Clowns in surgery

Well. Let me tell you. My mind has been blown.

Yesterday and today I observed the Pallapupas clowns visit and accompany children as they went into Surgery to be aneasthetised. I saw children giggling as they walked down the corridor to the Surgical Room, lying on the bed about to go under general aneasthetic and laughing their heads off!  Waaaaaaa!! 

This work is SO EXCITING AND EXTRAORDINARY AND IMPORTANT. 

And it's not that these kids are all unusually brave and resillient. Before the clowns come to meet them, they are often in floods of tears or pale and quiet with anxiety. And that is not to mention the parents...

I will explain a little the mechanics of how it works.

There are 2 surgery rooms and each clown takes responsability for 1 room each. In a morning, each room might have 5 or 6 proceedures scheduled. The clowns are given the list in the morning. Once they are in their surgical garb, they run through who is on the list, ages, what they are in for and check if there are any repeat customers (these can be more challenging as they can be more anxious...or more excited becasue they know they will see the clowns).

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Gota Gota and Oxígena looking over the list of patients for the day

Then they begin. There is a very clear structure and mission for the day.

They meet the child and set up a game. The game is usually something that will involve a journey (along the corridor) and going to a new place (the surgical room). It will also involve blowing or breathing into a mask. And a lot of silliness.

The Stage is too small for both Gelocatila and Ventolín.

Then they leave and meet the next child and do the same with them.

Then they check the surgical room to see how long until the first child goes in.

When there is only 10 or 15 mins to go, they will go back and continue the game with the first child and start to incorporate the idea of using the mask. This will be a playful continuation of the same game. They might also leave and check in with the second child too, depending on timings.

In this case, the masks are microphones. They have them in all different sizes, and often get parents to join in the game.

Then the medical team arrive, and with any luck, the game has reached the ideal point to go on the journey. They go down the corridor together (on foot). A parent is allowed with their child in this hospital too.

Once in the surgical room, the child will need to put on the mask and breath into it. 

Then the child is asleep, and almost without fail, the parent will burst into tears. One of the clowns will accompany the parent out of the room to the cafe or waiting room, and the other goes to check-in on the second child.

The clowns find games in the same way that they do on the floor - by using what is there. On Tuesday, Oxígena was training to be a cheerleader. She needed a song - the girls mum chose Beyoncé. A nurse played Beyoncé on the ward computer, and the clown started to dance. Then she realised she needed a wind machine to make her hair flow. So off the clowns went to find a wind machine. They came back later with the face masks for the girl and her mum. They all had to blow through the masks at the clown (much hilarity and slapstick). Then they decided to film a music video. They would make this super-modern and do it down the corridor (in the surgical room)...

And the idea of all of this is to humanise the environment. To help children and thier parents to play, even when they are feeling anxious or scared.  To distract them. To help the child live their experience in a different and better way. 

It was INCREDIBLE to see and hear how integrated they are in this environment. Several times, doctors, nurses and anaesthetists came up to tell me what a great and important job the clowns do. One even said she wanted to do a study on the different types of ways that the clowns engage! It was clear that the clowns make their jobs easier. They are just a part of the team. No-one bats an eye-lid. They have access all areas and complete trust. And they make everyone laugh a lot.

What I saw today at the Hospital de San Joan de Deu was an integrative approach to healthcare - a holistic model that puts the emotional wellbeing of the patient on a level with their physical wellbeing. It looked good. I really hope that it is our (not too distant) future in Scotland. 

But of course, getting to this level of integration takes time, commitment and all of the right ingredients...