Showing posts with label Julia Pelle. Show all posts
Showing posts with label Julia Pelle. Show all posts

Friday, 1 May 2015

The Simulated Real World - Kingston University

Alice
The knock on the front door echoed throughout the cold rooms of the Crime House and we all tensed in anticipation. Inside we waited for the nurses to enter and visit their patients, yet this wasn't a ward scene but one firmly placed in the community. What could be more ordinary than a leafy street in suburban Kingston-upon-Thames, although what was going on behind the closed doors was a series of teetering narratives not light-hearted Margo and Jerry tittle-tattle . Who knows how common these unravelling stories are, how often desperation creeps under the crack in the door or for those lives in disarray to be rebuilt piece by piece. This was a chance to see behind those ordinary doors and capture the individual worlds of three people.

Julia Pelle
This is my third and final year as artist-in-residence at the School of Nursing, Kingston University and St George's University of London. Previous years have seen me ensconced in a corner of the simulated mental health ward furiously capturing the drama in sketches and words. Today (01/04/2015) we had the chance to see students working in teams throughout a simulated weekend where patients/clients were rooted between the four walls of a house.

Sharon Putt
Alice was recently returning to the family home after a hiatus, the dynamic of husband and children creating a soap opera of instability; Julian was back in the 'real' world, desperately trying to survive without money and in a barren and inhospitable bedsit; Peter found himself in the care of his parents once again, trapped in a world dominated by the dubious reality of the internet.

Kevin Acott
The day started for the students in a lecture room with the promise of an emotional assault course to come. Lecturers Julia Pelle, Kevin Acott and Sharon Putt set the scene. "This is a proper home visit, you're really going to get it today!"

Mostly in couples and sometimes alone, the students made their way to the Crime House door. This house is usually used by Forensic science students who find themselves quite literally at the scene of the crime. One after another over the course of this simulated weekend (that in reality lasted but one day) each group of students had to visit their patient, assess, advise and help. They would then have a meeting with their counterparts who would be the next people to visit the patient. So it was both an exercise in being the person at the cutting edge of the situation but also the ability to move forward as a team. It meant as an outsider I observed and sketched 3 unattached narratives, like jumping across random pages of a novel.

Martyn Keen
The story I first opened would be a Dashiell Hammett, it is short and full of motivation. I am the detective, not the hard-boiled kind more soft and pliable in the hands of actor Jane who plays the role of Alice. With us in the room is Martyn Keen, the professional who is keeping any eye on proceedings. Our two students accompany Alice into the room but there is another presence here too. It is the room's elephant, who is the shadow of the past.

Alice is here in her house on a weekend pass, so this is a fleeting visit for her too. For the past five weeks she has been on a mental health ward. Alice hugs a child's toy, she rocks gently squeezing it's soft body with an intensity that would rid a lemon of not only its juice but its zest as well. Her voice wavers like a doll, it's as if someone had pulled the ringed cord at her back and her words rise and fall, changing in pitch and emotion.

Student - Olawumi Olatunde
The two students sit across from Alice, directly in her eye line, close but still giving her the space to breathe. There's a hysterical tinge to Alice's voice and they pick up on it immediately. "No, No I'm happy" Alice says, "When I'm upset I'm tearful. No I'm happy". There is talk about a 'chat' with her husband and it's the first shift that pulls the rug from underneath my feet and the elephant stirs again in the room.

Student Olawumi Olatunde asks if Alice has the 'urges' at the moment, and her colleague speaks honestly, helping Alice realise she is teetering on the verge of a 'manic phase'. Tears start to well in Alice's eyes and the most revealing words escape between her lips, "I'm worried they're going to find me out".

It is one of the finest interactions I have witnessed between student and patient. Martyn Keen thinks so too as he launches into a debrief, he tells the students "Alice was more honest with her nurses than she was with her husband or children". Alice is left alone and someone will be here to check on her progress in the days ahead.
Julian

The second visit is to see Julian (actor Nigel) who's numb bottom is aggravating him more than any mental rollercoaster. He has spent another night sleeping on the cold linoleum of his bedsit. Money is an issue and the support that he should be a receiving is a safety net which has more than one hole in it.

