Inspiring new perspectives:

A cross-disciplinary exhibition of the art and history of care

This fascinating art exhibition, in a variety of mediums, was created by undergraduate and postgraduate cross-disciplinary students including nursing and occupational therapy, healthcare practitioners, and patients. Featuring the Department of Health and Care Professions Patient and Public Involvement Members, Hospiscare, Co-Lab women and Army 243 Multi-role Medical Regiment.

The exhibition incorporates work from students of the The Art and History of Nursing module NUR3109.

Each contributor has chosen a theme which has inspired their artwork these include women's health, culture/racism in healthcare, palliative and end of life care, spirituality and mental health, pain, cancer, military health, or historical leaders of healthcare. The display will also reveal through accompanying text, the rationale for each piece and how the artwork may have impacted on their own and wider practice by revealing new perspectives to care.

Please note the exhibition contains some challenging themes, which some might find distressing.

Theme: Women's Health

The Presence and Companionship of the Husband

by Cuihong Xie

Mixed media

On the black paper, a nurse is explaining pregnancy precautions to the expectant mother in the clinic; while the husband is scrolling through the phone outside. The pregnant woman is only able to take in a little bit of the information; because she is fatigued during pregnancy.

Pregnancy could influence women's cognition (Orchard et al., 2023), such as worse subjective memory. Also, their brain structure could be changed during pregnancy, including the grey matter volume reductions (Hoekzema et al., 2022), for adaptations to the shift into the role of 'mother' (Hoekzema et al., 2017).

You could move the flashlight a bit to the left, and shed a light on the pregnancy.

Currently, the husband and the pregnant wife are together in the clinic, attentively listening to the nurse's guidance on pregnancy. The husband's presence and companionship has brought a sense of calm to the wife's emotions.

This small change shows the husband’s care for his pregnant wife and the child within. In addition, both spouses' brain structures are undergoing adaptive changes in response to their impending 'parental identity' (Abraham & Feldman, 2022; Horrell et al., 2021).

Vulva Vista

by Stage Three Nursing Students

Collage

This interactive artistic piece presents some of the taboos present in society with regard to women’s health, which can result in psychological distress such as body dysmorphia and influence cosmetic interventions such as vulvoplasty.

The rationale for exploring this topic was to promote the importance of improving access and quality of education around women's health, especially around normalising diversity of vulva structures. Stigma surrounding women’s health has evolved throughout history, from optimising male attraction to women and their experience during sexual intercourse to societal stereotypes and ideology on how vulvas should look, influenced by pornographic material.

During a women's health seminar led by Dr Charlotte Patton she highlighted the importance of using the correct medical terminology in women's health to reduce stigma around using such medical terminology within society.

It takes a village

By Heidi Garner

Illustrative drawing

This artistic piece aims to explore and contrast breastfeeding support in the United Kingdom (UK) and Africa, using illustrations. The left-hand side represents Africa with three women uniting together to breastfeed. Breastfeeding in Africa is viewed as a communal responsibility, with mothers receiving support from family and friends. In comparison, the right-hand side represents the UK in which a nurse is supporting the mother to breastfeed. The rationale for using simple illustrations, with no facial features, is to create room for the viewer to gather their own thoughts on what the art may be demonstrating.

As a new mother, I wanted to explore the topic of breastfeeding support as I could relate back to my own experience. Through researching the topic, I discovered the UK holds one of the lowest rates of breastfeeding in the world and this is due to inconsistent support. Another factor of low breastfeeding rates in the UK is due to how, as a society, we still do not normalise public breastfeeding. This information gave me my rationale to compare the UK to African society where breastfeeding is a cultural norm and has higher exclusively breastfeeding rates. Upon learning the UK has such low rates of breastfeeding, I wanted to make it a goal of mine to find out what support nurses can offer to support new mothers in successful breastfeeding.

Bringing awareness to the topic of breastfeeding support, I hope to encourage more people to talk about the benefits and importance of supporting mothers to breastfeed and to not shy away from the subject.

