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Queens Medical Centre, Nottingham (Children’s)

Nottingham Children’s Hospital Mentoring Reflections – Dr Angela Kang

Angela Kang 2 b&wMy name is Angela Kang and I have taught and researched about music at the University of Nottingham, University of Hong Kong, and currently at Rose Bruford College of Theatre and Performance where I teach and design modules for the opera degree programme. As a flautist, pianist and accordionist trained in the classical music tradition, I maintain a strong interest in how music can improve physical health and well-being.

Smiles

A little smile can be the beginning of a musical adventure. It can open a door to interact with a child patient and create beautiful sounds which will gently filter down hospital corridors. Today we knocked on the door of an isolated room, and sensing a rather curious and friendly little girl with a beaming smile, we started to gently play music. After a while, we picked out a glockenspiel and some shakers from the percussion box and showed her the sounds that could be produced. She happily took these instruments from us and began to take part in the music making. Her relatives were clearly delighted to see her enthusiastically and creatively join in, as were we. Beginning with a soothing guitar medley, the delicate sound of the ukulele and glockenspiel added a glistening touch. Underpinning this was the lively and spirited sound of the bodhrán, accompanied by melodious accordion interludes.

It is sometimes nice to be fortunate enough to be able to see there and then the immediate positive effects a musical interaction can have on parents and their children. In the afternoon, we all softly sang ‘Sunshine’ in 4-part harmony to another little girl cradled in her father’s arms. As we wandered off to the next ward we all heard the father continue to sooth his daughter singing the very same song – and of course that left all of the OPUS musicians with a big smile.

 

Musical Bonds

Creating music in a clinical setting forms relationships of two kinds: first, those which are created between the sounds and, secondly, those which are created amongst the participants. As professional musicians, we must use our musical intuition and skills in order to produce quality music aimed for a very particular situation (eg, a parent carrying a child on a hospital corridor, a dialysis ward with a large central open space, or even a child patient undergoing some form of treatment in an enclosed area). A heightened sensitivity and empathy towards listening and perceiving situations is crucial. Creating music in these situations involves very careful listening and communication between musicians; sometimes we are located in awkward areas of the ward and not necessarily in close proximity. An acute sensitivity to changes in volume, harmony, texture, rhythm, and melodic direction is paramount, especially amidst the hustle and bustle of a busy hospital ward. There is also the desire to create music that is appropriate for the situation and that can gently welcome patients, carers, and staff to participate (if they so wish). When this delightful moment happens, we forge a unique and special relationship with all the participants. One cannot predict what lasting effects these moments will achieve. If it provides a momentary sense of relief, relaxation, or positive distraction from the humdrum of the clinical setting – that can only be a good thing. If it provides a charming musical memory to talk about, or a sense of pride felt in contributing to a musical piece – that also, can only be a positive.

Nottingham Children’s Hospital Mentoring Programme

In November 2013, OPUS Music CIC, in partnership with Nottingham Music Hub, was delighted to deliver two days of training for eight musicians exploring the role of the musician in healthcare settings. These two days have been followed up by ten days of mentored practice for two musicians at Nottingham Children’s Hospital. Joe Danks and Dr Angela Kang were the musicians selected for the mentoring programme, supported by OPUS Musicians and trainers Nick Cutts, Richard Kensington and Sarah Matthews. This programme continues until the beginning of March when we will be reflecting on this training process, a new approach for OPUS and a new partnership with a local music service.

The following posts are Angela and Joe’s reflections on the training and mentoring programme so far…

dept education logo nottm music hub logo youth music full logo

Having Something to Say

Our first visit of the year to Nottingham QMC in January 2014, and Rich and I went into E40 Ward first thing in the morning and checked with staff for advice on where to start playing and who to work with.

We walked right to the end of the unit, passing a sleepy patient on the left who was having a good cuddle with his Mum and watching TV. We met a lively little girl who listened to our music first of all, and then joined in with actions and singing and then happily explored the box of instruments, each one in turn, fully. After playing with all that we had to offer, she then showed us a squeezy plastic concertina that belonged to the hospital, which she had been enjoying the previous day.

