highly structured by adults, and often close-ended. When left to their own devices, kids often choose tablets, smart phones and video games as their go to. Child life specialists and hospital play specialists know the value of deep, open-ended play that encourages self-expression, exploration, self-regulation, social development, and problem solving. My friends at the Klicek Foundation in the Czech Republic provide these play opportunities at their summer camp for children and families affected by illness and loss. This year, they invited me to partake in a unique camp experience, and I immersed myself in the healing environment of Camp Klicek, which has been in operation since 1992.

 

Children after a long-term therapy (and sometimes even patients under treatment, if their health allows it) take part in the camp, as well as their friends, siblings, parents and pets. Several bereaved families come too.

Our camp activities began as an attempt to offer a two-week stay in beautiful natural surrounding also to those children who couldn’t participate in a “normal” summer camp. We have always tried to create a friendly, open-hearted and open-minded atmosphere in our camps, and we hope that the camp program gives its participants enough opportunities to have fun, to do some useful work, to talk about things that are important to them, to simply be with friends.

The camp games and plays (mostly non-competitive) follow the make-believe story of a man who decided to spend some time with nature and is thus confronted with new situations and thoughts and starts to meditate on his own life and on the civilization he lives in.

Children live in big Indian “tee-pee” tents which are able to accommodate up to six inhabitants and have a fireplace inside.

Since 2000, we organize our camps on a meadow just behind the respite hospice building at Malejovice – thanks to this, children whose condition requires special attention can also participate in the camp program, backed by the safe environment of our house.

 

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Indeed, I found myself amidst a remarkable mix of campers and staff, a combination of people and circumstances that is hard to imagine anywhere else. The youngest camper was seven years of age, the oldest, twenty. The children’s diagnoses differed significantly, as did their abilities, disabilities, ethnic and socio-economic backgrounds. There were children undergoing treatment, survivors of serious illness, siblings, friends, parents, and bereaved parents who had lost a child. The camp leaders, Jiri and Marketa, are purposeful in their choice to bring children and adults together where they might not otherwise interact in larger society. Watching connections form between the campers and staff of varied backgrounds was a blessing on so many levels.

The focus of our days involved living in nature, eating good, healthy food, exploring tough topics such as “What is evil?” and “How can we make the hospital experience more pleasant?”, and above all, building community. The virtual lack of technology at camp was so refreshing. I felt myself detoxing from my smartphone addiction as I wrapped myself in nature, old fashioned, simple play, and grand company.

Many friends have asked me what it was like for me to be surrounded by children who spoke Czech. Did I learn any Czech? How did I communicate with them? Well, I was immersed in a foreign language – of that there is no doubt. Most children spoke no more than a few words or phrases in English, and my Czech is abysmal. But the children understand more English than they speak, and play is a universal language.  The children’s welcoming of me was profound, inviting me into play, making me feel immediately part of the group. “Frisbee?” “Will you play?” “Come play football.” “Ping pong?” “Draw.” Once engaged in a game or project, there was much good will and laughter as we all tried our best to communicate.

I too, grew my Czech vocabulary one word and gesture at a time. I made it my goal over the week to learn everyone’s name – a challenging feat with names that were not familiar to me.  But with each name and greeting, I could see the rapport growing, the shy kids responding, the teens warming. Some of my favorite moments were when I would board the 1970’s retro bus for a field trip, and a kid would smile at me and pat the seat beside them to show they’d been saving it for me. Or that wonderful moment, when the quietest camper, one who spent much time alone and looked down or sideways rather than meeting your gaze, took my hand as I stepped off the bus and walked quietly with me to our destination.

It’s the small stuff, really.

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Children berry picking on a picnic in Czech countryside

 

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Klicek Foundation cofounder Marketa leading us in a trivia game in the camp’s mess tent, where we ate all of our meals.

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Handgames

In my next several posts, I will dive deeper into some of the activities we did, the games we played, the lessons I learned.

