It’s the final day of our 5-day music in healthcare training today, and we’ve had a great time exploring the skills and competencies required to deliver this work alongside a fabulous group of trainees. We’ve spent time in the training room exploring, alongside many other things, repertoire, improvisation and ethical principles behind this practice. We’ve also spent a couple of afternoons at Derbyshire Children’s Hospital, playing music for and with patients, visitors and staff on surgical and medical wards, in the neonatal unit and in A&E. Final day today bringing all our learning and experiences together. Many thanks to our trainees for embarking on this journey with enquiring minds, a spirit of adventure and enthusiasm, and a real passion for this practice.
Our 18 month residency at Leicester Royal Infirmary Children’s Hospital began on 11th September, and what a fabulous day it was! After having a tour of the wards and outpatients areas of this really busy hospital, we began our work on one of the wards accompanied by one of the play specialists. Some lovely interactions with children and babies, all of whom were finding the music engaging in ways which suited their individual situations. Play staff had been struggling to engage one particular patient in any activities, however he immediately found the music-making engaging and his mood brightened significantly. Music became a means of communication with him, and one which staff were then able to use.
During the afternoon session we were asked to attend a treatment room where a doctor had previously tried to take bloods from a young girl accompanied by her mother and play staff. Despite trying various distractions, the child had previously become too distressed and agitated for them to be able to take bloods, and it had taken a long time for the child to calm down after the attempt. We were asked to help. We were already playing music as the child and her mother entered the treatment room, the doctor and nurses all ready to take bloods. The girl sat on her mother’s knee, and though she was still a little agitated and upset by the procedure, it was completed quickly and succesfully this time around. As the child had become agitated, we reflected this in our music, recognising the child’s distress and being ‘with her’ through the music. As the procedure finished, we gradually calmed the music and she quickly calmed with us until we gradually resolved the music to a gentle rendition of Zamina (aka Waka Waka), a popular song across Africa. The girl’s mother knew the song, and joined in with us, singing gently to her daughter as her previously restraining arms transformed to ones for cuddling and comforting. We all left the room in a calm and peaceful state (if a little emotional at the beauty of what we had all just witnessed), and crucially with mother and daughter reconnected through music.
In Kings Mill hospital last Friday we were invited to play in a single bed room for a young boy who was connected to a lot of monitoring equipment and had an oxygen mask on. We played a song for him and his reaction was fairly muted but he did say that he liked it. We took our time and spoke a bit to his Dad who said that he himself was a song writer. We played some improvised music and offered the boy a shaker to see if he would like to join in. He declined it and just looked on. He was making his spider man doll move about a bit to the music and we picked up on this by changing the way that we were playing depending on how he moved the doll. Once he realised that spider man was conducting the band he couldn’t get enough of it. He had a great time determining the pace and duration of the music with his doll and he laughed and smiled as he did so. His Dad said we’d done well to get a smile out of him.
Before we left the room the boy’s dad asked if he could share some words he had written about his son being in hospital and we listened as he did so. He’d written a really moving rap about his love for his son and family. At the end he said ‘Thanks for listening to that… It’s quite hard to get people to listen’.
Music in hospitals gives people the time and space to reveal and express their emotions.
Last Friday was my first visit to Kings Mill Hospital in Sutton in Ashfield. While being guided round the wards for the first time by a member of the play team, Nick and I were invited to play for a young girl who was profoundly disabled and who had very restricted means communication. We played a song for her and her parents seemed very pleased to have us there. After we had played, they mentioned that the girl responded very well to whistling. This was only the second time that Nick and I had worked as a duo and we had discussed a variety of different ways of doing this without Sarah playing the lead melody. Whistling had not been on the list but we took up the gauntlet and set to whistling a version of ‘Maid and the Palmer’. The girl responded with a show of great pleasure, the parents were pleased and I was reminded of the importance of maintaining a versatile and light hearted approach to music making in hospital!
Through playing music in hospital wards we are constantly learning to read patients reactions and developing our sensitivity as to whether a patient is happy for us to be there, wants us to be there or would rather we left. Sometimes this is easy as the patient gives a clear response to our arrival and we can feel confident as to whether we should stay and play or leave.
