Pain Management / Sedation

Tune into the healing power of music

…And to heal. Music can target pain, anxiety, muscle tension, sleep, nausea, or patient satisfaction. Music can also distract a patient or create a healing environment for patients and their families.
Many types of healthcare professionals, including nurses and physicians, are using music therapeutically. Specialists, such as harp therapists, music healers, sound healers, and music thanatologists, also provide specific types of music interventions. And specially trained music therapists use an intervention called music therapy.
So, you may wonder, does music produce any measurable, therapeutic effect? Well, investigators have studied the use of music during healthcare procedures, such as GI tract procedures. Most investigations of music interventions during GI procedures have focused on anxiety, using anxiety questionnaires or physiologic findings values such as blood pressure. These studies show that during the procedures, music reduces:
• pain
• anxiety
• heart rate
• blood pressure
• the need for sedation.

Sounds of the music therapistMusic therapy goes beyond creating healing sounds. Music therapists use music and the process of making music as tools to encourage development in social, emotional, cognitive, and perceptual-motor areas and in rehabilitation, healing, and wellness.
Music therapists trained in a primary instrument, such as voice, flute, or violin, and proficient in using the piano or guitar for accompaniment provide music therapy. They are also trained in assessment, treatment planning, implementation, evaluation, and documentation. Their curriculum covers various areas of study, such as music therapy, psychology, biology, social and behavioral sciences, music theory, and disabilities. Music therapists work with patients of all ages, including those dealing with chronic pain, developmental disorders or disabilities, cancer, neurologic disorders, terminal illness, physical disabilities, and dementia.
Heavenly music, Tibetan singing bowls, and music vigils
One of the oldest instruments, the harp can create sounds that evoke images of angels and heaven. Harp therapy may include playing the harp at the bedside, giving harp instruction, providing soothing harp music, or using the harp in conjunction with other therapies, such as vibroacoustic therapy or biofeedback-relaxation training.
Music and sound healers use many different types of instruments, including Tibetan singing bowls, tuning forks, and voice. Their techniques include toning, singing, breathing, storytelling, audience participation, meditation, and cymatics. Targeted outcomes may include general wellness, decreased pain perception, decreased stress, and increased coordination.
Music thanatology provides comfort to dying patients through a music vigil—that is, a prescriptive music cycle at the patient’s bedside. The vigil comes from traditions of sacred songs and is delivered by one or two music thanatologists for the benefit of the patient and family.Play on, nurse
Healthcare professionals who use music in their practice include nurses, doctors, social workers, mental health professionals, physical therapists, speech therapists, recreation therapists, and therapists using other creative arts, such as art, dance, or drama.
As nurses, we are well positioned to integrate music with conventional interventions. We all have patients who could benefit from music. To advise them and effectively incorporate music into their care, you need specific education and training. You can learn from in-services provided by music therapists and from additional reading. And journal clubs can help you understand the empirical basis for musical interventions.
You can acquire training through professional journals, workshops, and continuing education courses. Techniques may include music listening, music vibroacoustic therapy, music-elicited imagery, music and directed imagery, music and bio­feedback, and active music playing and singing.
If you use music, you’ll need to consider your patient’s preferences for specific types of music, such as orchestral, jazz, or harp music, as well as cultural differences affecting the patient’s responses, such as showing of emotions. Keep your specific patient’s preferences in mind. One person’s Mozart may be another person’s Metallica. Have a wide variety of music available for patients and family. Also, encourage patients to bring in their favorite music from home.
Conducting the program
If your facility doesn’t have a music therapist, you can find other ways of bringing music to the bedside. You can use music yourself and perhaps even develop a program of music interventions. Depending on your location, training opportunities may be limited. And financial constraints may hamper your ability to provide patient resources, such as compact discs. Neither of these issues should stop you, but you may need to show those who control the budget that music interventions can be a cost-effective way of achieving positive outcomes.
Developing a program of music interventions takes time in all phases from assessment through evaluation. But again, that shouldn’t stop you. By collaborating with multidisciplinary team members and demonstrating the effectiveness of music in the healthcare setting, you can create and conduct a musical program.
Selected references
Bedside Harp. www.bedsideharp.com. Accessed November 8, 2007.
Eliopoulos C. Complementary and alternative healing. In: Cherry B, Jacob SR, eds. Contemporary Nursing: Issues, Trends, & Management. 3rd ed. St. Louis, Mo: Elsevier Inc.; 2005:338-356.
National Center for Complementary and Alternative Medicine. What is complementary and alternative medicine (CAM)? http://nccam.nih.gov/health/whatiscam. Accessed November 8, 2007.
For a complete list of selected references and a summary of studies on music therapy’s benefits, visit www.AmericanNurseToday.com.
Susan B. Fowler, PhD, RN, CNRN, FAHA, is a Clinical Nurse Researcher at Morristown Memorial Hospital in Morristown, N.J. Leah G. Oswanski, MT-BC, is Coor­dinator of Music Therapy at Carol G. Simon Cancer Center in Morristown. D. Anthony Forester, PhD, RN, is a Professor at the University of Medicine and Dentistry of New Jersey, School of Nursing in Newark, N.J.



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