 

Velvet Revolution Remembered

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November 17, 2017 marked the 28th anniversary of the Velvet Revolution, when  Czech citizens rose up against communism and succeeded in toppling the regime, foretelling the coming dissolution of the USSR. This date is no coincidence, as it echoes a previous moment in history, when the Nazis responded to students’ protests by closing all Czech universities, killing 9 students and imprisoning 1200 in concentration camps.

On the national holiday, the Kralovecs and I joined the throngs at Wenceslas Square in Prague to remember and celebrate the arrival of freedom and democracy  to their country. A large stage with a giant screen broadcast live music and political speeches. When we first arrived, yards away a news crew interviewed one candidate for the presidency, surrounding him with bright camera lights and microphones.

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Booths lined the street, some displaying candles in red glass jars, and ribbons in Czech red white and blue, others offering political information. One encouraged passers by to sign a petition calling a stop to the hunger strike of a man protesting the current president running again for office. People feel that his life is more important than the foolishness of the current president.

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The self sacrifice is reminiscent of a student’s martyrdom in 1969.  Jan Palach set himself on fire at Wenceslas Square after the Soviet Union invaded his native Czechoslovakia to crush the reforms of Alexander Dubcek’s government.  The actions of people who sacrifice themselves in order to awaken awareness and resistance against oppression are as disturbing as they are inspiring. Why should this have to happen in order for people to wake up and resist?

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We headed to Narodni Trida, the place where the protestors and police clashed on the fateful day. Entering a building where an exhibit of enlarged photos of the revolution hung in the lobby, I noticed a father explaining one photo to his small son.

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The photos told the story of the revolutionaries, who were students for the most part. They carried signs calling for freedom. One showed students with raised and open hands. A banner read “Our hands are empty!” indicating their lack of weapons. Apparently the wording for “We have sticks in our hands” is very similar to their statement, and the authorities later lied in the press, reporting that the students were inciting violence. In fact, it was a peaceful demonstration and many students handed or threw flowers to the police in riot gear, who responded with violence.

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Outside the building a sea of glowing red candles and flowers surrounded the edifice. Citizens young and old  approached the flickering monument to add their own candle or flowers. Small children crouched at the edges, observing the firelight while they braved the cold night.

 

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A marching band made its way up the middle of the street along the trolley tracks and stopped beneath a balcony to accompany a singer whose voice silenced the crowd. She sang a rendition of a song performed from the same balcony during the protest, and I could see that many people were moved to tears by her words. Even though I don’t speak Czech, I too felt a stirring and energy that seemed synergistic with the crowd’s mood.

I  had many questions for Jiri  and Marketa about what they recall from that day in 1989. They explained that their role was a small one, handing out pamphlets and showing up for the protests. The people of Prague were mostly open to the ideas of change and democracy, but the citizens in rural areas were more closed to the revolutionary ideas and less willing to risk protesting Communism. Well known actors took up the cause to travel in groups from village to village to impart the message of freedom and facilitate change. It makes me think of what evil can do in the face of no action at all, and it was the many risks that people took, large and small, that brought about tremendous change.

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We drove home watching the television broadcast of the Memory of the Nation Awards broadcast from an elegant theater on the Square and streamed on Jiri’s smartphone. A dear friend of the Kralovecs, Father Frantisek Lizna, was one of three recipients. The nation celebrated the Jesuit priest for his service to the country in taking a stance against Communism that landed him in jail, and for a life of service to those in need. I had met him on one of my previous visits, and I recall his kind, open and playful nature. Indeed,  jokes and banter peppered his acceptance speech, and he exuded humor and lightness even in this formal environment.

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Funny enough, we found out later that we all appeared on the national Czech news prime time that night, as the news cameras caught us unaware in the crowd. I felt extraordinarily blessed to stand witness to the history of this place and to share in the personal memories of my revolutionary friends. As we headed home through the dark and foggy roads to the village of Malejovice, I thought about how the students proclaimed that in unity there is strength, despite the authorities’ attempts to separate the workers from the educated classes in order to tamp down knowledge and resistance. I think of our own country and how coming together may be the only way to survive and thrive as a true democracy.

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Whose Woods These Are

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I awoke to my first snow of the season dusting the rooftops, fence posts and trees of Malejovice. The woods called to me and so I donned hiking boots and set out over the fields to the forest. The snow sifted quietly, the mud of the unpaved road sucked at my feet and the utter silence filled my heart.

