Thanks for engaging with this innovative new programme, developing a Music in Paediatric Healthcare (MPH) curriculum and training Programme.
The following links will take you to relevant documents:
Information about this programme (along with printed questionnaire and sign up sheets)
“Oh I can’t hold a note!”
“I’d better not sing, it’ll start raining”
“Oooo you’re so good, you should be on X-Factor!”
So often we have been met with comments like this. It seems to be assumed that regular, every day people cannot sing, and that if you can, or do, or are comfortable trying, you are someone special and should be put on a stage. Within the last twelve months, I have been part of three events in three different healthcare settings that demonstrate the importance of singing in making deep impact connections with other human beings, where the spoken word often fails.
The first of these was a young boy waiting in hospital for a procedure and needing some cream in preparation. The cream needed to be placed on his hands and elbows with bandages. This was not painful, but he appeared understandably anxious and unable to remain calm. We began singing a jolly upbeat song (Zamina) quite loudly, to meet his intensity, volume and energy. Mum was sitting with him and encouraging him, with the promise of a visit to McDonald’s later on. All of this initially calmed and engaged him, but he soon started thinking about what was going to happen to him, and started crying again. I decided to try changing the words of this song to make them about him and the special bandages he was having put on. This made him think differently about his bandages and smile a little, and altered his mood and energy. As the nurse completed the preparatory procedure, the young boy was smiling and looking at his bandages with a bit of pride and pleasure, as if the song had validated them and made it ok. The nurse stated that the music and song had really helped her finish the task.
The next event was in a different hospital, one morning, with a family comprising a young male patient, Mum, Dad, and little baby boy brother visiting. As we entered the room we started playing Twinkle Twinkle Little Star. After a few moments of listening and looking, Baby started vocalising whilst looking at me. I moved closer and got down on the floor nearby. I vocalised as best as I could the same sounds back to him and maintained good constant relaxed eye contact, open mouth, and smiles. He continued vocalising with me whilst I was singing words. Then I sang in the baby’s words “ye ye, ye ye” to the tune of Twinkle. There was instant recognition and reciprocation – good confident eye contact and vocalising with me, not just at me, including some copycat exchanges, intermingled with little bits of the melody of the song. Then ensued some smiles and giggles and real joy in Mum and Baby (sitting on Mum’s knee). This is the youngest person I have ever sung with and I really feel that we made quality music together on this day.
The final example of singing together came during a short session of playing music for a group of eldery people with dementia in a care home. There were at least 17 residents and 2 members of staff sitting round in a circle facing inwards, no one talking to one another. As usual, there was a lot of shouting out and getting up and wandering around prior to the music. As we started, with some gentle tunes, trying to match the volume and energy of the room, but trying not to be too loud, there was some joining in clapping, lots of smiling round the room and looking at each other. We started singing “Oh my Darling, Clementine” (a choice made by one resident’s continual quoting of the lyrics and rhythms of the song), and the room changed. There were at least 6 people singing the same words in the same time in the same song in the same room – a real sense of shared experience, working towards the same goal. Unable to see each other, talk to one another, or share most other activities, these elderly people seemed positively engaged in this activity together with smiles.
Our voice is very personal to us. It is part of our identity and gives an indication as to who we are and where we are from. It is the product of vibrations made by tiny tendons being contracted and relaxed inside the voicebox, as air flows from the lungs and out through the month and nose. It is developed and formed on the way by the shape of that unique individual’s vocal tract. In order to be able to develop the voice over time, the vocal folds need to be flexed and exercised regularly in order to develop the control of the sound quality, the pitch, the breath and, with all of that, the confidence to allow your singing voice to be heard. Most importantly though, it is not about perfecting the use of the voice, but about the true benefits of taking part…..
Professor Graham Welch, Chair of Music Education at the Institute of Education, University of London, has studied the developmental and medical aspects of singing for 30 years. He found that the health benefits of singing are both physical and psychological. “Singing has physical benefits because it is an aerobic activity that increases oxygenation in the blood stream and exercises major muscle groups in the upper body, even when sitting. Singing has psychological benefits because of its normally positive effect in reducing stress levels through the action of the endocrine system which is linked to our sense of emotional well-being. Psychological benefits are also evident when people sing together as well as alone because of the increased sense of community, belonging and shared endeavour.” www.heartresearch.org.uk.
I believe it is important to keep facilitating opportunities for people to use their singing voice more and learn to feel comfortable with this, developing their skills through experiencing the benefits of song, especially in healthcare settings. Just because you are not Adele or Robbie, why would you deny yourself these life-changing moments? To baby, Mum and Dad’s voice is the best in the world.
Sarah Matthews
10th October 2016
OPUS Music CIC relies on grants and donations to deliver music-making in healthcare settings.
Please consider supporting our Music and Health practice by donating to our funds.
OPUS Music CIC is a non profit-making organisation, dedicated to ensuring that all donations go directly towards providing music-making opportunities for people most in need in healthcare settings.
