Current renal dialysis and peritoneal dialysis patients; family and friends of departed patients; interdisciplinary dialysis staff including key personnel, Professor George Mellotte and Clinical Nurse Manager Cesira Mc Crohan CNMIII; the Smyth family; Social Worker Vicky Fourie; Alison Baker Kerrigan, Programme Manager at NCAH; Artist in Residence Lucia Barnes and fellow artists from the NCAH.
The above will be referred to as the Dialysis Community in this case study.
Renal dialysis patients and staff are a particular type of community as they spend a lot of time together and thus become similar to any family unit, e.g. ongoing treatment can often last 12 -16 hours weekly or 832 hours per year.
The primary aims of this project were:
(1) To create a permanent artwork to the many people that have journeyed through the Renal Dialysis Unit over the years, with a view to installing it in the proposed new Haemodialysis Unit, thereby enhancing the department.
(2) To create a fully inclusive collaborative art project that would embrace the multiplicities of emotions that people have around the dialysis journey.
(3) To provide a series of outreach workshops, extending an invitation to family and friends of departed dialysis patients to re-engage with staff again in a relaxed creative atmosphere.
Lucia Barnes has worked as Artist in Residence for the NCAH since 2003 across many departments throughout Tallaght Hospital, facilitating arts and health projects predominantly in the Dialysis Unit. With a background in Nursing and a BA Degree and Masters in Fine Art, her artistic themes embrace the interface of arts and science. Therefore, she is ideally positioned within a healthcare setting, traversing medical environments, machinery and equipment; patients’ personal stories and medical staff’s perspectives.
The initial idea for the project evolved from a series of discussions with the family of deceased patient Deborah Smyth, dialysis staff and the NCAH.
Each step of the project was planned and organised to be inclusive and above all patient-centered, encouraging maximum input and suggestions from the Dialysis Community.
Aspects of this inclusivity included discussions around the overall theme, dimensions, art materials used, fundraising ideas and feasibility regarding implementation.
Two words repeated often were: ‘Family’ and ‘Tree’.
The idea of a tree is symbolic on many levels, in this case as a representation for the Dialysis Family – both past and present. Each leaf represents an individual presence, whilst the leaves and branches represent the community and remind us of the level of engagement, commitment and the reality of dialysis treatment. The roots, although not always visible, provide the stable support that keeps everything in place.
Lucia Barnes designed the artwork for the tree consisting of a range of mosaic leaves, a driftwood trunk and branches, all mounted on a painted wooden background. It was felt that mosaic, with its vast array of colours and textures, enabled all those involved (with participants ranging in age from five to 80 years) to create their own unique leaf.
Driftwood was the favoured material chosen for the tree’s trunk and branches. These well-worn, uniquely-shaped forms, washed up on the coastline, suggest a spiritual feeling of having undergone an invisible process of change – this identifies closely with some patients’ own experiences.
Activities in Hospital:
Lucia, along with fellow artists from the NCAH, facilitated patients to make their leaf at the bedside or while in the waiting room. The materials needed to be easily accessible: a large variety of wooden leaves were cut in various thicknesses; mosaic tiles were prepared into smaller pieces and arranged in different containers according to tone. Each patient received a small tray containing a leaf, glue, and the chosen colours which allowed them to create their own designs in an encouraging, patient-centered approach.
Activities outside Hospital:
Patients on home dialysis, and staff unable to participate during work hours, became involved using prepared take home packs.
To further expand the project in an outreach capacity, a series of family workshops were organised for relatives of departed patients to participate in the project. The workshops created a unifying force and sense of camaraderie between relatives, staff and artists with many memories shared over creativity, coffee and scones.
Aspects of health and safety, fire protection and structural issues were considered and negotiated prior to assembly and installation.
All participants were invited to give their suggestions in the naming process with the use of a simple questionnaire. The leaves were collected from the different activity sources, documented, grouted and sealed in preparation for the final edit. The wiring of the leaves added a sculptural effect.
Since driftwood is a challenging material to source naturally, Lucia visited many Irish beaches for collection. The driftwood was later sterilized and re-sized.
Muted tones of paint on the background for the artwork allowed the natural grain to be visible. The tree was assembled in the artist’s workshop in two parts and installed in the Hospital Atrium at a later date.
The collaborative aspect of this project has provided a poignant permanent artwork that will enhance the overall environment of the new Haemodialysis Unit for posterity.
An accompanying Participant Legend has created a presence and shared testament for all those involved.