On Friday 1st of June I was part of an interaction in a day surgery ward that went something like this… We entered the 8 bed ward and played for the children and their families there. We were met with a variety of reactions from the patients on the ward, from interest, through indifference to excitement. We felt confident to stay and play. We played for about ten minutes and had engaged a couple of children who had interacted with us to varying degrees, but all positively.
While this was going on a child (who we later found out was just one year old) was brought back onto the ward from surgery. He was coming round from anaesthetic and was in some discomfort and distress and there was very little that mum could do to comfort him. He would not stop crying. At the end of the piece we had been playing Sarah moved over and started playing for the boy. Nick was playing behind her and I was some feet away able to view the scene from a distance but still able to provide musical accompaniment. As I watched and played and the piece progressed I couldn’t see that what we were doing was having any discernible effect on the boy or even that he had registered our presence, even though Sarah was only a couple of feet away and crouching down playing at the boys eye level.
I was starting to feel uncomfortable and that perhaps we were distressing the boy more and my reaction was to move away but Sarah continued to play so I stayed and played. After a few more seconds (that to me felt like a long while) the boy all of a sudden stopped crying and became transfixed by Sarah. He stared straight at her and became completely absorbed in the music that she was playing on her fiddle. Nick and I stayed in a supporting role continuing to play but leaving Sarah free to steer the interaction. She carried the piece on for a couple of minutes during which time the boys gaze did not leave her once. The boy seemed calmed, still and relieved of physical discomfort.
Mum made the comment “I wish we had you at home!” and both adults continued to remark at how soothed he was by the music. After a couple of minutes more the boy seemed to become aware of his physical discomfort once more and started to cry again. As he did so we started to leave but continued playing as we left the ward.
For me it was a lesson in gentle persistence. I would have left the interaction before anything had had a chance to happen. Trying to judge a patients reaction to the music you are playing in hospital can be very difficult and requires a mixture of self confidence, humility and to keep the mantra of ‘expect nothing’ at the forefront of your mind. Just remember not to ‘expect nothing’ too soon!
Our residency at Derbyshire Children’s Hospital began again yesterday, and what a fantastic day of music-making with children, families and healthcare staff it was! It’s fabulous to be back at the hospital where we are made to feel so welcome and really supported in making a big difference to the lives of those we meet. It was a real priviledge to spend some time on the wonderful neonatal intensive care ward yesterday, playing music for and with babies and their families. Staff and families commented on the positive change of atmosphere within the ward, and the feeling of calm and relaxation which ensued. We saw some lovely reactions from the tiniest of babies and plan to make regular visits to neonatal as part of our weekly sessions.
We are extremely grateful to our funders, Youth Music and The Derby Hositals Charitable Trust for supporting this residency which will continue until at least March 2014, with 3 OPUS musicians visiting the hospital on a weekly basis.
OPUS’ residency at Sheffield Teaching Hospitals is continuing, with musicians working regularly on spinal/neurological injury, general medical and rehabilitation wards. This work takes various forms, mostly seeing musicians playing at the bedside in 1-1 and small group situations. Yesterday saw 2 musicians working with a group of elderly patients in a day room, with everyone playing instruments, singing and ‘dancing’ together. All agreed it was great exercise, thoroughly enjoyable and most of all a humanising experience, giving all patients an opportunity to express interests, curiosity and individuality! With recent press around the need to humanise care for the elderly, we feel like we’re on the right track.
At OPUS’ AGM on 14th January 2012, OPUS became OPUS Music Community Interest Company. This development supports OPUS’ aims of continuing to deliver high quality music-making opportunities for the benefit of the East Midlands community and beyond. OPUS delivers this aim with the support of a highly skilled and dedicated board of directors. OPUS is grateful for the support of accountants Poulter Blackwell Limited in incorporating OPUS as a CIC
‘Kissing Tree Lane’ is an OPUS Ensemble arrangement/composition from 2009. The first part of the tune is an arrangement of a tune entitled Kissing Tree Lane by Rob Harbron, while the second part entitled Apple Tree Games is an OPUS composition. OPUS Ensemble are Nick Cutts, Richard Kensington, Sarah Matthews and Laura Zobel. Click on the player on the right hand sde to listen. Enjoy!