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Confusion

Louise Carter

Drawing
I based this piece upon an encounter in a neurosurgery ward. As the day shift started, we began to wake patients and prepare their breakfasts. One particular patient was visibly confused and resistant to communication, and I had at first assumed it was due to their neurological condition. As the day progressed however, they became much more animated, went on multiple walks, played a game of catch and were even able to answer straightforward questions by nodding or shaking their head. This highlighted to me that the simple act of waking up in an alien environment can be jarring enough to cause confusion in any patient, and that it may be even more difficult for someone with impaired perception and cognition to cope with.

I decided to create my piece from the perspective of a patient waking up in their hospital bed: lying down with a low-angle field of vision and a team of masked healthcare professionals crowding around. I used a continuous line drawing to make the figures appear hazy and show the disorientation that the patient is feeling – there are no straight lines or clear-cut edges. To contrast this, I drew certain parts of the picture, mainly medical equipment, in lots of detail including: a stethoscope, a clipboard, the face masks and the patient’s own hand with a cannula inserted. These are the elements of the clinical environment that might be the most foreign to someone from a non-medical background. I used shades of blue for these parts to show that the atmosphere of the ward is potentially quite cold and can be very intimidating.

I have learnt that I may have subconscious biases towards patients with specific conditions and that the underlying factors affecting a patient’s behaviour can often take a while to recognise. In a busy ward, a single doctor or nurse may not have enough time to spot these factors which is one of the reasons why having a range of healthcare professionals in multi-disciplinary team is so important. I also learnt that even if a patient is not medically delirious, the clinical setting can cause many psychological detriments and may impair communication between a patient and those providing care. Memory problems are common among patients with neurological conditions so they may be more vulnerable to loneliness than other patients who could find small comfort in a familiar face on the ward. It became clear to me whilst creating the piece that the simple positioning of a supine patient with standing healthcare workers surrounding a bed can be unintentionally menacing and can make the healthcare workers appear almost vulture-like. Overall, I found this encounter to be eye-opening and it has encouraged me to further consider the patient experience from all angles.

I have kept this patient’s details anonymous and the scenario as vague as possible as they did not have the capacity to be able to consent to their story being used.

Effective Consulting, Year One
Creative Prize 2021 – Highly Commended