Five years ago, during my initial training as a musician in healthcare settings, one of the first challenges I faced was how to take my specialism of percussion into hospital settings. How could I use percussion instruments, particularly drums, in spaces that I assumed would be very quiet in a way that would enhance that environment? How could I use something as potentially noisy and intrusive as a drum in an a space populated by children suffering from a variety of illnesses or conditions which are unknown to us and doctors and nurses doing a job that required great concentration and accuracy? After having spent 10 years playing in a variety of loud percussion based bands and running drum circles and percussion workshops, I couldn’t see how a drum would do anything other than disrupt a hospital space, over excite or disturb patients and distract doctors and nurses. At that time the thought of taking a drum into a hospital ward seemed like a bad idea and if the possibility of taking one into an intensive care unit had been raised it would have seemed ludicrous.
In the last couple of months I’ve had cause to remember and reflect on my initial thoughts and reactions to drumming in hospital.
The first occasion started with walking into a children’s intensive care unit in a large hospital in the East Midlands. The unit has about 10 beds in it with only a few feet in between each bed to allow access for nurses, parents etc. The feeling on the ward is quite enclosed and cluttered due to the large amounts of medical equipment around each bed and the large numbers of staff attending the patients.
I was working with two colleagues, Sarah on fiddle and Marc on guitar. We had been requested by a parent to come and play music with her little girl who was about two years old. The little girl, who we will call Lisa, had special needs, no speech and had recently had a tracheotomy, so she couldn’t make any sounds at all with her voice.
When we arrived Lisa was sitting up in bed and her mother was at the bedside. Marc started playing a nursery rhyme and her actions and facial expression showed that she was immediately responding positively to the music. Her mother reinforced our reading of this response with positive comments and an increase in engagement with Lisa. We continued to play, with Marc leading the interactions and encouraging Lisa to shake along or engage with the animal toys around her bed. I changed from accompanying a lullaby on ukulele to playing a deep quiet and steady beat on the bodhrán on the next song. As I did so I noticed a shift in Lisa’s focus towards the drum so I asked Marc to make some space so I could get to the bed.
I knelt down at the bedside and asked Lisa’s mother if I could place the drum on the bed so she could see it and hear it more clearly. I continued to tap along on the drum as we sang, just keeping a gentle pulse and as I did so Lisa leant forward and started touching the drum skin. She was exploring how it felt, sometimes tapping it and sometimes just leaving her hands on the skin to feel the vibration as I continued to tap the drum. Sometimes I copied what she did on the drum but she seemed to be getting the most pleasure from experiencing the vibration from the skin as I hit it. She moved from having both hands on the drum, to both hands and one foot on the skin, to putting both hands, one foot and her face pressed against the drum as I continued to gently tap the pulse of the song that was being played and sung by all the musicians.
Once Lisa had become used to the sensation she decided she wanted to find out more about this object so she started to try and move it around. I responded to her attempts to move the drum, moving it for her in the direction that she was trying to get it to go. She turned the drum around and put her hands inside it. She tapped inside the drum and left her hands on the skin as I played the other side. This continued for at least 5 minutes after which time Lisa started to get tired which she showed by simply disengaging from the drum and leaning backwards onto her bed.
All the way through the interaction was accompanied by beautiful music and songs from Marc and Sarah. As Lisa was exploring the drum and interacting with me, a group of nurses and doctors had gathered to look at what was happening. From their comments and faces they all seemed to be really enjoying the opportunity to see their little patient behaving like a normal child enjoying her exploration of her environment.
The second instance of drumming in ICU was in a different large hospital in the East Midlands. This time a nurse said it would be ok if we went into a side room where a young toddler, we’ll call him Mohammed, was standing in his cot. His mum was in the room with him and the TV was on with the volume turned up. After saying hello to them both we checked with the boys mum if they would like us to play. They had already seen us playing in the main part of ICU so we felt like they would understand what we might be offering. When Mum agreed we asked if we could turn the TV off. Once we had done this we had Mohammed’s full attention.
As soon as we started playing he was jiggling around to the music and wiggling about holding onto the bars on his cot. He also had a tracheotomy and was attached to oxygen through that. I was surprised at how much energy he had and how little the tracheotomy and the oxygen tube hindered his enjoyment or compulsion to move. He was really grooving and smiling. We gave him a shaker and he quickly learnt the ‘throwing the shaker out of the cot’ game so I approached him with my drum. His response was very similar to Lisa’s. His hands were immediately on the skin and again rather than his focus being on hitting the drum himself he seemed to be enjoying feeling the vibration through the skin. Mohammed too was intent on exploring the drum, constantly turning it around and around so he could feel it inside and out. The drum must have seemed enormous to him, as he was only just taller than it’s diameter. Once he got the hang of how to get a sound from the drum he started really enjoying the loudness of the instrument and as we were in a side room I was able to allow him to really get into this, knowing that the volume outside the room wouldn’t be distressing to other patients and staff. As he started to lose interest in the interaction I refocused my playing of the drum to join back in with the tune that Sarah had been playing throughout the interaction and so we were able to leave the room in a musical way with Mohammed having played his part in some great interactive music making while learning about and experiencing a person sized drum!
