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Engaging patients and staff

One of the most important elements of an arts in health project is to engage participants and help them to feel comfortable and relaxed. However, this can also be challenging, especially when working in a healthcare setting or with a vulnerable group who is new to an activity. Advice on how to deal with different situations varies according to the location, participant group, and type of activity. However, there are often common themes that run between different arts in health projects. Below are a list of common questions relating to working with participants and with healthcare staff. These are not intended to be hard and fast rules for project success but may help in preparing an arts in health intervention. These questions cover four common themes that can emerge during arts in health projects: creating rapport, respecting participation and privacy, communicating with staff, and what to do in an emergency.

? When working in a healthcare setting such as a hospital with multiple beds, what is the best way to engage participants in an activity?

Entering a healthcare setting and trying to engage a group of people who may not necessarily have opted to take part in an activity (such as a public performance) can be challenging. First, any artist or individual involved in a project should introduce themselves to participants and say a little about the type of arts activity they are involved in and what they are planning for the session they are about to lead. If appropriate and if the group is relatively small, it may help to ask the names of the people nearby and draw them into the activity by asking them some simple questions, such as have they ever taken part in the arts activity before. As the activity gets going, participants may naturally become more involved or they can be encouraged to give their opinions from an observer’s perspective. Offering choice can be really key in this. For example, a musician could offer to take requests from participants, by taking open suggestions, providing participants with a list of their songs from which to pick, or simply giving people binary choices, such as ‘an upbeat or a relaxing piece’ or ‘classical or jazz’. The selection process allows participants a choice, which can be empowering in a setting where they may feel some of their independence has been removed, and can draw them into being more engaged.

? What is the best thing to do if a participant starts describing their health condition or asking for help?

Some people are very open about their mental or physical health, whereas others are much more private. Sometimes a participant may use an arts activity to open up about their condition. Simply listening may be enough to help that person feel supported. However, asking questions should be sensitively handled, preferably with a project policy determined up front as to whether individuals should ask any questions or not, especially if this is not essential to the running of the project. Offering medical advice should be completely avoided for those outside the care team. If a participant says they are feeling unwell or asks for a medical professional, the first aider in the project team should be called or, if the project is taking place in a healthcare setting, the patient’s call button should be pressed for them or a healthcare professional alerted. Again, decisions as to who should be alerted (whether a nurse or other member of staff) should be made in collaboration with the care team on site up front so the project team know what procedure to follow.

? What should be done if one patient in a healthcare setting (such as on a hospital ward or in a care home day room) is sleeping or speaking with a healthcare professional when an activity is scheduled to start?

An arts activity should never disrupt the ongoing work of a healthcare organization. If it appears that a medical consultation is in process, it may be advisable to ask another member of healthcare staff whether an activity can commence or whether it should be delayed until the consultation is over. If the activity is planned to move around different areas of the healthcare setting, it may be preferable to return later when people are awake and free, but alternatively it may be possible to start quietly with a subgroup of people in the ward or room. However, if a sleeping participant wakes up and asks that the activity be stopped to allow them to continue sleeping, their wishes should be respected.

? What should be done if one participant in a group setting asks for an activity to be stopped?

This can be a challenging issue if the majority of participants are enjoying the activity. This is where a project supervisor can be of support. He or she can ascertain whether the participant wants the activity to stop altogether, or just a component of it (such as a new song to be played as they simply do not like one particular song). If the participant is not enjoying the activity at all, he or she could be helped to move elsewhere (such as out of day room) or, if the activity is happening in a hospital ward and the participant cannot move, the supervisor could ask if it is OK for the artist to finish what they are currently doing and then move away. If a participant gets distressed or angry because of an activity and is unable to move elsewhere, the activity should be quickly brought to a close to prevent causing any further problems.

  • ? How much should healthcare professionals be involved in activity sessions? This will depend entirely on the activity and what has been planned with the healthcare professionals involved. Some projects may have a dedicated professional in the sessions either to provide support or to take part themselves. However, other projects may be partly designed to reduce the burden on healthcare staff and entertain patients, giving staff more time to undertake other activities. In this instance, it can be helpful to designate in advance of the project a member of staff who can be the point of contact: somebody the project team can report to when they arrive, liaise with about any issues or sensitivities on the day of which they should be aware, and approach if they have questions. In this case, asking for support or advice from other staff should be avoided unless essential so as not to add to staff workload.
  • ? What is the best thing to do if a participant tries to give money to the artist? As discussed in Chapter 7, different projects have different funding strategies. For some projects, this may be a viable part of donations processes with designated donations buckets, or participants may be directly invited to pay or make a contribution to their involvement. However, for other projects it may be unexpected and not formally part of the funding strategy. In this instance, participants should be notified that the project is already funded and they have no need to make a contribution, so as to stop others in a group also feeling they need to pay. If the participant is still keen to make a contribution, there should be a planned system in place, for example with any additional money going towards the wider fundraising efforts of the organization delivering the project or being donated to a charity involved. Participants who wish to make a donation should then be informed as to where their money will be donated.
  • ? What should be done if an alarm goes off?

If it is an alarm on a patient machine, the patients themselves may know what to do, or the supervisor can help them to press a call button or ask the patient if they would like them to fetch a healthcare professional. The activity may be able to continue if this is a routine occurrence. If it is an emergency alarm and the activity is happening in a healthcare setting, the artist should immediately stop and move out of the way to allow the healthcare professionals to follow their regular procedures. This is the same procedure as for a patient requiring urgent medical help.

For more on guidelines for delivering arts in health interventions, the Health Service Executive South (Cork) Arts + Health Programme and the Waterford Healing Arts Trust in Ireland commissioned guidelines for good practice available via www.artshealthandwellbeing.org.uk.(3)

 
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