Theme: Culture and Racism in healthcare

Maybe?

by Maya Gómez-Cano

Poem

The voice of the poem intends to be the voice of ethnic minority nurses who suffer and have suffered racism while working. It carries along the word ‘Maybe’ with the aim of not creating conflict but rather educating and finding connections and paths of freedom and love.

During my first placement as a student nurse at a hospital, I felt embraced by the little community of Indian nurses working on the ward as they learnt about my foreign origins (Mexican). Through their care and solidarity, I learnt how hard, in many ways, their paths had been. At some point they shared with me shocking stories of racism and how they overcame them by simply letting them pass without disturbing their commitment to care; with their hearts in peace with themselves and with God.

The poem attempts to praise all the nurses and healthcare professionals who selflessly and with great vocation to care, treat every single patient regardless of any background, regardless even of racist abuse (as my Indian teachers) with love and compassion.

I also felt the duty to express what I learnt through research on historical and present roots of racism. Hence the poem also speaks about the legacies of the British slave trade and colonialism, and the present era of ‘colour-blind-racism’.

The process of writing the poem revealed to me a greater sense of duty towards actively advocating for equality without overlooking my commitment to care.

At Risk

Collaborative piece following seminar with Co-Lab women

Card on paper collage

This collaborative piece came out of a workshop with Co-Lab Women who provide services to marginalised women. In healthcare settings the flag system is used to highlight patients with additional needs, but it can lead to discrimination and stigmatisation. The title refers to both the women at risk, but also to healthcare workers for whom labels could become stereotypes. The red flags show negative labels and the green flags show more positive things that healthcare workers can do to help.

Theme: Palliative and end of life care

DEATH The Inevitable End

by Charlotte Howcroft

Poem

Death and grief are part of life. Grief a word given to the feelings experienced after a loss. Mostly it relates to the death of a loved one, but it does refer to any loss such as job, home, or the breakdown of a relationship. The loss of a patient can be hard, you have built a therapeutic relationship with the patient and now they lie before you a cold body unmoving.

As nurses we come across death more often than the average person. Some of the patients you will have just met, other patients you will have had a good relationship with being with them in their last days or week. Though they are not family or friends each death will influence us. The first few we will remember for life and others will also stick with us for life. However, most we will accept and move on from as we can't morn every patient.

In the world outside nursing Death is often seen as a taboo subject and though in recent years it is changing, we still have a long way to go before death is not a feared topic that is skirted away from in conversations.

With modern medicine we try and push life expectancy. But as patient advocates we need to be able to spot the signs of a patient actively dying and advocate for them. Sometimes stopping their treatment can reduce patient pain and suffering rather than focusing on prolonging life.

Being able to reconcile and control your emotions at the time of a death is important for any nurse. You have other patients that need your care, you need to be strong to support the family that you have to break the news of their loved one’s death. In that moment as a nurse, we need to understand that death happens to everyone it is the only certain part of life and if they were dying, we could not have done anything to stop that process. We are not to blame for the death. Yes, there will be deaths that affect us and that is normal but we need to learn to manage the grief.

End Of Life they say

By Rosa Piramoon

Poem

This poetic piece explores two different perspectives of the same moment of time. This Poem explores the moments before death from the perspective of patient and relative.

The relative's perspective is centred around recognising and seeing the patient's physical global deterioration, and how they associate these physical changes with the patient being in pain and suffering and their thought process towards these changes.

The patient's perspective is centred around death acceptance and how they are not aware of their physical deterioration the relative recognises. They have begun their journey beyond physical life in the body they were in before their diagnosis, free of their terminal illness and from the pain they experienced when they were living with their disease.

A poetic medium was chosen in order to investigate the very different stages both parties were at, with regard to processing the events leading up to and during the moment of time the poem explores.

Attitudes around palliative care and cancer have evolved throughout history, from the way in which patients are cared for at the end of life to the beliefs about why ill health develops and how aspects of historical beliefs are still present in palliative care today. The rationale for developing this piece is to reiterate the importance of applying a holistic approach to care and that each patient and relative will have a different perspective on death and that it is important that support is provided to families, not only after death, but throughout a patient's diagnosis.