In order to use a bodhrán in hospitals I’ve had to develop my technique so that I can play very quietly whilst maintaining accuracy and positivity. I’ve also had to develop and change my musicality to think about how I use the drum to accompany song. Traditionally the drum is used to add drive to tunes and to bring out the rhythm and shape of tunes. There can be a lot of ornamentation used in bodhrán playing and I often choose to strip much of this away so that I focus on the essence of the rhythm of the song or tune, focusing on groove more than the shape of a tune. I always try and keep in mind that my focus is on playing for the space and the person rather than for my own enjoyment. The drum I have has a very rich bass end and even the top end is mellow sounding. This enables me to play with a variety of dynamics without bringing in any harshness to the sound. It has been my experience that choice of instrument is very important when using percussion in hospitals. My preference is for warm sounding drums that can be played to obtain a variety of pitches. The other factor that I’ve had to consider is the weight of the drum. The bodhrán is often played sitting down, so walking around a hospital for a day carrying the drum also presented problems. I fitted a strap to my drum and this has helped a great deal.
When using the drum for interactions there are number of things to bear in mind, not least of all the potential volume of the instrument and the impact that this can have on the space around. There is a lot of satisfaction and a sense of power to be gained by a child when they hit a drum hard and get a loud sound in response. It’s a great thing to allow this but the musician also has a responsibility to their surroundings and the other people in the space. Sometimes it’s not a problem to allow a child to make a lot of noise, sometimes it’s ok once or twice but then the volume needs to be managed. Other times a loud noise is not appropriate. I dampen the drum with my hand, use explicit verbal instructions or offer beaters with softer heads in order to manage the volume of the drum. If volume is becoming an issue I also try to refocus onto rhythm, pattern or copying.
I’ve come to realise that there is no problem with bringing and playing drums into the most sensitive of environments. My skepticism at the start of my training was rooted in the way I was seeing drums, thinking about them and relating to them at the time. The power of drums to transform mood, empower people, to facilitate communication and connection and to bring joy seems consistent in all situations. This power is not constrained to the volume or complexity of what is played. It’s up to the drummer to learn and then decide how to best use the drum to the maximum benefit in any given circumstance. Working with drums in hospitals has given me a great faith in the efficacy of what I do as percussionist and inspires me to explore the huge potential of drums still further.
Richard Kensington, OPUS Musician
We entered the ward as a group of three musicians. As soon as we entered though the doors we were noted by a doctor in the second bay down who had a group of 7 junior doctors with him.
He turned to us, introducing us to his group as a regular team that come into the Children’s wards each week, playing music for and with the children, parents and staff.
As the junior doctors were currently doing some observations on a small child at the time, we asked if it was appropriate to play some music at this time and the doctor (trainer) welcomed the opportunity to see how the junior doctors dealt with the situation and how they could use the music as an aid to their work.
We then played a gentle version of ‘Wind the bobbin up’ on Melodeon, Fiddle and Ukulele, adding vocals to act as a distraction to the small child whilst the junior doctors listened to her breathing through a stethoscope.
The child and her mum instantly recognised the song and joined in with the actions, singing along very happily. The junior doctor was instantly able to listen to the child’s breathing without any fuss from her, as she was far more interested in the music and joining in with us.
It wasn’t just the parent and child that enjoyed our music, as very quickly all junior doctors joined in the singing and actions too, much to the child’s delight.
Oli Matthews, Musician, OPUS Music CIC
Dancing in Hospital Corridors
‘Jim knew that he wasn’t much of a singer or dancer, and to him, a public display of singing and dancing implied he thought himself and expert. The villagers just stared at Jim and said, “What do you mean you don’t sing?! You talk!” Jim told me later, “It was as odd to them as if I had told them that I couldn’t walk or dance, even though I have both my legs.” Singing and dancing were a natural activity in everybody’s lives, seamlessly integrated and involving everyone. The Sesotho verb for singing (ho bina), as in many of the world’s languages, also means to dance; there is no distinction, since it is assumed that singing involves bodily movement.’
This Is Your Brain On Music – Daniel Levitin 2006
To some people, making music is an activity reserved for the elite. This is no more apparent than in the UK’s concert halls, with their ritual flower bouquets and coughing breaks. This is the same for dance, an art form most commonly seen at the wedding disco. So where does that leave us, stone cold sober in the harshly clinical environment of a hospital corridor, bobbing up and down in time to ‘Wind The Bobbin Up’?
I love dancing. As a child my role in my parent’s band was to be the first on the dance-floor and to encourage others to join me. Im still doing that now! I’ve pogoed and shuffled and bopped and moshed and salsa danced to all kinds of music and I hope I always will. However, most of my dancing has been with others doing the same thing in a dimly lit venue. Using movement in my music in healthcare practice has been a relatively new exploration for me. Its important to recognise that the young people we’re working with are often dancing, and we should positively reinforce this engagement with our music.
I do this sometimes by mimicking the movement of a young person, and sometimes by responding to their movement with music too. An example of this happened in a corridor, with a young person en route somewhere with his mother. He boogied along to the music we were playing in the adjacent ward, and his mum stopped and the both stood and watched. I turned away from the ward and noticed them. The child started, slowly at first bobbing up and down with the music. I joined in, naturally! This lasted for a minute or so. The music came to a natural conclusion, and I started improvising gently around a G chord, just to keep the music and dancing going. The rest of the musicians started to join in, not only with the music but with the movement too. Dave then led us into ‘Round and Round the Village’, an English Childrens song, and we all marched!
I think this highlighted the point to me that we are only embarrassed about dancing because we are told to be, and often children are yet to feel that embarrassment. I am now as confident in using movement in the hospital ward as I am singing and playing, and I feel that it is becoming an integral part of my practice. Its useful for making people laugh, making people dance and keeping people engaged; definitely not something to be embarrased about! Perhaps we all need a little more ‘Ho Bina’ in our day to day lives?
