Confusion
Louise Carter
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.
Creative Prize 2021 – Highly Commended
Extremely interesting to hear about the small details of patients perceptions of doctors being hazy, and the thing that often most sticks out to patients is the alienating medical equipment and environment around them. we should make more of an effort to connect with patients as people not just doctors.
I like this work because it considers it from the point of view of the patient, reminding us to be empathetic. The doctors are drawn in minimal line work but the clinical gear such as the masks, stethoscope and cannula are very detailed, showing how they can be the immediate things that patients notice It indicates how wearing masks can de-humanise individuals and contribute to loneliness, as the patient feels detached from the people caring for them. Having the angle of the drawing from the perspective of the patient allows us to realise how intimidating it can be to have a group of unfamiliar doctors standing above you, and promotes the importance of providing comfort and reassurance to patients.
I found it very insightful to read about this work and learn about the deliberate choices the artist made in order to convey the patient experience as realistically as possible. In particular, the contrast between continuous line drawings used for the professionals, and the highly detailed portrayal of medical equipment was extremely poignant since it shows very clearly how overwhelming the scenario of waking up in a foreign environment surrounded by unfamiliar objects/people can be. This work made me truly consider the fear patients may feel when finding themselves in a clinical scenario and highlights clearly to me the importance of approachability when working in healthcare so that the patient can feel at ease and comfortable.
The art symbolises the preconceptions that people have when viewing patients, as well as how easy it is to dismiss experiences we are so used to. The reminder that to everyone, being woken up in a place that isn’t your home by someone you don’t really know, will always be disorientating and maybe even scary. There is an emphasise to remember that not every emotion/action of a patient is due to their condition.
I like how this art piece accurately conveys the disorientation that a patient can feel in an unfamiliar environment like a hospital. I worked on a neurology ward for a while and I remember a patient very clearly who got extremely disorientated because none of the healthcare professionals introduced themselves or their role. The patient assumed their roles based on the colour of their uniform and when he found out everyone wears random colours he felt frustrated and confused because multiple times he didn’t realise he was talking to the doctor so didn’t get to ask his questions. Moreover, I think the fact the HCPs have been drawn standing up is very thought-provoking because it really shows how intimidating it looks from the perspective of the patient. This artwork reminds us to try and make a patient comfortable in their environment. We can do this by treating a patient’s hospital bay as their personal space. So we can ask to enter, introduce ourselves/roles, sit at their level. This will feel less intrusive and will help them feel more at ease.
Out of all the art this image particularly stood out to me. Using the blue as a highlight really adds to the eeriness of the drawing as it is not a commonly seen natural colour but one which we associate with cold situations and feeling and which does reflect the often harsh lighting of a modern hospital ward. The increased detail on alien objects adds to our questioning as these aren’t things that our mind can fill the gaps in for.
It is also a unique point of view as most images that we see are looking onto a patient as they are the centre of attention, but this is normally because we are most concerned with what the patient is thinking – and therefore maybe this is a better angle to view a hospital from? I think this makes it especially thought provoking and original.
The three sets of eyes bearing down, blocking the patients view while also being at a great enough distance not to be connected with the patient.
The image itself does take some deciphering to understand the blurry characters and then adjust to the harsh blues – I feel this takes us on the intended journey, similar to that of a patient first thing in the morning.
I really like how this work makes you, as a clinician/future doctor question you own behaviors and actions on the ward. It is almost too easy to just follow the crowd on a ward round without a second thought of how it must feel to be a patient waking up to an audience staring down at them. We forget that these are people and not just patients and deserve to be treated with dignity and respect.
We all want to offer the best possible care to a patient, with teams of different people coming and going, all working to serve their best interest, but this art helps you to consider how overwhelming and confusing this must be. As a patient you would feel anxious and stressed with the uncertainty and lack of continuity, unsure of who to ask and when. You may feel inferior, stuck in a bed with many pairs of eyes staring down on you harshly with concern, despite the best intention, you may feel under scrutiny and a sense of shame under a large power imbalance. As the abstract discusses this would have an inevitable burden on a persons mental health, regardless of where they started from psychologically.
The harsh blues contrasted with the white plain walls and striking masks highlight this idea of an alien environment. The environment could be described as “alien” for a variety of different reasons; on the surface the smells, noises and regimented routine will be new for most. Yet also going from being independent and free to being dependent on others, feeling completely out of control and helpless will be an alien experience for many.
This art teaches a valuable lesson in remind us to not just put our patients first but to also to put yourself in their shoes and reflect on how they may be feeling. What would you want to know? What would reassure you? What more could you offer to ensure they feel comfortable and safe in an alien environment? Can you spare a few extra minutes introducing/ explaining/ safety netting/ chatting?
How would this make you feel?
I found the intensity of the colour exemplified the cold, clinical nature of the ward, and the isolation these patients must have felt. The juxtaposition of the lack of colour in the rest of the drawing compared to the blue masks and clipboards conveys the loneliness and lack of warmth during the pandemic, as contact with patients was so limited so as to avoid exposure to covid. Especially during the pandemic when patients weren’t allowed people to stay with them or even visitors, the fact that patients couldn’t ever see the faces of the staff must have been very confusing for people who have just had neurosurgery. I like how the drawing is done from the patient’s bed to show how the interaction went from their perspective instead of the doctor’s.