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Arriving in the forest felt like entering the haunts of Hansel and Gretel.  I stepped past the trickling brook and into the peace of the sheltering pine trees. The pine needles cushioned my steps and the trilling of birds and patter of melting snow the only sounds. I passed a fallen tree, it’s root system an earthy sculpture.  Pine cones and balsam branches decorated the forest floor.  Mossy tree stumps stirred memories of nature walks with my dad when I was very young. He used to point them out to me and tell me that they were fairy castles.

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I stood still and closed my eyes and listened. The first poem that I learned and memorized at age seven welled up from within.
“Whose Woods these are
I think I know.
His house is in the village though.
He will not mind me stopping here
To watch his woods fill up with snow.
My little horse must think it queer
To stop without a farmhouse near.
He gives his harness bells a shake
To ask if there is some mistake.
The only other sounds the sweep
Of easy wind and downy flake.
The woods are lovely dark and deep.
But I have promised to keep
And mikes to go before I sleep
And miles to go before I sleep.”
Robert Frost

Indeed I knew that friends and breakfast awaited. I reluctantly left the silence of the woods and headed back to the warmth of Malejovice over fields glistening in the melting snow.

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Over the River And through the Woods to the Czech Republic I Go

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I greatly anticipated my fourth visit to collaborate with the Klicek Foundation in the Czech Republic. The cold weather brings to mind the song from my childhood of traveling via horse and sleigh through the woods to grandmother’s house. For me, it meant taking a new route flying to Prague via a stop over in Zurich, which provided me with my first glimpse ever of the majestic Swiss Alps. I had no idea they covered such an expanse.

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Our adventures began immediately, as Jiri and Marketa Kralovec included me in some important errands along the way from Prague to their home in the small village of Malejovice.  The Klicek Foundation has secured a plot of land close to the Motol Hospital, on which they will build a new hostel for parents of sick children visiting Prague for specialized medical care. Our assignment for the day was to measure the distance between several trees and a wall, so that an engineer could design the parking lot to meet the requirements of the environmental council.

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And so, armed with measuring tape and a clipboard, we gathered the necessary measurements. We then wound through the city, making stops at two publishing companies and an electronics store, where we gained sustenance in a lovely cafe to tide us over before the hour long trip home to the village.

Molly the dog and the many cats greeted us, and there was hot homemade soup waiting on the stove and a crackling fire in the green ceramic fireplace. Having missed a night’s sleep on the plane, I was happy to fall into bed in the dark country night, and I slept deeply without remembering my dreams until rising early for a full day’s work the next morning.

The first scheduled event was a gathering of three schools that are housed in one building in Prague. There are two secondary schools, one for nursing and one for social work, and a college of nursing. The students came together in a chapel at the school of nursing Jana Paula 11, and we presented a workshop on the value of play and the psychosocial needs of children in hospitals. The room was jam packed with young people, and the more interactive we got, the more engaged they became.

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Following this seminar, I accompanied Jiri and Marketa to a city council meeting where they advocated for permission to build upon the plot. There are many steps to take before they can announce the council’s approval and begin fundraising for their project. A well known actor, David Vavra,  who also happens to be an architect, is designing the building.

Following a challenging meeting, we headed over to the famous Old Town Square, to the medieval building that houses the Skautsky Institute. There we hosted a gathering of hospital play specialists that also included the medical director of a hospital on the northern border, a book publisher, and a British law student studying abroad at the Charles University. We discussed the challenges facing the profession, many of which involved issues of racism regarding the care of Roma families. The thorough marginalization of the Roma leads to trust issues between the families and the staff. The play specialists often feel overwhelmed by the intersectionality of the many societal factors that impact the lives of Roma families.  They feel helpless in the face of such poverty and hopelessness.