Last Orders

By Harry Hayes

Poem with watercolour accompaniment

This poem looks at end of life care from the eyes of a nurse, it moves through the journey of a patient along with how a nurse can support both the patient and their family throughout each step. I wanted to demystify the process of dying within the poem without taking away from the kindness that nurses give to every individual on life’s final journey.

The first stage is supporting the family with the initial passing, including the common rituals many nurses observe in the moments after passing. We open the window to allow the soul to move on, this is not linked to any religion or spirituality instead a kindness for the one who has passed. The next stage is certification supporting the patient be declared dead and finally we support the deceased into clean garments and off to the morgue to rest at last.

The accompanying water colour painting is a window scene showing an individual meeting a metaphorical version of death, he is dressed all in black with his legs taking root into the ground in contrast to his bright wings preparing for flight. He shows the importance of acceptance that need to grow around death and be strong in life, his job is to welcome the soul and guide their soul in a similar way that a nurse will guide the body.

Unknown Terrain. A timeline of grief

by Barbara Sweeney, Patient and Public Involvement and Engagement (PPIE) Group Member

Collection of poems, set on a timeline.

My exhibition piece conveys what happens when your world is turned upside following a terminal diagnosis. ‘What would be on your bucket list if you were told you had a year to live’? An open question designed to inspire thoughts of exotic journeys and dare devil stunts. But that assumes wellness! Receiving a terminal diagnosis with a prognosis of twelve months is an unimaginable experience. Time remaining is spent under regimes of distressing and debilitating tests, diagnostics and speculative treatments. And the living grief of a lost future.

The poems were not written at the time, but reflections fifteen years later, of images held.

I hope to encourage nurses to acknowledge the holistic nature of care. Each patient is a person with their own history. We are not just the label of our diagnoses.

Click on the poem titles below to read each poem in chronological order.

Theme: Pain

Masking

by Sarah Trickett, Patient and Public Involvement and Engagement (PPIE) Group Member

Sculpture made using cardboard, plaster, stone, drawing pins, paint

I chose to focus my artwork on my experiences around pain. I live daily with pain which manifests in different ways. I chose to use masks to represent this around the idea that people often don’t see pain because in our society we are so accustomed to masking pain and having to just get on with daily life.

The face on each mask represents a different expression from Wong Baker’s pain scale which is used with children to communicate their level of pain.

Theme: Spirituality and Mental Health

Change

by Caitlin Kight

Digital (overdrawing using original photography)

Shortly after relocating to the palliative care facility where he later died from metastasized prostate cancer, my grandfather pulled his bedsheet over his head and lay curled inside in the foetal position. My family received no explanation of this behaviour from the staff; indeed, neither the nurses nor the doctors ever openly described or attempted to demystify the death process – despite the fact that these frank discussions are considered good practice in the field.

In trying to understand my grandfather’s actions, I searched online using terms like ‘chrysalis’ and ‘cocoon’. This did not help me locate scholarly literature, but it did reveal that people frequently related death to the rebirth experienced by lepidoptera that, shielded in their silk and chitin shells, transform into moths and butterflies, respectively. Many palliative care facilities use these terms in their names, or in the description of spaces within their facilities – e.g., a ‘chrysalis room’ in which the dying process can proceed in a peaceful and supportive way. One guide described the journey of terminal illness patients as one involving caterpillar, chrysalis, and butterfly stages.

This piece acknowledges these ideas in multiple ways. The background depicts the homestead where my grandfather was born and lived out his life; it passed from the stewardship of my family after his death, and will hopefully be a place for new generations to make memories in the future. The flowering tree is a crepe myrtle – one of which my grandfather transplanted to his garden and lovingly tended for decades, helping it to survive significantly outside its normal range. The chrysalis in the foreground represents the changes brought by my grandfather’s death, while situating them in a broader ecological process of continual regeneration. A photograph of my grandfather, wrapped in his bedsheet, is hidden in the layers of the piece – allowing me to retroactively reframe that disturbing image as something more natural and hopeful than my family originally perceived it as being.

