By Sinead McCarthy, Psychology Student, MIC.
Supervisor: Prof. Niamh Stack
As a child, when you were sick what was the one silver lining? You didn’t have to go to school. However, for children and adolescents whose lives have been affected by illness that has resulted in hospitalisation, school is often a welcome distraction from their illness and treatment plan.
This refuge is provided by hospital schools, namely schools that are located within hospitals and paediatric wards. Hospital schoolteachers primary aim is to maintain a child’s education and development during a period of hospitalisation. However, my research indicates that hospital schoolteachers provide so much more than curriculum content.
Hospital schools form a relatively small proportion of the Irish education system and as such, unless you have had direct experience of them, not many people even know they exist. I had the privilege of completing a semester of college placement in an Irish hospital school and witnessed first-hand the impact of just what hospital teachers do. What these teachers witness and experience every day is something most people could not imagine. I felt that these experiences provided important holistic insights into children’s treatment and education plans and that these experiences were underrepresented in the existing educational, health and developmental literature. How can we support current and future hospital schoolteachers if we do not understand what the experience of being a hospital schoolteacher is?
After this placement experience, I knew that I wanted to capture the voices and experiences of the teachers working in Irish hospital schools in my own research. Therefore, my undergraduate dissertation question was Investigating the lived experience of schoolteachers working in Irish hospital schools. After examining past literature, both in and beyond this area, I decided to investigate the teacher’s experiences using anonymous reflective letter writing. Each teacher was provided with a writing prompt asking them to write a letter to their past self that they would have liked to have read on their first day as a hospital schoolteacher. Five hospital schools were asked to participate and nine fully qualified teachers currently working in Irish hospital schools took part. Each letter was assigned an anonymous pseudonym and then analysed using Braun and Clarkes (2019) thematic analysis as part of which five themes were identified.
The Definition of Success
The first theme focused on the definition of success. Throughout the letters, one matter that hospital schoolteachers repeatedly raised was that while working as a hospital schoolteacher your perspective of success changes. Success becomes individual to each student. The teachers have to consider the specific circumstances and possible constraints of every illness. Success no longer looks like how much of the curriculum they cover, or the results a student attains. Success could simply be coming down to the classroom to see what it is like. This was demonstrated by Alex who said;
"Don’t measure your success here by how much curriculum you cover. Measure it by connection, engagement and responsiveness. Your definition of success shifts. You become less focused on coverage and more focused on readiness, dignity, engagement and emotional safety. Very often, the most important outcome is that a child feels capable, included and connected, rather than how much work was completed."
Academic success is not devalued in hospital schools, but teachers ensure it stands side by side with other successes as they acknowledge the importance of both for their students. The awareness of how important this shift of perspective is was also demonstrated by the teachers. They acknowledge the significance and power of recognising every success;
"Sitting with our pupils at some of the hardest points of their lives and remind them that they are still students, thinkers, jokers, dreamers, it’s such a privileged space to sit in. That matters more than you can possibly imagine today". (Dani)
Normality in the Unknown
Normality in the unknown was the next theme. Illness and hospitalisation are scary and uncertain but school is something every student knows and understands. Dani says;
"School is the only part of normal that each student will experience while being in hospital, they know how it works."
Hospital school teachers provide this normality - they symbolise more than education for their students. They are a link to their past before illness and are a bridge to their future after. What this normality provides is highlighted by Alex;
"School brings normality, identity and connection into a medical environment. You are not just teaching lessons; you are restoring a sense of ordinary childhood in an extraordinary situation."
Equally Jordan states the importance of the normality that the teachers provide when they say;
"You see more of them than their consultants. You will be their constant, their safe haven, and with your support and guidance, they will feel a glimmer of hope."
The Emotional Load
The third theme identified was the emotional load - boundaries and support involved in this kind of teaching. The emotional load of the profession was acknowledged throughout. It was accompanied with the understanding that it is an emotionally charged setting;
"The emotional load is real and ongoing. Working with seriously ill children means regular exposure to distress, uncertainty, and sometimes bereavement".
However, it is also acknowledged that it is not always all negative emotions. Teachers experience sadness and loss, but they also witness and experience resilience, joy and recovery. Understanding the need to recognise and process both was illustrated within the letters;
"What outsiders don’t see is the amount of healing, recovery, humour and resilience that exists in the paediatric setting. Many children improve and go home well. If you only focus on the tragic cases, you won’t last, you must consciously notice the recovery and progress. This balance is what sustains hospital teachers."
Learning from those Around You and Sharing Knowledge
The fourth theme was the learning from those around you and sharing knowledge. As hospital school teaching is such a unique context it was apparent from the letters written that teachers in these roles recognised the need to, and benefits from, learning from those around you. This could be from other hospital schoolteachers, in Ireland or abroad, or from other professionals, doctors, nurses, SNAs or parents. Alex advises their younger self;
"Learn from everyone around you - nurses SNAs, play specialists and other teachers. The multidisciplinary environment is one of your greatest recourses."
It was clear from the teachers in this study that hospital schoolteachers believed that their most valuable resource was one another;
"Visit other hospital school settings whenever you get a chance, share practice, ask questions, seek advice, and don’t see it as a sign of struggling, rather a sign of confidence." (Sam)
Recognising the Value of Hospital Schoolteachers and their Work
The fifth and final theme identified was recognising the value of hospital schoolteachers and their work. The letters highlighted that hospital schoolteachers provide education but also so much more. However, even they need to remind themselves of the value of what they provide for their student. In a medical setting treating a student's primary condition can be seen as the main priority but the letters show that teachers are aware that they need to take more time to remind themselves that they are also contributing to the recovery of their students. Naoise illustrates this when they write about the work they do;
"Remember that it *is* making a difference, even if it doesn’t appear to be right now, it will live inside them, in their unconscious and eventually it will change their life."
Hospital school teaching is a unique profession that requires unique individuals to do the job. Knowledge and understanding of the experiences of these teachers can, and should, be used to help better supports for current and future hospital schoolteachers, hospital staff and families, as they play a vital role in maintaining the education and development of students who are experiencing illness.
It is stated in one of the letters that when talking about their job, hospital schoolteachers are often told "I could never do that" and having conducted this study I now believe this statement to be true. What makes it a challenging role is the need to be the type of person being a hospital schoolteacher requires you to be. You must have the ability to change your perspective and make every child feel like a winner no matter how big or small the success. You need the strength and integrity to provide normality for your students in such an unknown time. You must be able to manage and process your own emotions while remaining a support to your students, their families and other medical staff and have to have the resilience to see the joy and hope around you. You need to be capable of sharing your knowledge with others and have the drive and curiosity to continually learn from them in return. Finally, you need to actively recognise the value in your work because being a teacher in a hospital school is no ordinary thing and most people "could never do that".
References:
Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative research in sport, exercise and health, 11(4), 589-597.
