Day in the life of a ... clown doctor

February 2015 Vol 15 (1)
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Zack McCracken was a nurse for 15 years before she left to pursue her love of acting. Now she combines her passion for theatre and healthcare by working as a clown doctor.

Clown doctor

NAME: Zack McCracken (aka Dr Cracker)

JOB TITLE: Artistic director of the Clown Doctors New Zealand Charitable Trust and former RN
LOCATION: Starship Children’s Hospital, Auckland

 

8.00am WAKE: I’m not really a morning person so I like to have a relaxed coffee and then, if it’s warm, a quick swim before I start my day.

 

9.30am HOMEWORK: As Clown Doctor’s artistic director, I have extra duties like setting the roster, planning training schedules and arranging coaching for our clowns. I also keep in touch with our other teams in Wellington and Christchurch and talk over any issues.

 

11.00am FERRY TO AUCKLAND: One of the best parts of living on Waiheke Island is my commute into town. I love the scenery and I’d much rather spend half an hour here than on the motorway.

 

12.00pm LUNCH BREAK: I grab a quick bite to eat before putting on my ID and talking to the nurses in charge of the wards I’m visiting today. It’s essential to get a general sense of the ward, as well as specific patients. The charge nurse informs me if there’s a birthday, if someone has a condition we need to be aware of, or if there is something more serious, like a death, which means the nurses are feeling particularly stressed. These are all situations that must be handled with appropriate sensitivity and respect.

 

12.30pm PREPARATION: I meet my colleague Ruth (Dr Pick-me-up) in the volunteers’ room, get into my Dr Cracker costume and run some quick warm-ups. Clown doctors always visit wards in pairs; it’s better for creativity and it doesn’t obligate anyone to interact with us. 

 

1.00pm FUN STARTS: It’s a sunny day so we walk outside to Ward 26B. On our way we pass the hospital shuttle bus so I climb aboard to do one of my favourite things, giving an aeroplane-style cabin safety announcement. “In an emergency your oxygen masks should fall from here… Please fasten your seat belts and shortly we will be serving drinks.” In between giggles, someone tries pointing out we are on a bus. I introduce one of the hospital security guards as the flight captain, at which he jumps into character and pretends to fly the ‘plane’, much to the delight of everyone.

At Ward 26B we visit a 14-year-old boy who we’ve been told hasn’t smiled all week. No pressure! Teenagers can be difficult to connect with and his mum is quite anxious. DVDs surround him so we try re-enacting some scenes from the movies. No luck. Finally, after singing a bad rendition of Johnny Cash’s Ring of Fire, he cracks up laughing and his mother starts crying with relief. It’s wonderful when you have a positive impact like that because sometimes you’re not sure if you can achieve it.

I started training as a nurse in the 1980s when I was 17 years old, at what was then Greenlane Hospital. My mother encouraged me to enrol because I’d helped look after my grandparents and she saw my capacity to care for people. Becoming a nurse was an incredible training for life and I don’t regret it.

I think an important commonality between my work as a nurse and a clown doctor is confidentiality. In a hospital environment where you’re dealing with sensitive personal information it’s essential for the patients and is reassuring for the medical staff. It’s also important to maintain one’s professionalism. I’ve seen some terrible things in hospitals: terminal patients and victims of accidents or abuse. If you get caught up in the pain or grief of that, you can’t help. It’s a hard balance to keep because to do your job well you have to connect with people and be authentic but also not be paralysed by their situation.

I think nursing has changed since the 1980s and patients are treated more holistically, with staff encouraged to understand the whole person rather than just completing a set of tasks for them. I remember during my first week on the ward at Greenlane Hospital, the ambulance brought in an elderly man who had suffered a fall and spent a few days on the floor alone. He was dehydrated and confused, bruised and incontinent. The experienced charge nurse moved him carelessly onto the bed without any regard for his privacy or dignity. As I watched open-mouthed, she said: “Take a good look nurse, this is as good as it gets!”. I think it’s different now. I like to think nursing and clown doctoring share a view of their patients that is non-judgemental and inclusive. Ultimately we are both concerned with the wellbeing of the kids we see, but the nurses’ focus is more on their physical health while ours is on their psychological needs, particularly their desire for play.

 

2.00pm BREAK: Stepping ‘out-of-clown’ by taking our red noses off, we head to the Ronald McDonald House Family Room for a cuppa and a biscuit. It’s a chance to reflect on what we’ve done well and what we could improve.

 

2.15pm BACK ON THE WARD: We encounter a man by the vending machines anxiously waiting for his child to come out of surgery and he asks if we can visit his wife. We find the room and announce we’ve kidnapped her husband. “You can keep him,” she jokes back and offers to pay us in chocolate. Her husband joins us and we have a few more laughs but before we leave they both give us teary-eyed hugs. They thank us for the distraction and for breaking the monotony and stress of waiting for their daughter’s surgery to finish. Busy nurses don’t always have time to take care of worried parents. They have more responsibility and reporting than I ever had. I see this as one way that clown doctors complement the nursing and medical staff.

 

4.00pm FINISH: We take off our costumes and collect feedback from hospital staff, taking note of how many people we’ve seen. Evaluation and accountability is an important part of being a clown doctor. A nurse mentions that when she first encountered clown doctors she questioned what place we had in a medical environment. “Now I love you guys. You have a neutrality and capacity to play with kids that I can’t provide. I wouldn’t do without you now,” she says.

Wherever possible, we love to improve clown doctor/hospital staff collaboration and hope to do this more in the future. We rely on nurses for information and more nurses are now coming to us for help distracting or engaging a patient during a procedure. We record these instances so other clown doctors can learn from them too.

 

5.00pm FERRY HOME: Sailing past Rangitoto and looking out over the water helps me unwind. Even successful days like today are emotionally draining and my partner knows I’ll have no energy to cook, so dinner is always on the table.

I spend a little time in my vegetable garden

 

9.30pm BED: After a soak in the spa pool, I’m in bed early.

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