Assignment 5: Digital identities 2

Assignment 4 (Digital Identities 1) and 5 (Digital Identities 2) link

Throughout Assignment 4 I explored my identity as a theatre nurse, inspired by photographers such as Thomas Ruff, Claudia Angelmaier, Tom Hussey and Brian Griffin. Influenced by Anne Collier’s “Cut” (2010) and “Eye#3” (2014), Jo Spence’s “The picture of health” (1982-1986) series and Juana Gomez’s embroidered bodies depicting anatomy such as organs and blood vessels on the outside of the body, I experimented by swapping roles with the patient and making potential scars with sutures on my own body. To understand my identity within the operating theatre, I made a small series of images looking into a mirror whereby the viewer looked over my shoulder into the face of someone who I am influenced by, have influenced or my own reflection. Looking at image and representation of nurses enabled me to understand how nurses are portrayed in the media and how 21^st century nurses are encouraged to represent the profession in social media. Understanding the history of the nursing profession opened my eyes to the shifting role of women in the health service.

These ideas needed a narrative to link them together for Assignment 5. I used the Nursing and Midwifery Council’s Code of Conduct to illustrate some of the code from the perspective of my role as a theatre nurse using archived material, my personalised bitmoji (dressed in theatre greens) and my own work with theatre staff assuming the role of the patient when necessary. Nurses and patients are renowned for drinking tea, so to link the concept of patients and nurses together, I experimented with printing the images on teabags. This becomes a little ironic in the role of the theatre nurse as we withhold tea from patients for at least 2 hours prior to surgery.

Slideshow

I experimented using different slideshow programmes and eventually went back to Windows Media Player. Playing around with the effects, I was able to have the title screen coming across to make the whole image opaque which was similar to my teabag envelopes. This gave the viewer two viewpoints, being there and peeing through a window. I deliberated over a sound track and decided on silence. I considered the sound of surgical tools (which some patients complain about) or conversation recorded in theatre. I think this would need several attempts to get the right piece of conversation which didn’t alarm viewers and respected patient confidentiality. This is on my blog and will be uploaded to the G Drive for assessment.

The 2 above pieces were added as a result of my tutor feedback. The third piece is a detailed reflection on assignment 4 and 5 which is positioned before the tutor feedback on this page.

Background

Conflict between leading nurse figures in the 1800’s complicated the establishment of nursing schools, standardising education and development of nursing as a profession. The 1919 Nurses Act generated implementation of a register under the General Nursing Council providing the public with confidence that nurses were trained to a professional standard.   Nurses sent to the frontline in WW1 undertook extra training in anaesthetics and performed minor emergency surgery. Following the war, roles reverted. As part of the reduction of junior doctors’ hours in the NHS, nurses’ duties developed to include traditional doctors’ roles.  The Nursing and Midwifery Council (NMC) revised the code of conduct to reflect modern society and protect the public from harm.                                                                        

Contextualisation

Operating Theatre nurses are hidden away behind closed doors in a world of sterility and intrigue, anonymous to patients under general anaesthetic and most patients don’t remember their episode in recovery. Everyone wears similar scrubs, recognised by an obscured ID badge and unless one is a student or in charge, wear the same coloured hat, supporting the confusion surrounding visibility and identity. Peering through the fingerprints on another theatre’s door, the nurse becomes an outsider to the exclusive world of surgery. Coffee room stories told by long serving staff contribute to the feeling of timelessness.

The introduction of the NMC revalidation programme (NMC, 2015) required written reflection and evidence cross referencing four sections of the code; prioritise people, preserve safety, practice effectively, promote professionalism and trust. As a sign-off mentor working with students in their final placement I inform the university whether they are fit to qualify. Students transition between the student and qualified code during a period of preceptorship, so this visual illustration of the code becomes a discussion between mentor/preceptor and mentee/preceptee. “Preceptorship can be considered as a transition phase for newly registered practitioners when continuing their professional development, building their confidence and further developing competence to practice, and not as a way to meet any shortfall in pre-registration education” (HEE 2018). The images have a non-linear timeline, using archived monochrome photographs through to colourful modern-day social media images to represent the history of theatre nursing.