Our sleepy friend next door had been listening all the way through this interaction and had woken up a bit now. We began playing Waltz vor Polle for him, and then a melody that he knew, The Star of the County Down, as Mum told us that they were a family who sang a lot of folk songs together and that was one they knew. His attention was then drawn to our box of instruments and he tried out the frog, various shakers and the cabassa. There was no speech from him during this entire time, but a little smile had begun at the corners of his mouth and Mum indicated that was a very good step forwards for today. Our engagement started to come to an end – Mum commented to us that he nearly said goodbye – and tried to encourage him to sign and say bye to us. Just as we were potentially finishing our interaction, another young man returned to the same bay from some kind of treatment, with his head wrapped in a bandage. He was crying upon his return, but saw and heard us as we started another piece and he joined us with shakers and smiled.

After this piece, we had a little time out, cleaning our instruments in the play area adjacent, and this second boy starting really crying as his head was obviously uncomfortable. The crying became more intense and we decided to start Sunshine, and played for the whole room. By now, the first young boy’s father had arrived from parking the car, and Mum was telling him how their son had engaged with us and nearly spoke. This seemed to be something of note regarding his stay in hospital.

The whole room was engaged with our piece – parents singing, the multi-coloured toy bear was being made to dance by the first little boy – he himself wriggled on the bed – the tears from the boy in the other bed stopped. The song ended and some toast arrived for the second boy, so he could focus on something nice to eat. The first boy started talking to us a lot – it was fairly jumbled speech, but had the rough overall meaning of saying he had done a lot there and was tired, and he lay down on the covers with his bear as if to rest. Mum and Dad seemed delighted.

We both walked out of that ward with tears in our eyes, and had to take time out to reflect on the whole engagement and change our mood ready for the next patients. We do not know what was happening in terms of the illnesses or traumas of these two children and their families, but we left with the distinct impression that we had made a huge difference that day. Somehow the music, incorporating sung words, had reached the first little boy in some way that speech could not. He was perhaps more relaxed and able to respond to the song verbally than he could before to the spoken word. A connection was made – we don’t know how temporary or permanent, but it felt like one of great impact at the time.

Later we learnt from the Headteacher of the Hospital School that she had spent some time with the parents of this young man, and it had indeed been an important day where his speech had occurred for the first time in a long while.

Musicians in Hospitals – Training and Mentoring Programme, Nottingham, UK – COURSE FULL

THIS COURSE HAS NOW BEEN FILLED. If you are interested in attending our training in the future, please email us at training@opusmusic.org and we will contact you when we launch our next programme.

OPUS Music CIC, in partnership with Nottingham Music Hub, is offering a training and mentoring programme for musicians working in, or interested in working in healthcare settings.

Initially there will be a two-day programme of training for up to eight musicians (unpaid). Following the training sessions, two trainees will be selected by interview to go forward as mentees to the ten day mentoring programme (paid) to be held at the Nottingham Children’s Hospital, Queens Medical Centre, Nottingham.

Training will take place on 12th and 19th November 2013 in Nottingham, UK, with mentoring taking place on Tuesdays between December 2013 and March 2014.

For full details download the brief here: Musician’s Brief (Adobe PDF)
The application form is here: Word DocumentAdobe PDF file

dialysis violin playing

 

Elevator Music….

I was working in Nottingham QMC Children’s Hospital on Tuesday this week with Rich Kensington and Sarah Steenson. We found ourselves en route from level B back to the top floor to pack our things away at the end of the day.

However, our playing was not over for the day yet!

We waited for the lift…..but the first one to arrive was rather full with surprised but welcoming faces who wanted us to ride in the lift with them, but there was not enough room…..we waited for another.

The next lift arrived with room for all three of us, even though there were about 6 members of a nursing team who obviously knew each other and worked together. One said, “Oh Elevator Music” as we got in – and that was it – I had to play something.

We only had time for one A part of the Valse for Polle before it was their stop, but in that short time, the group were smiling and laughing together and got out of the lift singing the beginning of the second A part of the tune.

A lovely example of how having real instruments with responsive musicians in hospital can provide many places with different sorts of interactions, and sometimes in the most surprising of locations.

Taking time to be with people

A big part of our work as musicians in hospitals is to be there as a musician and a human being spending time with other human beings, to make music for and with them and to create a cultural venue within a clinical environment.

We often get asked if it is emotionally difficult to spend so much time in hospitals, especially with children. There are, of course, always emotional moments in our practice, and we allow ourselves to be emotional as part of our professional practice, indeed it is important that this emotion becomes part of our music-making to allow us to be ‘in-tune’ with the patients, visitors and staff with whom we work. We must always be careful, however, that we do not project our own emotions onto others – this is also part of our professional undertaking.