The law student, of Roma heritage, adopted by a British family, is researching the educational inequities and racism that Roma children face in Europe. He hopes to champion their cause as he progresses in his profession. He had connected with me after reading my blog about the children of Chanov — such a small world after all

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Child Life & Nursing: Practicing pediatric psychosocial support in Novy Jicin

 

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My recent visit to the Czech Republic, sponsored by the Klicek Foundation, included a return to the Mendelova Nursing School in Novy Jicin. This time, Maria Fernanda Busqueta Mendoza joined us from Mexico, and 50 students participated in our seminar, making it a great opportunity for global learning and a multicultural exchange of ideas. As you can see from the first photograph, the students were a lively bunch, and they eagerly participated in the highly interactive time we spent together. Jiri Kralovec served as our interpreter and his son, Jiri, touted  by Foto Video Magazine as this year’s hottest photographer on Instagram, documented our learning. Most of the photos below are his work.

Jiri and his wife, Marketa, started us off by sharing information about  the importance of play for hospitalized children and the history of their efforts to bring hospital play to the Czech Republic.  It has been a slow, uphill battle to change the hierarchal and disempowering bureaucracy of their medical system.  I followed with an introduction to the field of Child Life, the role of child life specialists in hospitals, and the possibilities for collaboration with nurses. I spoke about the role of play and community in the healing process, before moving on to some illustrative activities.

Sharing our own memories of play is one way to deepen our appreciation for the role of play in our lives and in the lives of children. I asked the class to think about their own childhood memories, using their five senses — what do they remember about their play environment? Did play occur inside or outdoors, or both? Were they playing alone, or with others? Did they play with toys, loose parts, or their imaginations? Are there sounds, smells, tastes or textures associated with their memories? What feelings are evoked in sharing them? The students paired up and took turns both sharing and listening to one another.

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Armed wth a deeper awareness of the value of play, the students were now ready to learn a bit about how to make procedures less frightening for children. I have always wanted to use role play as a way to demonstrate all the things that can go wrong during a procedure, and how minor changes can make things easier for medical staff, children, and caregivers. I took this opportunity and asked for volunteers. One young man played the patient. We instructed him to lie down and asked three others to pin him down to the table, much like medical personnel are likely to do when a child receives an IV. We demonstrated how the very act of being forced into a prone position increases one’s sense of vulnerability and loss of control.

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Add to that several adults talking at once, loudly over any protests you might make, telling you to stay still, not to cry, to be a big boy, not to look…. and you get the picture. Chaos, stress and shame accumulate to make for a disastrous experience for all.

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But there are some simple things that nurses can do, either alone or in partnership with play specialists, to change the outcomes of such procedures. It doesn’t mean that the child won’t cry, but it is more likely that the child won’t suffer emotional trauma, will return to baseline quicker, and the nurses can feel more successful and less like they are causing the child undue suffering.

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With these tips in mind, the students enacted a better case scenario, where the parent has a supportive role in positioning the child for comfort. The child is upright and held in a calming hug, rather than being restrained on the table. The child is given some choices, such as which hand to try first for the IV (the non dominant hand is preferable), and whether to watch the procedure or use a toy or book for distraction.

  • Electing one person to be the voice in the room,
  • encouraging the child to breathe deeply and slowly,
  • narrating each step of what the child will feel,
  • explaining how a tiny plastic catheter, not the IV needle, remains in the child’s hand to deliver medicine,
  • staying away from comparative or shaming statements,
  • and showing empathy

are all ways to provide psychosocial support, making the experience less traumatizing and painful for the child.  Accumulated painful and traumatic medical experiences can make children phobic and avoidant of medical care.

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We also spoke about non-pharmacological pain prevention and reduction. The interactive component of our lecture surely made our important information memorable. The action and laughter surely made more of an impression than a power point! We all reflected together about  how even adult patients can benefit from choices, information and empathy.

Back to the topic of play, we explored ways for the nurses to instill playful interactions into their communication with pediatric patients. Rapport building and distraction through the use of hand games is one way that they can put a child at ease. I demonstrated several hand games, and asked them to show me some of theirs as well.

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Our time with these wonderful students ended all too soon. We posed outside of the school for a photo with some of the Klicek Foundation hospital play specialists before heading to the historic square down the street. Around every corner of this country is a beautiful scene, no matter where you are!

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