Nursing studies

Drama workshops are helping nursing students to find their voice

Performance specialist Alex Mermikide's resources develop confidence and communication skills

Performance specialist Alex Mermikide's resources develop confidence and communication skills

As Alex Mermikides supported her brother through cancer treatment, she became aware of the emotional effect nursing staff could have on their patients.

Saying just the right words to someone makes them feel better, says Dr Mermikides, a former lecturer in drama at Kingston University and now doctoral programme leader at Guildhall School of Music and Drama. As a nurse, even coming into the room in a particular way can have an impact.

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Performance specialist Alex Mermikide's resources develop confidence and communication skills

Careful Encounters, a 90-minute drama, allows students to reflect on their emotions about nursing

As Alex Mermikides supported her brother through cancer treatment, she became aware of the emotional effect nursing staff could have on their patients.

‘Saying just the right words to someone makes them feel better,’ says Dr Mermikides, a former lecturer in drama at Kingston University and now doctoral programme leader at Guildhall School of Music and Drama. ‘As a nurse, even coming into the room in a particular way can have an impact.’

Transferable skills between theatre and nursing

Alex Mermikides: ‘What struck me
was the emotions of nurses’

The siblings made a show about their experience, touring it to audiences of different healthcare professionals, including oncology nurses.

‘What struck me then was the emotions of nurses and what they go through, especially on a cancer ward where they’re losing some patients and there is great distress,’ she says. ‘It was two sides of the coin.’

Inspired by what she had learned, Dr Mermikides approached a colleague at Kingston University’s nursing department, suggesting she create a new performance working with nursing students.

‘As we were doing drama exercises with the nursing students, we discovered they seemed to get a lot of out of it,’ she says. ‘For example, standing in a certain way can make you feel more confident. All the skills I was used to teaching drama students were useful for them too.’

Well-received practical workshop sessions

They went on to design three practical workshops, lasting around two hours, one for each year of the adult nursing degree at the university.

Launched as part of the curriculum in 2017, year one begins with Art of Communication, including how students communicate with each other as well as patients. The second year is Drama out of Crisis, about teamwork and multi-tasking in an emergency situation, and the third is called Voice at the Back, which looks at techniques to help with leadership and confidence, including speaking out and being heard.

Analysis of feedback shows that around 90% of those taking part think the workshops will have a positive effect on their practice, while around 85% said they had drawn on the learning during their next placement.

‘Anecdotally too, most people are positive,’ says Dr Mermikides. ‘It’s different to how they are usually taught. There’s something about this approach that gives people time to work things through perhaps a little more slowly, with a priority for the emotional side of nursing that may not always have been the case.

‘Whenever we do a workshop or a show, there are always people who want to stay behind and talk. It feels like it’s answering a need.’

‘The show was like a reality-check for me’

Chelsea Barrett: ‘It felt like a reality check’

Watching an online theatre performance has altered how Kingston University adult nursing student Chelsea Barrett intends to practise in the future.

‘It was powerful,’ says Ms Barrett, who is coming to the end of her first year. ‘It was a different way of learning, showing us the importance of managing patients’ and relatives’ emotions.’

The recorded 90-minute drama Careful Encounters is part of the suite of resources developed in response to the COVID-19 pandemic by Alex Mermikides to help students whose learning has moved from face-to-face to virtual. The show centres on five nurses in different scenarios, who perform to the audience as if they are talking to a patient. Afterwards, students are given a variety of questions, allowing them to reflect on their own emotions about nursing.

‘It's made me much more aware of how important our voices are and the impact we can have, especially as we’re dealing with some of the most vulnerable people. It’s opened my eyes’

Chelsea Barrett, adult nursing student, Kingston University

‘We were asked how we felt when we were watching – what we experienced and whether there were any particular traits we discovered in ourselves that we hadn’t realised were there before,’ explains Ms Barrett.

After watching the show, Ms Barrett’s personal insights included more appreciation of the need for self-care.

‘There were elements of dance in the performance, which is obviously physically demanding,’ she says.

‘It made me realise that, as nurses, we are also on our feet for 12 hours. Our priority is to meet everyone else’s physical needs but we don’t have that empathy towards ourselves. It felt like a reality check.’

The drama also highlighted the impact of tone of voice, body language and non-verbal communication.

‘Those playing the nurses spoke to the audience as if we were patients, speaking differently depending on each patient,’ says Ms Barrett. ‘It demonstrated there are so many different ways of communicating.’

Another online pack has been created for undergraduates who are going into clinical practice during the pandemic, with tips, videos and podcasts on how to manage unexpected situations, coping with a new environment, learning new routines and building relationships with colleagues.

It shares strategies that are part of a performer’s job, like learning lines and routines quickly, managing stage fright and other strong emotions.

When contact with patients eventually resumes, Ms Barrett feels she will be more conscious of the way she communicates, including her body language and non-verbal cues, such as facial expressions and hand movements.

‘It’s made me much more aware of how important our voices are and the impact we can have, especially as we’re dealing with some of the most vulnerable people,’ she says. ‘It’s opened my eyes.’

Looking ahead, there are plans to take the show to the north of England and Scotland, once live performances can take place again, post-COVID-19.


Reflecting on emotions and self-care

For retired senior nursing lecturer Terry Firth, who was instrumental in getting the initiative off the ground, the opportunity for nurses to address their own emotions is vital.

Terry Firth: ‘Self-care is so important,
but we don’t always do it

‘They’re the only ones who are with the patient 24 hours a day,’ she says.

‘Self-care is so important, but we don’t always do it. Historically, we may have pushed our emotions away, but we have more awareness now. You have to acknowledge how you feel or it just gets bottled up.’

Learning is individual, says Ms Firth. ‘When we ask, everyone says something different, and what they say can be unexpected. One student in her third-year talked about how she had found her voice within the workshop to express something that had happened.’

On 10 September, Dr Mermikides will be hosting a webinar for nursing lecturers interested in using drama-based approaches in their teaching. To find out more, email Alex.Mermikides@gsmd.ac.uk


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