At the REH Artlink have always supported the involvement of patients within creative and horticultural activity. The last couple of years we have been focused on the idea of ‘Grounds for Change’ which aims to not only provide valuable activity for the patients, but also to effect some form of physical change to their environment.
The programme responds to:
The need for activity that patients can undertake. Through a variety of workshop programmes we provide much needed activity around the hospital.
The need for patients to have non-clinical spaces within the hospital grounds. Our aim is to transform some spaces into spaces that feel much more like a home environment than a hospital environment.
Patients choices are often drastically reduced when they are in hospital, we also aim, where feasible, to increase the level of choice presented to the patient.
The need for patients peer to peer support within the hospital.
The need for some form of normalized social environment.
The need for relatives to have non clinical spaces in which to visit their loved ones.
Developing a long-term relationship with dementia care within the Royal Edinburgh Hospital through exploring ways in which patients, families, nursing staff and artists can work together as a team; learning from each other in order to make positive change within a ward.
Artlink has been working at the Royal Edinburgh Hospital over several years providing a range of participative arts opportunities and artists placements. The longer-term nature of our involvement allows relationships with patients and staff to evolve over time and creates opportunities to link in with specific NHSL led quality improvement initiatives.
In partnership with Charge Nurse Frank Charleston we identified Pentland Ward at the Royal Edinburgh Hospital, a long stay ward for men with early onset dementia, as the best possible place to take a longer term learning team approach. It was also the focus of a Quality Improvement initiative led by Frank and Frances Aitken, NHSL Practice Improvement and Development and therefore had the added benefit of understanding how arts activity can contribute to creating positive ward environments which contribute positively to staff development and tackles absenteeism and high staff turnover which has a negative effect on quality improvement efforts.
It was decided that the learning team should consist out of NHSL staff, relatives, Artlink producer and artists, and patients. Pentland Ward was selected to ensure a continuity of involvement for both patient and family members. Selecting a long stay ward allowed us to take time to establish strong working relationships and follow through work with the same people from beginning to end. From the outset, we identified that it would be important to bring in other collaborators/ organisations to increase both the reach and scope of the project, as well as provide the additional resources that our collaborators would bring.
Using interactive performance to gain a better understanding of patients’ needs and staff practice at Liberton Hospital in order to address immediate issues of low motivation, social isolation and boredom; ensuring relevance and greater impact of longer-term approaches.
We had been approached to provide input to Liberton in early 2018 as a date for a move of patients form Liberton to new wards at the Royal Edinburgh Hospital had been established and need for input identified by staff. For over a year the start date for the project was put off, as Liberton closure dates appeared imminent, only to be pushed back until a later date. During this time, we were also working as part of Specialist Dementia Unit Improvement Programme in partnership with Healthcare Improvement Scotland (report attached), funded by EVOC. We were interested in taking what we had learned from this work into other spaces facing similar issues.
Liberton specialises in medicine for elderly patients (a larger
percentage of whom have cognitive issues). In collaboration with with key staff
on the wards we decided in March 2019 that we should no longer hold off putting
anything on the wards, as the need for input was now seen as critical. Patients and staff had nothing on their wards
in regard to activity: ‘When we first
went in it felt terrible in there. A low mood. Tired people. Very empty and
isolating spaces as there were just the 4 wards working in the entire hospital
(and now just down to two!)’ – Miss Annabel Sings
Activity on wards had diminished over a period of years for patients and staff, in anticipation of closure, ‘we have not had regular activity over the last 8 to 10 years’ – staff nurse who has worked on ward over the last 19 years. A charge nurse identified: ‘There wasvery little happening, music in hospitals once a month. That’s it’. Little activity and the knowledge that the wards were supposedly closing imminently, had left staff feeling like they were in limbo. The impact on staff, patients and families was tangible. ‘I’m bank, its worse for the permanent staff. It’s a nice team and it’s worrying for them. When are all the patients going to go? They worry that they won’t be with same colleagues, that a good staff team will be split up’. – Bank staff nurse working on ward for last 5 years.
All the wards in the New Royal Edinburgh Building have had their first vitrine workshop with artist Tom Krasny. The project is supported by the Green Space Art Space PSP and the idea is to use the glass spaces in the wall that divide the communal dining and living spaces to create dioramas. Each ward will have a slightly different theme and the pieces made during the workshops will help populate and tell the story of the scene.
It is an energising process as Tom explains: “From my experience running workshops at the Royal Edinburgh Hospital, art activities allow participants to shift focus from stressful circumstances, concentrate on something external and make creative decisions which are at the same time intuitive and subjective. In workshops that take place in hospitals, making the work is often a collaborative effort – a dialogue between an artist or staff member and a patient.