By adding text and bitmojis to images, reducing in size, printing on teabags and obscuring with an envelope on which the relevant code is typed, the unseen world of the theatre nurse becomes a suggestion of what might happen “behind closed doors”. The theme of tea links together patients and staff, tea is synonymous with nursing, but theatres impose strict withholding of fluids on patients for prior to theatre.

Development of idea

Originally using dried teabags, I printed to mimic a sepia effect. I researched teabag sizes online, ordered and the resulting image was shiny and slippery. I experimented with emptying teabags in my cupboard, trying different makes, sizes and print (using different paper settings in photoshop). Ironing empty Yorkshire teabags gave the best results. I printed contact sheets, taped teabags over the images, reprinted using photoshop on a matte paper setting and reprinted some due to movement in the printer, too much tea left in the bag or damage from tape removal.

Initially, linking the code to the image via a teabag tag worked until the number of words increased, resulting in a large tag which I abandoned in favour of a teabag envelope.

After trialling printing on opaque greaseproof and tracing papers, I developed a template to fit the teabag which included the relevant code on the front. Printing without smudging required taping the tracing paper onto an A4 sheet of paper, keeping totally flat in the printer, using draft from word document instead of photoshop to print, drying and trimming to size. The colour and thickness of tracing paper looked more professional than greaseproof. Double-sided-sticky-tape was tidier than glue for sealing the edge. I trialled homemade opaque paper which was unsuccessful.

I sewed three different organza drawstring bags (like teapigs) to hold photos, but the organza was not adequate to be handled by several people.  I printed directly onto organza backed with freezer paper which was too fine; the print missed most of the fabric and ended up on the paper.

The wooden box contains four compartments for the different part of the code, each containing a title page with overarching points; the envelopes being subdivisions of the code. I removed the NMC logo after altering the copyrighted design. There is scope to build on this and cover more points; however, this number is a good representation. The last sheet contains image credits which was readable when printed on matte paper.

Self-evaluation

I researched development of the code of conduct and narrowed it down to the modern code rendering the subject more manageable. Included a couple of ideas from assignment 4 and only used material within the creative commons licence, so some images were mocked up with a group of volunteers. Staff were uncomfortable in front of the camera which limited choice to my bridge rather than DSLR. Unfortunately, anything modern showing patients is copyrighted. Trialled different ideas, size of print, type of paper and I now understand what my printer can do.

Need to work on a couple of the images where the print is unreadable on the teabag, but it worked on the contact sheet

In all, a time-consuming exercise but fun and something the staff were interested in; especially the dress code and the old Nottingham operating theatres which felt like we should know some of the staff from 1978.

References

Health Education England (2018) Preceptorships. Available at: https://hee.nhs.uk/our-work/preceptorships Last accessed 17/08/18

Nursing and Midwifery Council (2018) The code for nurses and midwives. [online]

Available at: https://www.nmc.org.uk/standards/code/ Last accessed 13/8/18

Bibliography

Bhardwa, S. (2014) Nursing in the First World War. Independent Nurse. [online] Available at: http://www.independentnurse.co.uk/professional-article/nursing-in-the-first-world-war/64504 last accessed 13/8/18

 (2001) Nursing Ethics Vol 8, Issue 1, pp. 77 – 78 First Published January 1, 2001 [online]

Available at: http://journals.sagepub.com.ucreative.idm.oclc.org/doi/abs/10.1177/096973300100800109

Last accessed 13/8/18

Appendix 1 Contact sheets

Appendix 2: List of illustrations

Part 1 Prioritise people

Figure 1 [photograph; World War One: Operating theatre, Great Northern Central Hospital] At: https://wellcomecollection.org/works/yusmyegt. Last accessed 6/8/2018

Figure 2 [photograph; Operating theatre, Great Northern Central Hospital] At: https://wellcomecollection.org/works/gcqafahs. Last accessed 6/8/2018

Figure 3 Hampshire, N (2018) Operating theatre daily briefing. [photograph] In possession of the author. Nottingham.

Figure 4 Wressell, Adrian, ODP moving a hospital trolley bed down a corridor, UK. [photograph] At: https://wellcomecollection.org/works/zkk3cuh5 Last accessed 6/8/2018

Figure 5 Hampshire, N (2018) Anaesthetised patient [photograph] In possession of the author. Nottingham.