James and I had been playing for a while with B (a boy of around 5 with Down’s), who had been enthusiastically playing on the xylophone. We played through a song and brought it to an end, and B carried on playing, so we picked up his tempo and played chords along to him until another piece of repertoire emerged and we played that through, B focussed intently all the while on his playing. There came a point where B very clearly stopped and gave the beaters to his mum, who remarked how impressed she was that we were able to play in such a way that made B the musician and us his accompanists, and that we played something really good that he was taking a leading part in. This felt like a ringing endorsement, that what she described is EXACTLY what we’re aiming for.
Three of us had played to a whole bay, where I had offered a teenage lad with cerebral palsy a shaker – a bit tentatively as I was not sure if he would be able to hold it and I knew his motor control would be limited. His face, however, was such a beaming welcome of the music that it felt right. He did hold the shaker and was able to move it from side to side and played exactly on the rhythm. The song ended and he handed it back. The others said their goodbyes and made to go, but I was having a strong feeling that the lad could happily play more. I decided to go with that and, rather than be led by the others, said we could do more and went back to him with the xylophone. He struggled a little with the beater (we need a thick-handled one!) but clearly enjoyed being able to make sounds as Rich played and we sang along, and his brother came along and helped him with it. Meanwhile, across the bay, Sarah had engaged a mother and child in more play with the glock. It seemed very much the right thing that I had followed my instinct there and gone back to him, and the others agreed. At this point in the apprenticeship (very few sessions left) I’m pleased to be taking a lead in this way.
Working as an associate musician for OPUS provides me with the great privilege of working musically within my local hospital setting. Three times a month, I visit both adult and paediatric wards at Furness General Hospital, making music for and with patients, staff and visitors.
Unlike the main OPUS music in healthcare practitioners, my work is mostly solitary, and I am aware of how this brings slight differences in our practices. I am also learning all the time, and the ‘expect nothing’ mantra is key to approaching each interaction with eyes, heart and mind open.
Music in a clinical setting has potential for impact in so many ways, from bringing a change in the atmosphere, providing comfort and distraction, reinforcing the well side of patients, through to providing some autonomy and control in a setting where so much can feel out of a patient’s hands.
Perhaps the biggest, lasting impact I notice in my own work is that of being the starter of conversations. On a bay of 6 beds, the shared experience of the musical presence frequently opens up interaction between patients on their own music experiences. The joy of music is something almost all have been affected by at some point or other in their lifetimes.
It is something we all have opinions on – ‘I don’t like this modern stuff’ ‘I like all sorts of music’ ‘You can’t beat the old classics’ ‘You can’t beat a bit of rock & roll!’
It is also something many have had lasting experiences with, whether it was watching live-aid or the proms on the telly, to seeing an act live on stage or at a wedding. Not forgetting how many of us either had the opportunity to learn an instrument as a child, or wish that we had. Perhaps family members play something now.
Conversations starting from the basis of music can lead to all sorts of further topics, from who is in your family to the places you’ve lived over the years… And even if no memory is sparked from being a part of this musical experience in the hospital, there is always the current shared music itself to discuss!
Also of note, is the way the music can spark non-medical interactions between staff and patients. Whilst of necessity tending to be briefer, these discussions take place between two human beings, at once equals and brought together by this shared experience. No longer a care-giver talking to a poorly person, the music can really have an impact, allowing both to see the other for the human being they are.
And let us not forget the family and visitors of patients, who may sit at their bedside for hours at a time. As before, sharing in the music together can spark so much to talk about, often when the day-to-day news has dried up. It can also provide a respite from having to talk at all – an opportunity to be present together without need for words – and this can be just as valuable.
I have also had the privilege to witness the presence of live music-making provide opportunities for parents of very young or very sick children to find additional ways to engage with their loved ones. Where words aren’t cutting through to a child’s understanding, the music can. As their mother, father, grandparent, aunt, uncle hold them close, or stroke their head, or hum and sing along, it can really help to convey their love, their caring, their desire to comfort.
I have found in all my work as a musician in healthcare that where the music itself ends, the interactions it sparks continue to ripple through the space remaining, often long after the musician has gone. Perhaps one of the biggest impacts of my work is when I am not present to witness it…
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Mary Dunsford is an associate musician of OPUS Music CIC, and has been working at her local hospital setting, Furness General Hospital, for the last 12 months. We are delighted that Mary has been granted a further 2 years funded residency, through the Sir John Fisher Foundation, to continue her programme of work making music on her harp for and with visitors, staff and patients at their bedsides.
Listen here for a BBC Radio Cumbria clip of Mary’s work from last year.
We get a wide range of reactions to our music-making in children’s hospitals – from the babies, children and young people themselves, and from their families and staff.
Staff greet us with delight as colleagues, often give us a ‘heads-up’ about their ward, and go about their work with the confidence that we will contribute positively to the environment and the people within it.
Patients and their families, especially those who have not previously experienced music-making in the hospital, often greet us with a look of surprise and amazement that music is ‘allowed’ in such an environment. Many instantly express delight that music can now be part of their hospital experience, some exhibit initial slight concern or embarrassment about what might be expected of them in return.