Engaging in creative activities together is fun and informal. It gives participants a sense of agency in a place which often makes them feel controlled. What’s more, it lets them personalise objects in an environment that can feel very impersonal. Art activities also allow space for valuable interpersonal exchange.
I am frequently surprised by and learn from people I work with, their ingenuity, sense of humour and creative choices. The success of a collaborative artwork lies in the approach and atmosphere in which it is made, and I can personally say working with Artlink has made me, as well as many other people, very happy.”
People get so much out of involvement in the arts. Working together in workshops encourages a solidarity between patients that often follows them from hospital to community. The safe space that the workshops represents allows people to be themselves, to use their imagination and follow through on ideas away from clinical environment. This is invaluable.
The Robert Fergusson Unit is the national brain injuries unit treating patients from across Scotland who experience psychiatric or behavioural problems after a head injury. The unit has a multi-disciplinary team which includes: nursing staff; neuropsychiatrists; speech and language therapists; physiotherapists; occupational therapists; art therapists and social workers.
We have worked with this amazing unit over many years and when we were approached to explore the possiblity of creating a permanent artwork with them we were excited to get involved! Artist team leader Anne Elliot worked with patients, Lynda Girvan, art therapist and Alice Landrock, OT over a number of months to explore what might be possible to create. It always takes a while for ideas to get to a certain stage and when they did we brought in a new pair of eyes, in the form of artist Tom Krasny, to develop the project further.
Tom tried out different ways of constructing and deconstructing 3 dimensional forms over a period of 4 weeks. She found that working so closely with patients gave her a great insight into what shape an artwork could take. We have just presented the idea for a permanent sculpture in one of the court yard spaces to patients and staff, and they have given us the green light to progress to the next stage.
We would like to thank the patients and staff for all their hard work and look forward to our continuing work with them. Of course we will share the photos of the final sculpture once it is in place!
We have been working with the Robert Fergusson National Brain Injury Unit for an extended period of time. This is a specialist clinic for the treatment of patients from across Scotland who have suffered psychiatric or behavioural problems after a head injury. The unit has a multi disciplinary team which includes nursing staff, neuropsychiatrists, speech and language therapy, physiotherapy, occupational therapy, art therapy and social work. No two patients’ needs are the same and the team work together to create bespoke care plans around each patient.
Artist Anne Elliot has been working with Lynda Girvan, art therapist and also the OT team, especially Alice Landrock. They have been working on generating ideas for an artwork that celebrates the patients and the work of the unit. It takes time to establish ways of working and at a certain stage we brought in a new artist, Tom Krasny, to take the project onto a new level and develop a series of workshops with patients and staff. Tom worked on four workshops to further test approaches that would have meaning to the patients. Working with a lightweight foam material, Tom constructed pieces that could be deconstructed and reconstructed by the patients – a bit like arty, colourful, oddly shaped, building bricks.
We were amazed at how well some patients took to this process, happy to take the pieces apart and reconstruct them in whatever way appealed to them. For some people reconstructing was about colour combinations; for others it was about putting different shapes together. The activity captured patients’ attention for up to an hour and a half, which is a mark of success on the Robert Fergusson Unit! We knew that we had hit on something that was of meaning to patients on the unit.
Over the last months we have been working in partnership with The Scottish Book Trust and The Reading Agency to bring Reading Friends to care for the elderly wards. Reading Friends is a UK wide scheme that uses books and reading as a way of fostering friendship and creating meaningful moments that have long term effects.
We are one of just two projects in Scotland and the first to be bring this project onto hospital wards. Fifteen new volunteers with varied and interesting backgrounds are ready to deliver this brilliant programme after some first class training from our partners at Volunteer Edinburgh. More training is to come as we continue to recruit but we already have a few of our wonderful volunteers visiting Prospect Bank and St. Johns Hospital. Simon Jay, Artlink’s volunteer coordinator for Reading Friends, has been bringing an exciting energy to the scheme:
“Since our first volunteer meeting mid-January, we’ve had new volunteers join us and we’ve begun to get out onto the wards. The volunteers themselves will be able to share their personal experience at one of our regular volunteer meet ups. Personally I have observed how the act of companionship, through sitting alongside someone and reading, can make a difference in unquantifiable ways. For instance, one patient a volunteer was reading to became much more engaged during an hour together looking at photo-books of Edinburgh. Relatives who visited after a Reading Friend had been to visit mentioned that everyone found it easier to talk and engage with each other. On another occasion, visiting a particularly distressed patient in their room calmed them down immediately and they found the companionship very soothing.”Simon Jay, Reading Friends Volunteer Coordinator