Citations

• McKenzie, K. and Harra, T. (2010). Mortuary confidential: undertakers spill the dirt. Citadel Press Books.
• Mannix, K. (2017). With the end in mind: how to live and die well. William Collins.
• Black, S. (2020). Written in bone: hidden stories in what we leave behind. Black Swan.
• Black, S. (2018). All that remains: a life in death. Penguin.
• Doughty, C. (2017). From here to eternity: travelling the world to find the good death. W.W. Norton & Company.
• Callender, R. (2022). What remains? Life, death and the human art of undertaking. Chelsea Green Publishing Company.
• https://www.cmcgc.com/media/handouts/340503/80G_McDermott_Jennifer_1.pdf
• https://blog.encompasshealth.com/2020/11/20/end-of-life-stages-and-signs/#:~:text=Chrysalis%20stage,on%20resolution%20during%20this%20stage
• https://aimeeschreiber.com/blogs/news/butterfly-symbolism
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913833/

Peace

By Hannah Tucker

Painting

I chose a mixed medium of graphite pencils and watercolours. I wanted to achieve a soft natural shading to evoke a calm and subtle feel to the picture however, it was important to create a pop of colour for the flowers to symbolise strength, nature and light.

A renowned painting named Irises by the Dutch artist Vincent Van Gogh inspired me. It was painted in France in the last year before his death in 1890. He used oil paints to capture a softness and light. The artist started painting Irises within a month of entering an asylum in May 1889, working from nature in the hospital garden. The flowers have strong outlines and unusual angles. He referred to the painting as his lightening conductor for his illness. He felt he could keep himself from going insane by continuing to paint.

The module has impacted my understanding of spirituality by allowing me to explore different patient perspectives. We looked at several paintings throughout the century, my work is a response to the painting The Young Girl and Death by Marianne Stokes (1900). I wanted to create light and explore death without the darkness, which it can often be associated with.

Where there’s a will …

by Glenn Roberts, retired psychiatrist

Acrylics on paper and associated print material

I’m fascinated by how images convey meaning. I made this picture as a reminder, to me, to reflect on the ‘5 Ways of Wellbeing’, as something we cultivate and grow.

Devon mental health services (DPT) have long associations with ‘The Recovery Movement’ and in 2008 there was a commitment, in the words of the then CEO Iain Tulley, to, ‘Put recovery at the heart of all we do’.

I helped formulate what that meant in terms of its guiding values, principles, practices and standards into an A5 leaflet, the ‘Daisy Pages’, which was then stapled to all 2500 staff members' pay packets, as a way of saying, ‘this is what we’re here to do. I worked with a skilled designer, Angie Frost, to transform a photo into heart centred flowers, and the ‘Devon Daisy’ was born as a symbol of recovery, which you’ll see all over DPT’s ever since.

In 2011 we promoted the national mental health education program based on ‘5 Ways to Wellbeing’ across Devon, using adapted graphics of the Devon daisy – see poster. My image is a recent reinterpretation of that poster, grounded in the Devon red soil, transforming petroglyphic script into the initials of the 5 Ways … C … L … A … N … G, and growing out of the green organicity of life, signalling that we cannot engineer our lives so much as cultivate them … and the ‘5 Ways’ remain effective gardening tips of what we can do.

Theme: Cancer

Theme: Military health

Remembering the Fallen of the First World War

by Captain George Harrill

Sketch and two paintings

Theme: Historical leaders of healthcare

Through the ages

by Stage 3 student nurses

Collage

These stamps and postcards were created by third year student nurses from both dual and adult registration pathways. Students were encouraged to think about the history of nursing and how this may influence their future identity and practice as a nurse today.

If you would like further information about this online exhibition, or the project behind it, please contact Dr Marie Clancy.