The interaction between professional musician and professional healthcare staff, both working as part of the same team, along with some gentle confidence on the part of the musician of their place and potential value in the setting usually sets everyone at ease, and allows the music to flow from everyone.
There are some patients, however, for whom there are no inhibitions, potential embarrassments or pre-conceived perceptions of what a musical offering could be. We met one such patient recently in an Accident and Emergency department. Sitting on his Mum’s knee, this young baby engaged the moment we began to play. Showing no signs of embarrassment, he looked straight into my eyes and connected instantly. He had been crying before we entered the space, but was now transfixed by the music and the human connection, and began gently wriggling and vocalising along to the music, taking time out occasionally to grin at his Mum and at us until eventually gleefully playing a shaker along with us. The sense of relief and joy between baby and his Mum was palpable.
At the same time, an older boy was sat with family in the next bed. His initial reaction, and to some extent that of his family, was one of giggling, possibly through embarrassment and the lack of ‘coolness’ of the whole situation. He and his family, however, watched intently as we played for the baby and his Mum. What I think they saw, was a musical connection made between musicians and family, one where no-one had any expectations, where everyone could be exactly who they are, and where they could all be part of a beautiful artistic exchange.
By the end, the older boy was filming us on his ‘phone, watching everything intently and joining in with songs along with his family. His family said he had been very upset before we arrived. We had, at least for a short while, given him some relief from this, and demonstrated the impact of strong connections made through honest music-making. As we left, he smiled, clapped, and thanked us for visiting. Upset was replaced by delight in the shared experience he had just been part of with his own and another family, and with the two rather ‘uncool’ but egoless musicians who had, for a short while shared some quality time through music making.
Music, especially in the hospital environment, gives everyone the chance to be themselves, to forget inhibitions and embarrassments, and to make human connections and great music which supports their own health and wellbeing.
Nick Cutts
Director, Musician & Trainer, OPUS Music CIC
Thursday 16th July 2015, 9.30am – 4.30pm Education Centre, Royal Derby Hospital, Uttoxeter New Road, Derby, UK.
We are delighted to launch the forthcoming International Music in Healthcare Conference, hosted by OPUS Music CIC in partnership with Royal Derby Hospital and Air Arts to Aid Wellbeing.
Bringing together music for health practitioners, healthcare staff, promoters, funders, researchers and other key stakeholders, this event promises to provide stimulus for discussion and debate around the ongoing development of Music in Healthcare settings across the UK and beyond.
A mix of thought-provoking presentations and discussion groups throughout the day will leave all stakeholders with new contacts and new ideas for continuing to develop their own practice.
Places are available to book for a modest charge of £10 from the Eventbrite link below (includes tea and coffee on the day).
We are also hosting a Music in Healthcare Settings ‘Music Sharing’ day on Friday 17th July 2015, to be held in Derby. Any musicians attending the conference are invited to come along from 9.30am-3.30pm (stay for as long or short a time as you like!) to make music with like-minded musicians (small charge of £2 payable on the day to cover refreshment costs).
Please email us at conference@opusmusic.org if you would like to come along to the Music Sharing day.
My experience as a Music In Healthcare Apprentice in 2014/15 has provided me with a fantastic platform to build my own practice in the coming months and years. I strongly believe that good MiH practice comes from experience, and that this work is all about learning how to adapt to different situations.
One thing I would like to highlight is how a combination of non-verbal approach techniques and repertoire in different languages can help overcome some of the challenges posed by cultural diversity in our hospitals. Instrumental music is not bound by language constraints at all and part of good practice is using repertoire with a ride range of languages. Working as a MiH practitioner has strengthened my belief that music is hugely effective as a communication tool between people from all backgrounds and all ages. There are countless examples of this happening in the last 6 months, and it was been noticeable from when I first engaged in this work in November 2013.
One that springs to mind happened in a neo-natal intensive care unit. Myself and Oli were working as a pair in a small space with 3 newborns. These rooms can often feel very cramped and often the breathing apparatus and monitoring machines can make them feel very noisy. For this reason it is important to be aware of the sound you are making and make sure you are not just contributing to the hum of medical equipment and causing a negative effect. Whilst we were making music with ukulele and melodeon, I feel that the most effective instrument in that space was our voices. We sung, Kyla Vuotti Uutta Kuuta (a traditional karelian wedding song sung in a Finnish dialect) and Zamina Mina (a cameroonian song sung in Fang). We also sung some traditional English Lullabies like Twinkle Twinkle Little Star. This seemed to be working well and the two parents in the room were making physical contact with their children and even singing to them!
We were then greeted by a young girl around 5 or 6 who had come to visit her baby sister; she was accompanied by her mum. We continued to play as they got settled. I then went to fetch the box of instruments from outside the room, and chose the Glockenspiel to get out first. I continued to play along with Oli on Melodeon but on the Glockenspiel now. Being aware of the sensitivities of the space, I carefully chose which beater to offer to the young girl and continued to play very quietly along with the music. The young girl hesitantly began to join in and grew in confidence as the music continued. We played 5 Little Speckled frogs together, and then she took to a spark shaker as we played Galopede, an english country dance tune. We were aware all this time of the other parents in the room smiling and vicariously enjoying the music making through the young girl who was clearly having a wonderful time.