Figure 6 Stone, Richard (1943) [photograph; Student Nurse Joyce Collier hands the surgeon a pair of forceps during an operation to remove a patient’s appendix in the Operating Theatre at St. Helier Hospital Both wear rubber gloves and masks, which consist of four layers of linen] At: https://www.iwm.org.uk/collections/item/object/205199881 Last accessed 6/8/2018

Figure 7 Kay, Joanne (2018) [photograph] In possession of the author. Wales.

Figure 8 Wressell, Adrian, A nurse carrying out observations on a patient at the Heart of England NHS Trust [photograph] At: https://wellcomecollection.org/works/qdafcge9 Last accessed 6/8/2018

Figure 9 Townsend, Frederick Henry (1915) [wood engraving; A patient complains to a visitor that he does not discuss with his doctor how he feels for fear of discouraging him] At: https://wellcomecollection.org/works/xp5khpcn Last accessed 6/8/2018

Figure 10 Hampshire, N (2018) Operating theatre sign in 1 [photograph] In possession of the author. Nottingham.

Figure 11 Hampshire, N (2018) Consent [photograph] In possession of the author. Nottingham.

Figure 12 Hampshire, N (2018) Operating theatre sign in 2 [photograph] In possession of the author. Nottingham.

Part 2 Practise effectively

Figure 13 Hampshire, N (2018) Scrubbing up [photograph] In possession of the author. Nottingham.

Figure 14 [photograph; The Operating Theatre. From left to right: Nurse Henry Young, T. Hampton, E.J. Toye, the matron and Sister Cosgrove. Photograph Faulkner photograph album, photographs of the Metropolitan Hospital, Kingsland Road, its staff and patients. Wellcome Library, London] At: https://commons.wikimedia.org/wiki/File:Metropolitan_Hospital,_Kingsland_Road_Wellcome_L0021211.jpg Last accessed: 6/8/18

Figure 15 (1925) Operating theatre, Nottingham City Hospital  [photograph] At: http://www.nottinghamhospitalshistory.co.uk/Monkey%20Days%202.pdf Last accessed 6/8/2018

Figure 16 (1895) Shipstone Operating Theatre [photograph] At: http://www.nottinghamhospitalshistory.co.uk/page23.html last accessed 6/8/2018

Figure 17 (1978)  Operating Theatre, Nottingham Children’s Hospital [photograph]  At: http://www.nottinghamhospitalshistory.co.uk/Lets%20Begin%20with%20the%20Children.pdf last accessed 6/8/2018

Figure 18 Hospital of the University of Pennsylvania (1898) Nurses actually engaged at an operation https://commons.wikimedia.org/w/index.php?title=File:Ladies%27_Home_Journal_Vol.15_No.06_(May,_1898).pdf&page=11 last accessed 6/8/2018

Figure 19 Hampshire, N (2018) Patient safety notice board [photograph] In possession of the author. Nottingham.

Figure 20 Hampshire, N (2018) Suction apparatus teaching [photograph] In possession of the author. Nottingham.

Figure 21 Hampshire, N (2018) Controlled drug register [photograph] In possession of the author. Nottingham.

Figure 22 Hampshire, N (2018) Completing a care plan [photograph] In possession of the author. Nottingham.

Figure 23 Hampshire, N (2018) Main theatre co-ordinator [photograph] In possession of the author. Nottingham.

Figure 24 Hampshire, N (2018) Gowning up [photograph] In possession of the author. Nottingham.

Figure 25 Hampshire, N (2018) Daily multi-disciplinary team board [photograph] In possession of the author. Nottingham.

Part 3 Preserve safety

Figure 26 (2018) [photograph] At: https://www.itv.com/coronationstret last accessed 6/8/2018

Figure 27 Hampshire, N (2018) Gloving [photograph] In possession of the author. Nottingham.

