By Cathryn Domrose
February 21, 2000
Photo: Photodisc

When Katherine Brown-Saltzman, MA, RN, comforts patients who are anxious, afraid, or in pain at UCLA Medical Center, she speaks in soothing tones. She may sit on their bed, touch them, or take their hand. She asks questions, observes their mood, and assesses their condition. Then, if they are willing, she helps them meditate.

The meditation might be a prayer or use of an image. Some patients prefer to chant a phrase or say the rosary. Others focus outside themselves, on their friends, or on a picture of a loved one.

"Sometimes I go into a meditative state and essentially do healing work through that state," said Brown-Saltzman, a clinical specialist and assistant clinical professor at the UCLA School of Nursing.

After meditation, most patients report feeling more relaxed and less afraid, she said. She has met patients years later who told her, "I want you to know that what you taught me saved and changed my life."

Accepted practice

At UCLA, Brown-Saltzman said she worked mostly with dying patients, but nurses and doctors began asking her to help other patients when they saw the results of her work.

Among mainstream practitioners, meditation is becoming one of the most accepted practices of alternative or complementary medicine. Hospitals are setting up or building meditation rooms and offering classes; nursing professors are teaching meditation basics; HMOs are including meditation and relaxation techniques as part of their wellness packages—even insurance companies such as Blue Cross/Blue Shield are beginning to cover relaxation therapies.

The relaxation technique can be called many things—prayer, meditation, chanting—but basically consists of two steps, said Herbert Benson, MD, president of the Harvard-affiliated Mind/Body Medical Institute in Massachusetts and author of The Relaxation Response. The first is to repeat a sound, prayer, phrase, or body motion. The second is to clear the mind of all thoughts, focusing on the repetition. Benson recommends two 20-minute sessions a day to reduce stress and stress-related illness.

"It’s not alternative medicine," said Benson, whose institute has affiliates in 14 states. "We’re evidence-based. Alternative medicine is not. We teach empowered self-care."

Several studies have shown that meditation influences the regions of the brain that process emotion and cardiorespiratory function. Blood pressure drops, heart rate slows, pain subsides. But skeptics contend little evidence exists showing long-term positive health effects from regular meditation.

Bedside nurses find the short-term effects are more than enough to justify the practice. Brown-Saltzman said her patients often emerge from a meditative state with strong feelings of well-being and safety. "Whenever we reduce anxiety, we increase healing," she said.

The look of meditation

Hospital meditation centers can be elaborate. The Memorial Sloan-Kettering Cancer Center’s Integrative Medicine Service in New York offers massage, acupuncture, and nutrition advice.

Or they can be as simple as a converted patient-family meeting room at the San Francisco VA Medical Center. Stuart Berger, MSN, RN, a clinical nurse specialist in psychiatry at the hospital, persuaded administrators to open the meditation room in October. The room has low lighting, a table with handouts on meditation, comfortable earth-tone furniture, and a fountain. Berger and his colleagues plan to hold weekly meditation classes for the staff.

"There may be people who are not comfortable with meditation, who don’t know what it is," Berger said. "We also want to promote the room as a quiet space for patients, family, and staff."

Many nurses are uncomfortable approaching a patient about prayer or meditation, said Elizabeth Johnston Taylor, PhD, RN, clinical assistant professor of nursing at the University of Southern California in Los Angeles. Other barriers include lack of time, a biological rather than spiritual approach to nursing, and lack of training.

Though she and other teachers give brief orientations to meditation in their nursing classes, and institutions like Benson’s offer training to all medical professionals, Taylor does not know of any programs in nursing schools that offer extensive meditation training.

Brown-Saltzman believes that will change as more patients request meditation therapy.

"I think people are really embracing this as a viable alternative in healing," Berger said. "I think it makes sense."