It is, however, more normal for us to work with the well-part of the person, to enhance and support the cultural, vibrant, and well part of the person. Medical staff work hard to take a holistic approach to their work, however, they are principally there to treat the illness. We are hugely privileged to be able to take the time for this approach, one which seems to complement and support the work of the hospital staff so well.

Over recent weeks, we have seen this human-to-human approach work so well. In Sheffield Teaching Hospitals, working with elderly patients and those with spinal and neurological injuries, we have recently been able to take more time to explore musical interests with individual patients, to support them in singing and playing musical instruments with us, and to rediscover their creative and cultural selves. Medical staff have observed and taken part in some of these sessions, making new, human-to-human contact with patients and seeing new potential despite their illness or injury. It is fantastic to be able to support these new patient-staff partnerships.

In children’s hospitals, the time spent with individual patients and their families becomes special time, time for a parent and new baby to bond in a neonatal intensive care unit, time for ‘normal life’ to resume if only for a moment, time for music 🙂 When doctors, nurses and other hospital staff become part of these interactions, the space and relationships within the hospital change completely, and we are all human beings together.

Leo Tolstoy wrote (What is Art, 1897):
‘… In order correctly to define art, it is necessary, first of all, to cease to consider it as a means to pleasure and to consider it as one of the conditions of human life… Art is a human activity consisting in this, that one man consciously, by means of certain external signs, hands on to others feelings he has lived through, and that other people are infected by these feelings and also experience them.’

It’s wonderful to be able to share music-making, a ‘condition of human life’, with all those we encounter in hospitals.

More feedback

This time from some of our artistic young participants taking part at children’s hospitals around the region…

Some feedback from the past 2 weeks…

Here’s a small selection of feedback from children’s hospital patients and parents from the past two weeks….

Thank you so much for the musical experience this morning. What a lovely surprise…… it was fantastic that you came in with your instruments so that both children and adults could have some much needed stress relief, entertainment and engagement.

It’s made my stay memorable and I really liked it cause of the guitar as I love them. Thank you.

‘J’ really enjoyed the music. He joined in and enjoyed looking and learning about the different instruments. Thanks for taking his mind off being in hospital.

Your music and songs have really helped cheer my daughter ‘A’ up. Any myself too. It was great to see her smile. You have brought her happy memories back from her holiday. We were all really interested in learning about your instruments. I think you may have encouraged her to get back into her dance now. Also you have helped relax her prior to her MRI today. Thank you. She keeps humming WACKA WACKA and smiling. Thank you very much.

I enjoyed it, thanks very much. It was my first time playing the violin. I liked the sound. OPUS played very well.

‘B’ was in bed when you came in still feeling quite drowsy. Now she’s up and about feeling happy.

The music was a lovely surprise and very calming for the children. ‘J’ especially enjoyed using the instruments and making up his own music.

I have seen the musicians in our daycare ward and in outpatients. It was clear to me that the music was enjoyed by all and so very well received. I was particularly impressed to see the children participating.

It was fab, really cheered everyone up and brought everyone together.

Thank you so much. Wow, what a wonderful lift to all of our days. “We are not poorly any more” Well maybe only a little. Please continue with your wonderful music. x

It’s clear from the great feedback we are receiving that our aim of creating cultural venues within the hospital is really working, allowing children, parents and staff to share music-making together, and within communities of wards, bays and families. Thanks everybody for your feedback, including some fabulous pictures which I will try to post soon 🙂

New music in health residencies

As you’ve probably noticed from our lack of blogs recently, OPUS is currently on a summer break. While we’ve not been in the hospitals so much over the past month, much has been going on behind the scenes to finalise arrangements for our new residencies beginning very soon. Thanks to funding and support from Youth Music, Nottinghamshire County Council and Leicester City Council, we are delighted to announce new long-term residencies in children’s wards at three new hospitals beginning in September. These will take place at Leicester Royal Infirmary, Queens Medical Centre, Nottingham and Kings Mill Hospital in Mansfield, with OPUS musicians visiting the hospitals on a weekly or fortnightly basis. This is planned to continue until at least March 2014, though we hope to sustain these residencies beyond this date. We are extremely grateful for the support of our partner hospitals and our funding partners in making these new residencies possible. OPUS has busy and exciting times ahead, with existing residencies continuing at Derbyshire Children’s Hospital and Sheffield Teaching Hospitals alongside training programmes for musicians and healthcare staff. We’re all really looking forward to it!