Figure 28 [photograph; nhsengland – The NHS] At: https://www.england.nhs.uk/nhs70/resources/images-films-and-digital-assets/ last accessed 6/8/2018

Figure 29 NMC (2017) Whistleblowing to the NMC At: https://www.nmc.org.uk/standards/guidance/raising-concerns-guidance-for-nurses-and-midwives/whistleblowing/ last accessed 6/8/18

Figure 30 Hampshire, N (2018) Checking controlled drugs [photograph] In possession of the author. Nottingham

Figure 31 Hampshire, N (2018) Safe storage of controlled drugs [photograph] In possession of the author. Nottingham

Figure 32 World Health Organisation (2017) The role of infection prevention and control [poster]At: http://www.who.int/campaigns/world-antibiotic-awareness-week/2017/infographics/en/ last accessed 6/8/2018

Figure 33 World Health Organisation (2018) Save lives: clean your hands [poster] http://www.who.int/infection-prevention/campaigns/clean-hands/en/ last accessed 6/8/2018

Part 4 Promote professionalism and trust

Figure 34 Hampshire, N (2018) NMC Revalidation 1 [poster] In possession of the author. Nottingham.

Figure 35 Hampshire, N (2018) [poster] In possession of the author. Nottingham.

Figure 36 Hampshire, N (2018) Role model [photograph] In possession of the author. Nottingham.

Figure 36 Hampshire, N (2018) [photograph] In possession of the author. Nottingham.

Figure 37 Hampshire, N (2018) Social media feeds [poster] In possession of the author. Nottingham.

Figure 38 Hampshire, N (2018) NMC Revalidation 2 [poster] In possession of the author. Nottingham.

Figure 39 Hampshire, N (2018) Rota [poster] In possession of the author. Nottingham.

Figure 40 Hampshire, N (2018) NHS Celebrating70 years [photograph] In possession of the author. Nottingham.

 Artists looked at:

https://bethlemartstudio.weebly.com/nursing-the-image.html

https://www.kcl.ac.uk/cultural/-/projects/nursing%20the%20image.aspx

https://www.itsnicethat.com/articles/lewis-khan-060617

http://www.helensear.com/portfolio/inside-the-view/

Assignment 4 and 5 reflection

Where have you come from?

I have an interest in representation of nurses and the shifting role of nurses over time, which positioned the start point of my research. In 2016, our multi-disciplinary team was filmed by medical photography for a patient who requested a gentle caesarean section as an educational tool which subsequently went viral on social media.  I was eager to explore the representation of nurses on social media and whether the same stereotypes thrive in the virtual world. A course exercise and exhibition visit to view Julie Cockcroft’s work inspired me to alter photographs using embroidery.

What have you learned?

I visited Thomas Ruff’s exhibition at the Whitechapel Gallery and hoped to feel more inspired by the huge portraits, which led me to experiment with my initial images. (Assignment 4, Images 12,13,14) I found it difficult to act in front of the camera and was uncomfortable looking at them because it wasn’t what I thought I looked like. (Assignment 4, Images 1,2,3,4,5,6,7,8,9,10,11) The idea behind my series was based loosely on De Bono’s thinking hats using different hats worn in operating theatres; each hat representing a different role and consequently a different personality. This created a role-related typology but didn’t work so well wearing a mask, although non-verbal communication takes place through eye contact.

When photographing parts of my body, my set-up was self-portrait. I could not always reach the remote-control camera lead, so I tried directing someone to take my shots. I changed camera and re-photographed the areas myself; I spent the longest time trying to photograph my eye from the surgeon’s perspective. Dressing up became the performance; I had not considered this aspect of self-portraiture.

By printing body images on glossy photographic paper, the colours represented the skin under operating lights. Matt paper removed the shine making the skin lifeless. By working with the printed image, I saw my body in more detail.

The relationship between the initial printed photograph and holding the image to re-photograph it created a relationship between my body and me and demonstrated an empathy between nurse and patient. My brain believed I had sutures in my skin.

Sutures in the analogue print link the pixels from the digital image together. By working in two mediums the captured image recording part of myself changed into a representation of how my role affects my body through understanding of scar formation. In effect, this work became a projection of myself rather than a reflection of reality. By holding the printed image and re-photographing, the image moved from being a medical record into something more personal and cognitive.

A possible method of presentation for assignment 5 was journal covers. My research showed modern theatre nurse journal covers were banal and uninspiring, perhaps because people read online?

To bring my narrative into the 21^st century to engage younger nurses, I experimented with a bitmoji dressed in theatre greens resembling me, linked with Gmail and sent myself different captions and poses.