Isaac
The students who have to unpick Julian's problems are Isaac and Maddie. They have been proceeded by colleague Danny who has already made Julian promises, for who wouldn't. Julian's situation is heart-breaking, the room is bare, a tin of beans and bottle water sit beside him, the fireplace is boarded up and there's no discernible signs of heat.

Harvey Wells
Isaac and Maddie are caught in the same Groundhog Day as Julian. They go through a check list, making sure their patient is safe but unfortunately not changing his immediate dilemma, there is still no furniture and no money for food. There is a genuine frustration and sympathy for all the people concerned because the 'system' is a tanker of behemoth proportions that doesn't change course easily, let alone in these choppy financial waters.

The impasse is best illustrated in this short exchange. Isaac asks "If we sorted out all your problems out would you feel better?" and Julian replies "Of course." Then after a long pause he adds "You can help me by helping me".

Harvey Wells is overseeing this exchange in his role as facilitator and the pursing of his lips is only interrupted by a pensive tap of his pen before it makes another note in his book. Time is the winner, the turgid second hand ticking variety. The minutes that stick in Julian's room barely escape the firmly shut door nor permeate the condensation that lines the window. It is not just the maze of mental health that makes Time move slower but also the inability to sit on a sofa or watch the TV. Small comforts that we take for granted.

Peter
My third and final chapter was a much more animated affair. Peter is back at home with his parents and there's enough tension between father and son to inspire a Greek tragedy. Conspiracy theories are rife, the internet as we know is a fountain of knowledge but in Peter's hand it is starting to fuel his fears and insecurities.

David Condon
The man who has to help Peter is student David Condon, and he has to decide how much fuel he wants to add to Peter's fire. He is determined to dominate this exchange, he is fluid and forceful, never scared and very impressive. David is a terrier, never letting go of the conversation and yapping at Peter's heals until he relinquishes a ball to chase down.

David Tracey
David has decided that Peter's conspiracy theories aren't to be indulged for too long but by curtailing these conversations he's cutting down on the information he needs. It is a balance of listening, thinking ahead and deciphering the past. It is a skill that is developed in simulations just as this, and it is one you can't help but admire.

Under the gaze of facilitator David Tracey it is David our student who makes the gesture that catches me by surprise. It is the difference between being on the ward and out here in suburban London. David needs to get Peter out of this environment, even it's only for a few hours, away from the addictive conspiracies and the volatile father son dynamic. Rather than a solution constructed of words David offers one made of actions. He will go with Peter himself, out there beyond the boundaries of this secure bedroom and into a world full of permutations which are ready to trip them both up. It is also a world that offers support and friendship, the first steps will be physical, taken together, while the latter ones will be navigated by Peter alone.

AL.

Tuesday, 28 January 2014

The Open Window - Simulated Mental Health Ward

'Jeffrey'
The blues screens arrived over night, slicing the room into claustrophobic cubicles of tense and nervous energy. The chilling light that passed through the screen's opaque skin made you feel as though you were trapped underwater, breathless in a mental health fish tank. Here was a Simulated Ward with experienced facilitators acting as the safety net, the students darted in out of cubicles while the trapped mental health patients roamed their minds in search of answers.


Graeme
Two days of preparation can never quite ready you for the plunge you are about to take. You can read books, talk to your lecturers, health professionals and even the actors who 'play' the role of mental health patients but this is a 'live' ward situation were the unexpected can happen. Patients react with each other, student nurse's failures and successes impact upon their fellow participants in this mental health dance.



'Sandra and Karen'
The first moments on the simulated ward are quiet and tense, the patients are already in the starting stalls, their minds whirring with back stories, emotions brimming in the imaginations. I am lucky enough to be an observer and sketcher so I placed myself in my favourite patient's cubicle. Jeffrey was sitting nonchalantly beside an open window, and his muse Sandra sat at his feet, love it seems had blossomed on the ward, another permutation in an already complicated mental health story for the nurse's hoping to make a difference here today. Out of the blue Jeffrey announces


'Peter'
"I did it with Joan Collins many years ago!"
We all do a double take as the nurse puts his body between Jeffrey and the open window. Danger averted for a moment but it feels like the nurse has just shut us in the cage with the tiger.
Jeffrey - "Midsummer Night's Dream that is dear boy, Sandra and I were just running through the introduction."
Nurse - "I don't want you to fall out of the window"
Jeffrey - "Joan is delightful. Do you know Faustus?"