As the final tune wound to a close we were asked to stop by a member of the medical team as one of the babies in the room was about to have an X-Ray and they had to move the X-Ray machine into the room. We did so quickly and packed away our instruments. It was only then did we say thank you to the young girl for playing and realise that she spoke very little english. It struck me that we had managed to facilitate music making for a young person, relax the room and provide music for patients and parents, and perhaps most crucially of all provide a platform for parents and siblings to interact with their newest family members using almost no words.
It is important to say that this is one of the instances where music has really been useful to overcome cultural barriers, but this is not always the case. There has been times where it has not worked so well (presuming that every child knows wind the bobbin up springs to mind!). Even the trickiest interactions provide an opportunity to learn, and I am trying to soak in as much as I can from the apprenticeship programme as I begin work at Great Ormond Street Hospital, a hospital that will provide an even more diverse body of young people to make music with and learn from.
APPLICATIONS ARE NOW CLOSED
Many thanks for the many applications we received.
We look forward to announcing our new Apprentices for 2015/16 soon.
We are delighted to launch the second year of our Music in Healthcare Settings Apprenticeship programme.
From September 2015 to June/July 2016, we are offering four paid apprenticeships, exploring Music in Healthcare Settings practice alongside highly experienced OPUS Musicians and Trainers and supporting the development of new programmes of practice.
Click on the following links for more information:
Full Apprenticeship Programme Details (pdf)
Apprenticeship Timetable (pdf)
Application Form (word)
Application Form (pdf)
The deadline for applications is midday on Friday 5th June 2015 with interview/auditions to be held in Derby on Friday 12th June, Monday 15th June or Tuesday 16th June 2015.
** ADDITIONAL INTERVIEW DATES ADDED **
This programme is made possible with the support of public funding by the National Lottery through Arts Council England.
I have met and played music with James (name changed) several times while he has been receiving treatment in hospital. Our first encounter was on my second day as an OPUS Apprentice and remains one of my most memorable experiences so far. James’s Dad saw us coming down the corridor and, after checking with James, invited us in. As the three of us entered his room James greeted us and asked my name as I was new. After a brief sizing-up of our instruments James began leading us in a musical improvisation. Eyes shut with concentration he conducted us effortlessly, without hesitation, his every hand gesture full with musical expression, which we followed with equal focus. Often he would sing out and whoop and we would respond and riff on his signals. It was wonderful to see someone so completely engrossed in what they were doing artistically, beyond all sense of ego. He channelled every part of himself into creating the music he wanted to hear. The joy and satisfaction we were feeling resonated through the room and out into the corridor, prompting nurses and James’s Dad to look round the corner, smiling and nodding their heads. “That’s James” his father said as we left, with look of pride.
For the next few weeks I found myself secretly ‘hoping’ to see James, so we might relive our great musical encounter. I felt that perhaps this was a selfish thought, as he was hopefully out of hospital and living his life. This is something that happens so often with music; the wanting of those great moments all the time. Yet my role as a Musician in Healthcare demands so much more than this. The hospital is a challenging, ever-changing place where no two visits are the same. A patient’s conditions can fluctuate, on one visit they might feel like music, the next visit their door maybe shut, the lights out and with little sign of activity.
For me, James’s playing demonstrated so clearly the principles we work by as Music in Healthcare practitioners. To be open and generous with the music we make, sometimes playing, listening, and with sensitivity and a feeling of wellbeing within ourselves.
Dave McKenny, Music in Healthcare Apprentice, OPUS Music CIC
February 2015
Working one day in Leicester in October 2014, we spent some time on a Ward playing for a whole Bay to listen to. There were several families there who had obviously been waiting for some time, for a procedure or surgery. The curtain was closed around one bed, but when Dad heard the music he threw back the curtains and made encouraging comments. His little boy was about 3 years old and quite shy to begin with, but with gentle encouragement and plenty of time and space, he found the confidence to have a go. He tried the shakers to begin with and then progressed on to the glockenspiel. We played Diamond Day and a few other pieces that engaged each family.
After playing Waltz vor Polle in the bay next door, it was time for this little boy from next door to go down to theatre. He was waiting in Dad’s arms by the reception desk, crying and becoming increasingly upset. We came over to him again, still playing, and immediately got his attention and he stopped crying. As we started Wind The Bobbin Up, Dad said he became much more relaxed and calm in his arms. We offered to play and sing as they went down to theatre, and they all liked this idea a lot … our young patient still very much calm and relaxed.
As we walked off the ward, down the corridor to the lifts area, we switched to Twinkle Twinkle, as I thought perhaps if we were unable to go down in the lifts with them, Mum and Dad would be able to continue singing. … But we all fitted in the lift … and as the doors opened on level 3, to a very surprised audience awaiting the next free lift, everyone smiled. Still our little friend was engaged with the music and quiet.
Finally, we reached the doors to the theatre waiting area and left this family. A tired, grateful father said thanks and the doctors smiled in appreciation.
From Nottingham Post, 19 June 2014
MUSIC is helping an 11-year-old boy battle crippling headaches which have left him unable to attend school.
Mrs Bell said:
“James gets really down when he is in hospital because he sees other children and he can’t do what they can do, but he gets so excited about OPUS – the first time he did a session with them he was beaming. James feels that he is creating music and for that time the pain and depression does not exist and it is just wonderful. What they do is absolutely vital for so many people and it has inspired me to play piano at home and we have started singing together.”
