A theme for today seemed to be making puppets as presents for siblings. Last week the sister (6 years) of my most regular `customer` had made a magician called Mr Nobody who she had then given to her brother (3 years). As usual he was my first stop and had decided in advance that he wanted to make his sister and mum dog puppets. We set to that with fun and games, and lots more cutting up - luckily one dog needed a lot of spots so we had somewhere to stick all the bits. We took some photos of them - he is getting very skilled with the camera, and then he made a lot of short films mostly of dogs licking things. I was also persuaded to make them sing `The wheels on the bus` and `Twinkle Twinkle` in barks - all in a day`s work. His Physiotherapist joined us then, and asked me to stay as he does not enjoy her visits, and he was absorbed with the filming and able to largely ignore that she was thumping him on the back (good for him not so good for the films). He then said he would like to go online but I had just begun to set it up when he announced that he was tired, so I left him as we had been together for well over an hour.

The day ended with another patient`s brother (6 years) making him a puppet while he waited for him to wake after his operation. He started by saying he would just make one for his brother, but rapidly decided he needed to make two, one for each of them, and then they became `Jedward`. A story emerged about Portugal and how he would send the bus there, so when he had finished and photographed them he quickly made a little set with a swimming pool and doors and windows and had some fun filming them fooling around there.

Most of the patients today were very young babies, I worked with a 20 month old girl for a little while. She was very shy of me at first so I showed her the new bus poster I had made for the corridor to display pictures of puppets made over the past six weeks, placed in windows that can be opened to show their little stories or names. She seemed fascinated and I thought the stories would draw her in till she tried to pull off the shiny cd wheels I had given it and I realized the true source of her fascination. She was too young for any of the puppet materials to be safe for her so I gave her some colored paper and crayons and she started happily scribbling ensconced on her daddy`s knee. The next patient was 11 months and in isolation, his nurse approached me delighted when she saw I was going into him, saying she had been trying him with every toy she could - he was bright-eyed and bored, and greeted me like a long lost friend. He sat on his mother`s knee while playing with the crayons and paper I gave him, interacting a little with some drawing I made one of his toys do, but mostly communicating through dropping and handling crayons, they being toys to him as much as mark makers. He seemed to thoroughly enjoy himself, and I stayed until he became tired of it.

My eldest patient today was a four year old who had spent the morning in the school and was waiting to seen by the doctors so he could go home. He was tired and unsure at first but gradually warmed to the idea and decided he would send the bus to the city, and agreed to make a little cityscape. He is from Donegal so we tiptoed to the window past other sleeping patients and raised the blinds to look out for inspiration but were met with a blank wall opposite! Luckily he had spotted a better view in the corridor so we went there and had a look out. He wanted to know what the Zebra Crossing below was, and we spotted a crane and some interesting chimneys. Back in the bed he drew and cut out a scene and made a crane, and then a puppet from pipe-cleaners he decided was John, the crane driver. Happily he was interested in trying for a weblink as we had two of the project sponsors discreetly watching in the corridor. Unfortunately we couldn`t see the musician we were linking with (some interference with her webcam) but we could hear her, and he was very absorbed with twirling his puppet - as it was made of glittering pipe cleaners it looked quite like a sparkler on the camera. Mr Nobody`s maker was with her brother on the other side of the curtain so I called her in to see if the puppets might interact, but John was the strong silent type, and his owner was tiring, so we soon called it a day.

After the web-link I went to meet the sponsors and Helium director to tell them a little about the work. One of the nursing staff was already with them and I was pleased to hear her say how reports back are very positive. The sponsors also said nice things and seemed delighted, so that was uplifting.

High points: The fun I had with the long term patient, the twinkle in his eye as we worked. The four year old telling us there was a better window in the corridor and he, his aunt and I having a good look out, and chat about what we saw. Seeing the sponsors out of the corner of my eye as he was online and realizing they had an excellent view of the most suitable thing they could!

Low points: when you have begun to build up relationships with children through your work, it is hard to witness how unwell some of them are and hard also to see such tiny new babies arriving in ill. I need to remind myself of and admire the resilience of children despite this - their determination to play when unwell, and the community of the ward where staff and parents work together to create a normal and nurturing child-centred environment.

4 patients, (from 11 months to four years) 2 siblings, 11 parents/adult visitors, 5 support staff 4 nursing staff