Julia Pelle
It seems you need to be a thespian as well as a therapist in this line of work. Bringing Jeffrey back into this world to discuss his problems isn't going to be an easy task. Student Graeme does a jocular and calming job, never shutting the metaphorical window on Jeffrey's humour or hopes. After all the open window represents both the danger and freedom for us all.



'Tim'
Most of us know what it is like to visit or be in hospital and a mental health ward is no different in many ways. Your physical privacy is just a thin veil, shouts and expletives roll through the blue wipe-clean curtains. I can hear Sandra and see Peter confronting a new face on the ward, Tim. The ward explodes with movement. Peter hasn't been taking his medication because it was stopping the important messages hot-wiring in his head. Ward manager Ben tries to help nurse Carmen but it has become too much for her, and tears spring forth. This is the where the simulated environment is so versatile because Facilitator Julia Pelle calls a timeout. She carefully dissects the last volatile minutes, divulging her experience and helping everyone including myself learn from the experience.


'Leo'
You would think that this 'Stop Start' scenario would disrupt the actors rhythm but their characters flow deeply through their consciousness. 'Out of role' I talk to 'Leo' who is John in the real world. He takes these potentially toxic characters home with him over the course of the simulations. "Sometimes I sit at home and I can't get Leo out of my head".
When in character he can often can be heard saying  "This is like a prison in here!" You can not help but contrast the actors who are temporarily trapped in these painful personas and the patients who cannot escape them.


'Frances'
Laurie who plays 'Frances' is an accomplished actress in her own right, with many years of experience with the Teddington Theatre Club and YAT. Her performances always have to be understated when inhabiting the world of 'Frances'. Less is more and she often lures the student nurses into the trap of an over compensating babble on their part.

'Sandra'
When Lyndsay plays the role of 'Sandra' she goes to the well of personal experience rather than professional acting expertise. Her performances are never short of intensity and power, with tears and a raw emotion that is virtually petrifying for an observer like myself. Lyndsay finds the whole experience therapeutic and feels a natural affinity with her character. She was never physically abused like Sandra but certainly feels the emotional bruises from her youth.

She has been known to be so caught up in her role, that she once ripped a students t-shirt in a frenzy of Sandra's paranoia. Today she flares up once more but fortunately student Karen competently guides her to calmer shores.

Martin McIntyre
Like all good Lecturers or Facilitators in a teaching role the team on the simulated mental health ward possess an overwhelming nurturing propensity with a wicked streak of course. For the final roleplay of the day they threw a spanner in the works, a Care Quality Commission Inspector arrives in the form of Martin McIntyre.


Student Snowdon
Luckily the students don't have to deal with the real paperwork associated with a mental health ward, lets face it they've probably got enough on their plates in their 3rd year at University, but this CQC Inspector revealed some of the draining resources on their future energies and possibly sanity.

David Tracey
A CQC Inspector arrives unannounced and spends their time directly observing care and talking to patients or people on the ward and their families or carers, as well as staff. I can't imagine the tolerance it must take to balance all these scenarios and practicalities. It is probably why many of the Facilitators at Kingston University have a Zen like aura. None more so than David Tracey who gently rocks back and forth, with eyes closed, a softly spoken mantra on his lips.


Harjinder Sehmi
The final speech of the day went to the perpetually mobile Harjinder Sehmi who had rattled round the ward all day like one of the minions in the popular film 'Despicable Me'. With legs for once planted firmly on the floor, he looked pensively at the students gathered around him. They stared back, a mixture of exhaustion and relief relaxing the muscles but one still had the strength to speak out, "I faced myself in there".

We were all impressed by the students commitment to the Simulated mental health ward but Sehmi had one last pearl of wisdom,

"Within the next few months someone may be giving you the keys to the ward and say....here you go, you are in charge."

In time I know that these students will be keeping the windows locked for the safety of their patients but having the confidence to open them when the time is right for hope and freedom.

AL.