Consultant pediatric nephrologist Martin Christian, from Queen’s Medical Centre, said: “It would be a disaster if we didn’t have them. Some of our patients are mesmerised by them when they come round and they give them a huge psychological boost. I think there is something incredibly calming about the music which has a positive effect on both the staff and the patients.”
Barbara Cathcart, chief executive of the Nottingham Hospital Charity, said: “There is something special and powerful about what OPUS Music does for the children, including known benefits to their healing. These types of projects are made possible through the generosity of our donors, for which we are very grateful.”
We are delighted to be able to continue, and expand our existing relationships with Derbyshire, Leicester, Nottingham and Kings Mill Children’s Hospitals with support from Youth Music and from our local and hospital partners.
This support means that OPUS musicians will now visit each hospital on a weekly basis until April 2016, making music for and with the patients, their families and staff.
Our recent evaluation and documentation work has demonstrated the highly valued impacts of this practice; we are incredibly grateful for the support of all our partners in enabling this work to continue.
We are delighted to introduce Mary Dunsford, Harpist and OPUS Associate Musician who we have been supporting in establishing a programme of ‘Harp in Healthcare’ at Furness General Hospital, Barrow in Furness.
This programme, taking place for the remainder of this year, is supported by funding from the Sir John Fisher Foundation, and sees Mary visiting the hospital on a weekly basis, making music on both adult and paediatric wards, mentored by OPUS Musicians and Trainers.
Here’s a great audio clip from a recent BBC Radio Cumbria broadcast featuring this project…
We are delighted to have Mary on board to develop this practice in Cumbria.
Angela Kang:
What does a hospital musician do? This was a question asked at the beginning of working with Opus Music CIC. It was a question that seemed straightforward and simple to answer. Truth be told, one cannot fully understand and appreciate the many diverse aspects of this role without actually physically being in the hospital wards, taking part in the music making, or watching first-hand. Reading a scholarly article, training manual, or a blog entry can only give you an impression of what might take place. The positive benefits of music in healthcare settings are well-documented. Watching a video is perhaps the closest you can get to understanding without being there, but it still cannot fully convey the emotional and multi-sensory experience of delivering and receiving music in a busy hospital ward. Explaining to others the work you do never seems to do justice to the magic that actually takes place. One thing is clear: a hospital musician needs to be empathic, understanding, creative, and able to adapt their approach to a range of medical situations. With these skills, an array of exciting possibilities can be explored to engage patients, visitors and staff in music-making and create open spaces for cultural exchange. Bringing music into healthcare settings is always personalised and uniquely directed towards the particular mood and setting of a ward, group, or individual – that is why it can be difficult to explain. As Plato writes “rhythm and harmony find their way into the inward places of the soul.” Music is a form of communication that is far more powerful than words, far more immediate, and can be far more effective.
Joe Danks:
Over the last 4 months I have been participating in a training programme delivered by Opus Music. The programme mostly involved me delivering musical interventions at the Queens Medical Centre, but also involved a day spent talking about our experience as mentees. It is with great sadness that I wave goodbye to what has become a part of my routine, and a part that I looked forward to each week. I would like to thank Opus for the high quality training I have received, and recognise the patient and gentle nature of the musicians I have worked with. I would also like to express what a joy it has been to spend time in the hospital school with the selfless hospital staff and teachers; the hospitality from everybody at the QMC Education Base has been wonderful.
I said in my first blog post that the real treasure in this work lay in the young people that we met on a day to day basis, and I am even more convinced of that after 10 weeks than I was after 3. The sheer diversity of character displayed throughout Nottingham Children’s Hospital is constantly astounding, and the positivity reflected back to us as musicians is immensely rewarding. The positive effects of music are very clear to me, and I have experienced its wide ranging benefits on a regular basis all the way through my life and I feel like the mentoring process has allowed me share a little bit of this with people when they need it the most, and that’s been really fantastic. I think its important also to recognise not only the social and psychological benefits but the educational benefits of this work. I’ve spent a lot of time talking about my instruments (Guitar, Ukulele, Percussion) to young people and parents, and I feel like people have really learnt about music as well as participating in playing it.
Music In Healthcare has gradually become a part of my life, and I am striving to make it a part of my future plans. I am hoping to visit projects across Europe, and hopefully engage in some music making with those projects. I have been instilled with a passion for the importance of this work and I intend to continue with it for many years to come. Huge thanks again to Opus, Hospital School and also to Angela Kang who has been my fellow mentee during the process. Its been a pleasure working with all parties.
Knowing what type of music will enhance the psychological and physical wellbeing of patients relies on empathy and intuition. There are two things that are always necessary for this type of work – appropriateness of musician, and the appropriateness of musical selections. Empathy (personal and musical) is of great importance. First and foremost, a hospital musician needs to survey the situation, and identify whether a patient would be happy to listen to or engage with music. In some cases, this can be quite obvious (a smile, a curious stare, parents directing attention of the children, a willingness to engage in conversation). For example, the other day a hospital teacher informed us that a teenage girl was struggling to complete a piano composition for her school exams, and would be delighted to meet Opus musicians for some inspiration. We created the opportunity for the young girl to develop her ideas, and encouraged her to feel confident in improvising as together we instigated a medley of improvised musical waltzes. Although focused on one patient, it was clear that others on the ward were happily watching.