Printing on different materials such as dried and emptied teabags, different papers and fabrics was a steep learning curve and very frustrating at times when the slightest piece of fabric or paper which was not stuck down smudged. Throughout the project I printed everything on my printer. The most important lesson was turning off windows colour management in photoshop and printing colour specific work in photoshop.

Most modern images showing patients is copyrighted. I improvised by asking theatre staff to act but were uncomfortable in front of the camera which limited choice to my bridge rather than DSLR.

What mistakes did you make?

The gallery shop had a couple of images for sale (I wish I noted the name of the artist) which were layered portraits and pieces were peeled away. I experimented and couldn’t get it to work.

Claudia Angelmaier’s work was referenced at Grain’s Landscape Symposium. I tried to present my work in her style but my photoshop skills need development. (Assignment 4, Image 15)

I started Assignment 5 trialing a series with plant leaves from anaesthetic drugs juxtaposed on archived photos and discovered the series was too small.

What were the low points?

Time was the biggest factor required to develop ideas. Finding relevant images to fit the Code of Conduct and when revisiting the image and caption felt some links were tenuous. Having completed Assignment 4, I played around with ideas trying to find a narrative.

High points?

I developed a context for the sutured body images which showed me the importance of visiting exhibitions and looking at other works. I was pleased my self-portraits looked different in print than on screen. Theatre staff were encouraging and supportive of my idea and we shared tea and cake after they acted with me. (Assignment 5, Images 3,5,6,11,12,13,14)

Who influenced you?

Tom Hussey’s advertising campaign for a dementia drug looking at the self and younger self reflected in a mirror helped inform my series on self-portrait and identity (Assignment 4, Images 16,17,18,19)

In Anne Collier’s “Cut” and “Eye”, “Cut” is an image of an eye in a paper guillotine which is in the process of being cut in half and in “eye” a hand holds an image of an eye. Combined with Jo Spence’s “The picture of health” series and Juana Gomez’s work on anatomy and the body, I started to explore mark making and potential scar formation on printed photographs of my skin with suture material which I then digitised. (Assignment 4, Images 20,21,22,23)

How might what you have produced impact on your future projects?

There are several ways I could develop this work; using different aspects from my research to juxtapose reality and myth with language, represent nurses, explore performance and multiple identities.

Have you found a personal voice that you would like to develop?

I am so far undecided whether to continue with nursing as a project or revisit landscape for my body of work as I enjoyed both.

How did your technical decisions impact or impair the final outcome?

My work is not as neat as I had imagined based on the printing, cutting and sticking and difficulties with working with the medium of teabags but it is more creative than I envisaged at the start of the course.

Were you true to your artistic intentions?

I deviated from what we discussed during Assignment 4 tutorial as the work developed into a narrative. I planned to use more Assignment 4 work in Assignment 5 but it did not fit, reusing only 2 images. (Assignment 5, Images 16,18)

What did you learn from the editing process?

Suturing the photographs was more difficult than I imagined because different materials have different properties. I edited out the eye and neck based on scale and type of suture needed. The print is unreadable on some teabags but worked on the contact sheet. I left it due to the small size and it did not make the final selection of prints. I thinned out the teabag selection of large prints to a representation of the tea caddy. I experimented using different slideshows to replicate the opaque sheet similar to my teabags.

What are the main lessons you will take away as a result of this course?

I became more creative and open to ideas which I will carry with me through Photography 3.

Assignment 5 Tutor feedback

Overall Comments

An engaging and thoroughly researched submission. I’ve made some comments in this report on how to further strengthen the introduction of this project.

Feedback on assignment

"researched and experimented widely in response to this assignment. You have found a creative and original way to represent and re-contextualise a series of images (historical and contemporary, found and original) exploring the role of the nurse in contemporary culture. You have experimented widely with different presentation and production techniques – finally choosing to print these onto a series of teabag style sheets which you intend to display in a tea caddy/box"

"your ideas in DiC – and in this assignment in particular – have been very interesting, exploring as they do aspects of your own working life as a senior theatre nurse. The image that you use on the header of your blog – a self-portrait shot over your shoulder looking at your reflection of your younger self in a round hand mirror seems to sum up your project as a whole, looking as it does at the shifting role of the nurse – and by association, the shifting role of women in the health service over recent decades."