The outreach workshop brought family members back to the hospital where they previously only had clinical involvement. This time they participated in an art session and re-engaged with dialysis staff and artists in a creative atmosphere similar to what their departed relative had experienced.
The public launch of the Forget Me Never Project in April 2017 was thought-provoking, highly anticipated and emotional on many levels.
The Forget Me Never Tree is now part of the Hospital Arts Trail at Tallaght Hospital.
Following the completion of the project, there was a qualitative and quantitative study with patients, staff and artists in the Renal Dialysis Unit, carried out by three students from the School of Medicine, Trinity College Dublin.
This study evaluated the art sessions in the Renal Dialysis Unit and involved a mixed method survey with patients and staff exposed to the arts programme. The survey contained a variety of questions tailored to discovering the different perceptions of the art programme, including the Forget Me Never Project. A paper on the findings of this survey has been written by Dr Hilary Moss and accepted by the Irish Medical Journal for publishing at a future date.
The collective artwork impacted on the participants in different ways.
For patients, it provided a positive distraction from their illness and a sense of achievement to be part of the making of a permanent artwork for display in the new Haemodialysis Unit. There was ongoing interest and excitement as each aspect of the project was realized.
For dialysis staff, it was a way to personally remember patients who had touched their lives, many dedicating their leaves to the different characters that they had become so familiar with during the different stages of treatment. They felt the art project ‘occupied the patients creatively and prevented them thinking of their illness.‘
Lucia Barnes – Artist Reflection
I found the creation of the leaves and attaching them to the tree very poignant, as it prompted memories of all the discussion and decisions on colour, design, chats, laughs with some patients who are now deceased. Meeting the relatives at the workshop and launch was also very special. I could relate another aspect, the creative side of their loved ones, and how we had worked together on different projects away from the clinical aspects of hospital life.
As I documented and read the various messages on the back of the leaves, I realized how important and significant the project was for the relatives. Working closely by the bedside in the Dialysis Unit, there is time to chat and hear about different aspects of patients’ lives, interests and families.
The highly anticipated public launch had a happy, cheerful atmosphere with the provision of music uniting staff with relatives of people cared for over the years. There was also support from previous dialysis patients who had now received kidney transplants and had engaged with the project.
Comments from relatives at the workshops
‘Peter (my husband) would have loved this project – particularly since it was mosaics – he was a tiler by trade.’
‘Making the leaf for Betty brought me close to her and made me think of all the chats and laughs that we shared in the waiting room before we started our treatment – I miss her.’
Rodney, Deborah Smyth’s husband, gave his personal perspective on the project’s benefits: ‘This project gave us as a family the opportunity to re-engage with the dialysis community which was always such a big part of our lives before Deborah’s passing. We were able to share openly about our loss with others who had similar experiences.’
Rodney wishes to continue fundraising for the Hospital’s Art Programme to support similar outreach projects in the future.
From the start of the project, the idea of whether this was a memorial project, or whether it was both a project for current and deceased patients, posed an enormous challenge both in terms of discussing it with participants and in documenting it. This required a sensitive approach. The project took its lead from Rodney who was absolutely determined that this was not just a memorial project, or particularly just about his wife, but a collaborative inclusive project for the Dialysis Community.
Throughout the realization and implementation of this project, the artist was very fortunate to have the constant support and understanding of the NCAH, particularly Alison Baker Kerrigan, and renal dialysis staff.
Documentation and Dissemination
The Forget Me Never Project was documented in a variety of ways: through artist’s notes, implementation plans, minutes of organizational meetings, budget proposals, interim reports to the relevant supporting bodies such as Punchestown Kidney Research Fund and The Meath Foundation, and the Tallaght Hospital Annual Report.
There was photographic documentation throughout the project of the evolving artwork.
The project was featured in The Echo Tallaght newspaper; TouchPoint, the in-house newsletter for Tallaght Hospital; and on the social media platforms of supporting bodies.
The external evaluation by students from Trinity School of Medicine led to the project’s inclusion as part of the Arts and Humanities SSM Trinity First Year Medical Students’ Poster and Presentation Day in May 2017. It was the winning project in the students’ group. The project is also featured in CPD seminar days facilitated by the NCAH.
Fundraising events such as a table quiz and marathon race were advertised on national radio and local newspapers, successfully raising the profile of the ongoing reality for renal patients undergoing dialysis treatment and the benefits of an arts and health project.
National Centre for Arts and Health, The Smyth Family, Punchestown Kidney Research Fund, The Meath Foundation