‘Acts of caring’: applied drama, puppetry, medical simulation and ‘sympathetic presence’ in Person-Centred Nursing

Matt Jennings, Patrick Deeny

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‘Acts of caring’: applied drama, puppetry, medical simulation and ‘sympathetic presence’ in Person-Centred NursingMatt Jennings, Lecturer in Drama, School of Creative Arts, Ulster University, mj.jennings@ulster.ac.ukPat Deeny, Senior Lecturer, School of Nursing, Ulster University PG.Deeny@ulster.ac.ukThe practices and principles of Nursing are associated with kindness, respect and compassion (Nursing and Midwifery Council, 2016). Nursing pedagogy promotes these attributes as necessary for therapeutic practice (McCormack and McCance, 2016). Such values resonate with a relational ‘ethics of care’, as described by Noddings (2013) and Held (2005). However, Nurses can struggle to maintain these qualities in the workplace, in the context of ‘mechanistic’ paradigms of care (De Zulueta, 2013), inadequate staffing levels and challenges to patient safety (Louch et al, 2016). Models such as Person-Centred Nursing (PCN) have emerged as frameworks for improvement (McCormack and McCance, 2016). One key feature of PCN is the concept of ‘sympathetic presence’, whereby a nurse actively responds to the physical and emotional state of a patient ‘in the moment’ (McCormack and McCance, 2016). However, the key challenge is to develop ‘sympathetic presence’ into a set of transferable skills. Since 2013, students and staff of Nursing and Drama degree programmes at Ulster University (UU) have been using applied drama and actor training techniques to enhance ‘role play’ practice for Mental Health and Adult Nursing students. Evidence suggests that Nursing students have advanced their self-awareness and communication skills, demonstrating an improved understanding of ‘sympathetic presence’ and its value within the nurse-patient relationship (Deeny and Jennings 2016).More recently, this intervention has incorporated the application of puppetry to medical simulation. Karen Torley (Banyan Puppet Theatre) has been working with Nursing and Drama students and staff to explore the use of puppetry techniques to animate medical mannequins. In approaching the mannequin ‘care-fully’ - through awareness and connection of breath and touch - the object attains a sense of agency, within an intimate ‘aesthetics of care’ (Thompson 2015). Using puppetry within medical simulation, health professionals can practise humanising an object, in order to avoid objectifying humans.Key Words: Applied Puppetry, Empathy, Sympathetic Presence, Patient-Centred Care, Care Ethics, Applied Drama, Aesthetics of Care, Pedagogy.References: De Zulueta,P. ( 2013) Compassion in 21st century medicine: Is it sustainable? Clinical Ethics, 8(4). 119-128.Held, V. (2005) The Ethics of Care: Personal, Political and Global. Oxford: Oxford University Press Jennings, M and Deeny, P., (2016) Development of an interactive model of creative play and critical reflection to advance ‘sympathetic presence’ in Nursing practice: a case of interdisciplinary pedagogy with Nursing and Drama. Performing Care Research Symposium, Royal Central School of Speech and Drama (London), December 15th 2016Louch, G., O'Hara, J., Gardner, P. and O'Connor, D.B. (2016) The daily relationships between staffing, safety perceptions and personality in hospital nursing: A longitudinal on-line diary study. International Journal of Nursing Studies, 59, 27-37. McCormack,B and McCance,T.(Eds) (2016) Person-centred Practice in Nursing and Health. Oxford: Wiley Blackwell.Noddings, N. (2013) Caring: A Relational Approach to Ethics and Moral Education. Berkeley: University of California Press.Nursing and Midwifery Council (2015) The Code: Professional Standards of Practice and Behaviour for Nurses and Midwives. London: NMC O’Neill, K (2013) (ed.) Patient-centred Leadership; rediscovering our purpose. London: King’s FundThompson, J. (2015) Towards an aesthetics of care. Research in Drama Education: The Journal of Applied Theatre and Performance. 20(4): 430-441
Original languageEnglish
Title of host publicationUnknown Host Publication
Number of pages2
Publication statusAccepted/In press - 2 Jun 2017
EventThe Broken Puppet: A Symposium on Puppetry, Disability, and Health - UNIMA Research Commission/Cork Puppetry Festival, University College Cork
Duration: 2 Jun 2017 → …


ConferenceThe Broken Puppet: A Symposium on Puppetry, Disability, and Health
Period2/06/17 → …


  • Applied Puppetry
  • Empathy
  • Sympathetic Presence
  • Patient-Centred Care
  • Care Ethics
  • Applied Drama
  • Aesthetics of Care
  • Arts and Health
  • Experiential Pedagogy.


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