In other cases, whether a patient is open to listen to or engage with music is much less obvious. In this situation, a gentle and tentative approach is best. It might also be appropriate to ask if they would like to hear a song – giving the option to a child patient (who often does not have choices concerning medical interventions) can perhaps be liberating. For example, the other day, a young child looking a little unhappy and fatigued was cuddling up to her mother in the corner of a ward. Her mother was clearly delighted to see musicians coming over to pay special attention to her little one, and this enthusiasm from mother triggered a little smile from the fatigued girl. We gently played ‘Yellow Bird’ as they happily watched, midway handing over a shaker to the little girl who (despite her tiredness) wanted to join in. At some point, her curiosity about the accordion led her to ask about it, and we let her press a few keys – which perhaps made the connection a little more personal. After this, realising she probably might want to rest, one of us asked if she would like some more music, or if she had enough for that day. She chose to rest, and looked happy as we gently said “thank you for playing, and goodbye”. Knowing how and when to end a musical interaction requires a good sense of empathy and intuition.
We have a range of musical pieces that we can play and improvise with. Sometimes a well-known and catchy song might be in order. However, sometimes, a well-known piece can evolve into a new and totally improvised piece of music – which can be equally effective and appropriate. According to Vescelius, “discrimination in the choice of music is essential; in ill- health one does not enjoy a musical banquet but a musical specific” (Vescelius, 1918).
There are lots of skills required for this work, and as I come to the end of ten weeks training I realise there has been a huge amount of progression in all areas. I also understand now probably more than ever that there is a long way to go and even were I to train for ten years there would still be situations and interactions that would surprise me, and situations I could learn from. This has been demonstrated throughout the process, with new challenges presented every week. I think this is best described as a non-linear learning experience, as some weeks you feel like you really feel like you have made progression and some weeks you feel like you are back to square one. The diversity of challenges is equally reflected in the diversity of reward, and there is a new joy to be found every time you meet someone new.
There are lots of musical skills that I have found to be invaluable in this process, I must say most of these have come from my experience in the folk tradition. I would like to focus on watching as a purely musical discipline. Whilst watching the young people, parents and staff is of paramount importance, I am focusing on the way we as musicians watch each other. In my opinion the way in which we watch each other is closest in style to the way that I would watch fellow musicians at a folk session. The music works in a very democratic way, far from the dictatorship of a classical conductor. This is intrinsic to the way we work, but it does bring its own obstacles. It certain situations it is necessary to communicate a vast amount of information in a very short amount of time. This usually takes the form of simple eye contact; I don’t think I’ve ever appreciated my eyebrows quite so much! There is also a lot of information communicated with body language. Little ducks down to designate volume or hand signals to gesture to drop to just voices for example. I’ve done an awful lot of discreet pointing. For this to work, is it crucial to have a good musical rapport with your colleagues. I think this comes from experience playing together, and experience playing in a hospital context. Knowing how each musician plays is really important as there is no set structure and the form is very loose. You need to be able to follow each other. This is something that you develop from getting stuck in and doing, and a skill I feel like I possessed before, but one that has developed hugely through my mentoring.
Spatial awareness is crucial to the success of this work, and takes 2 different forms. You need not only to be aware of your physical position in the space, but also your sonic position. There is a real difference between playing to a space and playing to an individual. Sometimes it seems appropriate to play for a whole bay from the adjacent corridor as opposed to entering the space to interact. Sometimes this is a doorway into interactions but often it is deemed more beneficial to simply play for a few minutes and move on from the space. Receiving music passively is often all that a patient can engage with, and this is a good way to provide stimulation without being overbearing. Conversely, the work that we do often requires us to get extremely close to patients. This requires a great deal of tactfulness and awareness. Moving towards a bed is very easy to get wrong. Awareness of your own size, and your instrument’s shape and appearance is very important; otherwise you run the risk of coming across as something to be feared. Learning to show your openness with your body is important. As hospital musicians we often joke about working in the hospital being a great workout, but it is very true. A huge majority of interactions happen whilst I’m on my knees or squatted next to a bed. Putting yourself below a patient can transfer control to them. It is also important as it helps you present your instrument. Feeling the sound is very different to just listening to it. I remember very clearly an occasion where my colleague Angela had a young man in a wheelchair simply holding the two halves of the accordion whilst she gently worked the bellows. He could feel and hear the air rushing through the accordion and it was having a huge impact on him, it was really wonderful to watch.
Whilst your position in a space is a tool, it is also something to be careful of. Angela and I have joked about being like the ‘Men In Black’ in a space, but it is a really useful comparison! We often enter a space back to back and face one half of the ward each. This allows us to see everything that is happening whilst we play, allowing us to mitigate any negative effects of the sound we are creating. Another way of doing this is to have one musician dedicated to observing the wider space and not engaging one to one with patients. The wandering musician in the middle of the bay acts as a lookout, and watches for anything that we might need to be made aware of. This becomes much trickier when all the musicians are engaged with patients, and this is why it is helpful to have 3 musicians in the hospital at any one time. We need to be careful of our position in a space, but when used well our body language and positioning are some of the most powerful tools we have.
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