For the last year I’ve been volunteering at the University of Vermont Medical Center (where I am also a UX consultant and patient) through a program called Art from the Heart. We bring art to people in the hospital; specifically I’ve been volunteering on a floor for adults who are staying for anywhere from one day to many months.
Once on the floor, sporting our bright green volunteer vests, we travel around to each room and offer patients and visitors free art supplies. Adult coloring pages and colored pencils are the favorite. (They’re a hot trend right now, as my mom will tell you.) We also try to pin a nice piece of nature art on the wall if they don’t already have one — since research shows that nature scenes reduce stress.
Over the last year of volunteering, through the four seasons, I’ve learned a lot about creativity, boredom and companionship. I observed and absorbed a lot about life on inpatient hospital units, and in the end I came away with some important life lessons. Allow me to expound upon these below.
On mastering the awkward approach
It can be socially difficult to step into someone’s hospital room, uninvited, and start speaking to them. When I enter a room, I know that I’m probably just one of many strange faces who have barged through the door in the last hour. I try to put on my friendliest expression and make sure to introduce myself. If the patient has a stony glare, it usually softens once they realize I’m there to offer arts and crafts. Sometimes the most closed-off-appearing people become our most enthusiastic customers.
On the scenery
Hospital hallways are stark. Even with intermittent art on the walls, the lighting can be harsh. The beige is mind-numbing.
Staff on the unit deal with this lack of pleasing scenery for months and years at a time, while also facing disturbing yet commonplace sights like infected body parts and human bodily fluids. Their work is inherently stressful.
I’ve noticed that when we draw mini-murals of nature scenes on patients’ doors and windows, we get more compliments and thanks from staff, especially nurses, than we do even from patients. The natural world is calming, but it is quite the opposite of what patients and staff experience in a hospital setting. Even our somewhat rudimentary nature murals help bring some life and peace to the floor and remind staff (and patients) of the beauty that exists outside.
I have read many articles about what it’s like to work on an inpatient unit, including the classic “alarm fatigue,” wherein nurses and other staff become numbed to the constantly sounding alarms.
On the floor I like to stop, look and listen. Each room has lights placed outside of it, and I’ve noticed that often many of the rooms’ lights flash at once. Some rooms have alarms that trigger if patients who are at risk of falling get out of their bed or chair. Different devices have different types of alarms, and commonly they beep and chirp over one another, causing jarring, dissonant tones.
Staff rush around, looking stressed and at times haggard. It’s not so surprising — loud sounds can actually cause an increase in cortisol levels, and these alarms are a constant auditory stream that contribute to stress. The alarms fail to work in concert to keep patients safe, and they fail to help staff feel confident and in-control. They also worry patients, roommates, visitors and volunteers like me, who don’t know what the noises mean.
Some days, I walk onto the floor and immediately have a reaction to the smell. I can’t always quite tell what it was, but it offends the nose. Sometimes I go into the family room, our little hideaway, and wave a citrus spray around the room to mask the odor. Research shows that certain infections may have specific smells, so that might be what I’ve experienced. Apart from that, there are other, more expected smells associated with sick and aging humans that are difficult to encounter.
Overall the olfactory experience on the floor can be quite disturbing at times, and this seems like a huge opportunity for innovation.
The floor where I spent time is one of the main units that cares for people with dementia. It has been a special experience for me to interact with people with varying levels of dementia. I’ve encountered some who were chronically confused and worried, and others who seemed jocular enough but spoke in a garbled mish-mash. Some who mostly sat and stared, and others who were forever trying to plot their escape.
One time I entered a room and used window markers to draw some seasonal decorations on a patient’s window. There was an assistant sitting in the room, who was there to make sure the patient didn’t fall. Over and over the patient asked “who are you?” “where am I?” “will you get me out of here?” and the staff member calmly and repeatedly answered her questions — at least 15 times while I was in the room.
Patients with dementia can be sweet and kind. There was a man staying on the floor for many months whom we all loved and who became like family to the nurses and other staff. He spoke with a high, whispery voice and liked to sit and color pictures, which he dedicated to his wife. He liked to write love letters to his wife. We weren’t sure if his wife was still alive, but we were in love with their love story.
Then one day his wife came to visit. She was visibly upset as she sat with him in the family room. After he left she told us about the person he had been before — his professional career, how capable he had been, how he’d managed and trained people at his former company. She couldn’t reconcile that version of him with this new version: feeble, childlike, loving but sometimes angry and violent toward her for no reason.
We loved him for who he was, but she couldn’t move past who he’d been.
In the hospital, a picture of a sunset on your door means you’re approaching the end of your life. It’s a signal to staff. Often the people with sunsets on their door are not very responsive, so we don’t end up doing a lot of art with them.
Dying in the hospital looks different depending on the patient’s social and family network. Some patients don’t have much family, and the staff become their family; so they experience a more solitary death.
Others have elaborate networks of family and friends who, as the patient nears death, gather outside the room and take turns passing through. What should be a very private, fundamental moment, the closing of a lifespan, happens in semi-public, with other patients making noises and other footsteps walking by, with someone else’s meal being wheeled down the hall.
There is a sense of anticipation on the floor when there is a patient with a sunset on their door. Staff are caring for other patients, responding to the usual beeps and calls, while also watching and waiting.
When patients die, nurses are there. Professionally, they help usher the patient and family through the process of death. Privately, they mourn and then have to continue their shift.
How art helps
Art can offset some of these difficult aspects of the hospital experience. By providing patients and visitors with activities in which they can immerse themselves, art provides a healthy and calming distraction.
Even the act of drawing a picture for a patient is calming. It is relaxing to watch someone else draw or paint — so we tried to do our wall and window drawings in a place where patients had a good view.
Part of what we really did was provide interesting things for patients to look at — decorations for their rooms, pieces of flair for the common areas. Anything to create a more vibrant, lively space.
We especially liked to draw fun things on the large windows in the family room:
Some people didn’t care to do any art, but they just wanted to talk. We’d chat with them for awhile and leave them beaming in their room as we continued to the next one.
This year of volunteering and consulting at the hospital has taught me so much. I feel much better prepared for the process of aging and death that will eventually become a reality for my parents, my family, my friends and myself. I also learned:
Just how vital art and nature are to healing and peace of mind
How indispensable nurses are, and how hard their job is
How to interact with people who have dementia
That I’d like to die at home, surrounded by loved ones, if possible
A multitude of potential areas for design improvements in a hospital setting — especially when it comes to the sensory experience, which has informed my thoughts about the ‘ideal’ hospital experience (I am planning a follow-up post to explore this further)
I’m grateful for the experiences I’ve had so far, and though I’m taking a step back from Art from the Heart for awhile, I hope to see this program expand throughout the hospital.
This post was originally published on Medium.