Drawing on Art to Help Heal
Monday August 9, 2004
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Rosemarie Schwager (left), coordinator of NCH's visual arts program, and Penny Patrick, RN, oncology staff nurse, work with a patient.
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only to have her return to the hospital a month later in the
same weakened condition.
Finally, about a year ago, during one of Mrs. Franco's
frustrating admissions, the physicians told her that there was nothing else they could do for her and that she would have to live with the condition and try to keep it under control with medication - which she would have to take for the rest of her life. Mrs. Franco was a challenging patient in terms of both finding effective treatment for her illness and meeting her emotional needs. Now, with this disturbing news, she became even more cantankerous and depressed.
The oncology staff decided to enlist the help of the hospital's Arts in Healing program in the hope of lifting Mrs. Franco's spirits and helping her express her feelings through art therapy. Arts in Healing, established at NCH nearly three years ago, was used primarily for oncology patients to offer them a creative outlet for their stress, anxiety, and fear.
One of the most successful aspects of Healing in Arts involves giving patients a ceiling tile and encouraging them to draw a picture on it that reflects their feelings and emotions. Mrs. Franco was persuaded to paint a tile. With her interest in the Bible, she chose an angel as her design. The release of feelings through her drawing transformed her from a demanding, fearful patient to one who was self-sufficient, genial, and helpful.
"It was amazing - and the best thing we ever did for
Mrs. Franco," says oncology staff nurse Penny Patrick, RN, BSN, OCN. "In every subsequent visit to our unit, she has made an angel tile and seems to channel her feelings into it. She uses the paintbrush and her positive religious beliefs to successfully deal with her stress and illness."
Today, colorful tiles created by long-term patients are strategically positioned in the ceiling in oncology, rehab, pre- and postop, and the MRI and CT scan units - anywhere they can be enjoyed by patients who spend a lot of time lying on a gurney staring at the ceiling.
Building on Success
Eighteen months ago, Rosemarie Schwager, A.A., was brought on staff as artist-in-residence and coordinator of NCH's visual arts program. She oversees the expansion of the Arts in Healing program, which has grown under her leadership to include activities such as sculpture, fabric eggs, collages, music, silk painting, quilting, and humor (Clowns on Rounds and the video Chuckle Wagon). Most of these and other art forms are available to patients throughout the hospital, but art therapy is still chiefly used in oncology and rehab where patients tend to have longer stays on the units.
For example, one wall of the hospital's Comprehensive Rehab Center is adorned with a large, colorful diptych - two matching canvases hinged together. "It took two-and-a-half months for patients to create," says Schwager. "That artwork is the pride and joy of the unit."
Clinical studies have shown that blood pressure, heart rate, and respiration can be positively affected by exposure to the arts. Stress can be reduced and communication improved. Last year, research sponsored by the National Endowment of the Arts revealed that art can have a positive impact on the mood of patients, their families, and the health professionals who care for them.
For example, when harpists and guitarists were invited to play at NCH, the quality of life was dramatically impacted. A doctor reported to Schwager that he worked on one of the units while the harpist was playing.
"He told me the gentle music actually changed the whole aura of the floor and brought the stress level down a couple
of notches," she says. "It's pretty powerful stuff." According to the American Art Therapy Association, art therapy is based on the belief that the creative process involved in the creation of art is healing and life-enhancing.
All types of patients - neurological, orthopedic, and cardiac cases - are admitted to the rehab center. One such patient with peripheral vascular disease had lost both lower limbs.
"He was incredibly frustrated with his altered body image and his inability to express his anger and fear," says rehab clinical coordinator Susan Reed-Betts, RN, AS, BA. "When we brought him paper and paint, it was like opening the door for him. Art therapy gave him an avenue of expression for his pent-up feelings."
Art therapy works particularly well with stroke patients who are aphasic or struggling with paralysis, says Reed-Betts, an artist herself with a degree in visual arts. Putting a brush to a ceiling tile can be a wonderfully rewarding way to express feelings when a patient is unable to speak. "Medicine can be so cut-and-dried," she says. "The arts provide a creative diversion from the reality of illness and can identify a patient's previously undiscovered emotional and spiritual needs, leading to stress reduction and faster healing."
Staff and Volunteer Commitment
Hospital employees are great believers in the positive effect the arts program has on their patients. Being hospitalized or going under the knife is right up there with life's greatest fears. Through the NCH employee-based program, Partners in Caring, the Arts in Healing program was awarded funds to supply CD players and a wide range of music selections to the OR, the preop and postop units. and critical care areas to calm jittery nerves and mentally transport patients to a happier place.
In addition, employees have taken a personal interest in the program in their spare time. The staff has not only painted ceiling tiles in the past, but now they've caught the quilting bug as well.
"We leave quilting squares in the employee break rooms for the staff to paint and relieve the stress of a busy day," says Schwager. "Eventually, their squares along with those the patients have created will be gathered up and brought to a quilting guild in Naples. They'll assemble them into beautiful quilts that we can auction off at a future hospital fund raiser." Plans are also in the works to have patients paint silk scarves, which also will be used to raise funds for the hospital.
According to Schwager, who's also volunteer coordinator for NCH, the success of the Arts in Healing program is directly related to the commitment of a dedicated group of volunteers. With only two paid Arts in Healing employees, volunteers are the lifeblood of the program. Schwater cites a perfect example of the caliber of the volunteers. When one saw a need, she stepped up to the plate. "She established a patient survivor bracelet program for the NCH outpatient cancer center," says Schwager. "For a nominal charge, patients and their families enjoy assembling a colorful bead bracelet for themselves or to honor a loved one who is battling cancer or who has survived."
Kids Talk Through Art
At NCH, the Arts in Healing program is geared to adults ranging from 30 to 80 years of age. However, the arts can have a profound influence on children as well, and by providing them with an opportunity to express themselves in art, it can trigger feelings that can boost the healing process.
Miami Children's Hospital's psychiatric department manager, Cedric Wilshire, RN, has been working with mentally ill children and adolescents for more than 20 years and finds art therapy a valuable resource. It isn't painful, and it doesn't require downing some awful-tasting medicine, says Wilshire, noting that he's never seen a child turn down the chance to work with crayons or paint. An art therapist comes to the hospital from the local school system once or twice a week on a consulting basis. "She's very good at what she does," says Wilshire. "By watching children release their energy in their drawings and then looking at the pictures they've drawn, she can share with us her insight into their problems and what may be troubling them."
All Work and No Play...
A hospital can be a dark and frightening place when one is undergoing treatment. "We try to meet our patients' medical, physical, and psychosocial needs," says Reed-Betts. "Art therapy is an effective tool used to help patients express those needs." Staff needs are important, too, she adds. "Sometimes, everything is work, work, work. So if we can take time to have some fun and create beautiful things in the course of the day, it makes [the hospital] a better place for us to work - and a better place for our patients to heal."
Margaret M. Sloane, RN, BSN, is a frequent contributor to Nursing Specrum. She lives in Oviedo.
* Name has been changed.
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