To do: 

"write a short (300 word-ish`0 introduction to your project, outlining your motivations for your project and also what you wanted to say with your chosen form of presentation" which comes before the background to "help position the assignment for the viewer"

Animation of contact images on blog because "these images and their relationship to each other is a very important part of the project and shouldn’t be lost in thumbnails only."

RESEARCH NOTE: Look at Carmen Winant’s recent project entitled ‘My Birth’ which uses exclusively found archival material. This project may be a useful reference point for you-  both in terms of how to re-purpose found images but also to think about the representation of women during what is a normal medicalized activity – giving birth. https://www.vogue.com/article/carmen-winant-my-birth-being-photography-exhibition-museum-of-modern-art-moma-womens-health-feminism

RESEARCH NOTE: Look at artists Richard Prince’s Nurses series and write a blog post linking his own interest in the iconography of the nurse with your own work in this area.

‘Richard Prince's interest in clichés and stereotypes inspired his Nurse series, which he began in 2003. In appropriating the covers of 1950s pulp fiction novels, he explores the eroticized subject of the sexy nurse. He worked directly from the original sources, scanning the cover of the book, printing it on a large canvas, and then embellishing it with paint. The multi-stage process results in images that are both mass-produced and hand-rendered, manipulated through digital and analogue tools.

In each image, Prince preserves the figure of the nurse, her face obscured by a surgeon's mask, and the title of the book, although he often manipulates the details, swaps titles, and changes the features of the women through his drippy application of paint.

Like his earlier Cowboy series, Prince leads his viewers to reconsider the images that permeate American visual culture. Isolated as art objects, the images require closer examination; it becomes immediately evident that these nurses are not really nurses, but constructed icons of stereotypical fantasies.’ https://www.gagosian.com/exhibitions/june-19-2008--richard-prince

Student feedback Assignment 5

I received really positive feedback about assignment 5. I had pushed myself creatively over this assignment and it had taken me longer to come up with the idea than I originally anticipated. My experimentation with exploring the role of the nurse showed. Change of blog title photograph worked.

Assignment 5 could be improved by writing an abstract of about 300 words before the background to Assignment 5, explaining my background, my motivations and re-positioning the work for the viewer. We discussed this because I was unsure whether to link assignment 4 and 5 together, so I will write a piece that covers this and links them together. I explained that for assessment purposes, I was going to submit the teacaddy / box and some larger prints so that the assessors would find it easier to view the work. Assignment 5 would also benefit from a slideshow whereby the photos could be seen moving and dissolving into each other representing the passage of time and move further forward in my work rather than tucked away in the background as a contact sheets. I thought I could also submit the slideshow to the gdrive at assessment if it didn’t work well on my blog. I need to experiment a little here.

We discussed the research that my tutor thought would be useful for me to look at. I recall seeing Carmen Winant’s work at the beginning of Assignment 4 and thinking how similar but unusual it was as I work in an operating theatre where people give birth and although they take photographs of themselves with baby, there is an element of privacy around it. It would be good to reference this as a contemporary artist who is exhibiting at MoMA (2018). Wendy also mentioned Richard Prince, who I studied as part of the stereotype of Nurses in Assignment 4. So I can put a piece together on my blog.

We discussed it would be interesting to look at power relations and hierarchy in nursing professions, and maybe talk about male nurses. I had found historical evidence of recruitment drives to include men, which I didn’t include. Also to look at statistics, behavioural patterns and types of image appearing (always the same type). We spoke of the role of the medical photographer, photos taken of life and death (memento mori) but not the private space inbetween and representation of illness – Susan Sontag, Jo Spence.

Looking forward to the next stage in the degree pathway, we talked about how I could advance this and use it as a background to my BoW, and even further to SYP and start thinking about exhibiting space within the clinical environment and the audience I want to reach. E.g. Barts Hospital have an exhibition space.  Another idea is to look at the RCN archives and see what there is, and maybe use some of the archived photographs? Another consideration is the Wellcome Institute on Euston Road; I have used some of their online archived photographs in this assignment. Wendy suggested some playful self-portraiture using lights and different lenses in a theatre environment to see what I can achieve / evolve.’ NH