Bad Request (Invalid Hostname)

Terry Cockerham	More NurseWeek Features   Smoke-Free Zone   Nurses and patients tackle nicotine addiction   Bloodless Survival     Surgical techniques to use when transfusion drops out of the equation
Barbara Dossey, RN (left), director of Holistic Nursing Consultants of Santa Fe, N.M., and Cathie Guzzetta, RN, nursing research consultant at Children’s Medical Center Dallas, together with Marriane Chulay coauthored AACN Pocket Handbook of Critical Care Nursing.

Several years ago, when a group of nurses at the University of California, San Diego Medical Center were discussing the benefits of music for critically ill patients, a secretary overheard them and mentioned that he played the flute. Patty Graham, RN, MSN, CNS, CCRN, a critical care clinical nurse specialist, asked him to play right then and there, in the surgical ICU.

“A patient’s family member heard the music and asked him to come to play at the bedside of her father, who was unconscious, awaiting a liver transplant. He went over and played ‘Amazing Grace,’ and it was completely transforming,” Graham said.

People lowered their voices and moved more slowly, and an atmosphere of calm permeated the unit. Later, Graham saw that same patient and mentioned the impromptu performance. The patient thought for a moment and then asked if the song played was “Amazing Grace.”

That is one of many stories, Graham said, that illustrate the power of music, which is just one of many complementary medical therapies that are being adopted by health care providers in the United States — even for the critical care arena.

These are services many patients demand, despite the debate surrounding their efficacy. A recent nationwide survey by the National Center for Complementary and Alternative Medicine (and the national Centers for Disease Control and Prevention’s National Center for Health Statistics showed that 36% of Americans older than 18 use some form of complementary and alternative medicine (CAM). Other studies have estimated that as many as 50% of adults use complementary care, according to a University of Minnesota task force.

“Hospitals understand now when people come in, they know about a lot of this. Mainstream magazines have articles on relaxation, music, nutrition,” said Barbara Dossey, RN, PhD, HNC, FAAN, director of Holistic Nursing Consultants of Santa Fe, N.M.

Patients’ perceptions and opinions are powerful forces in changing attitudes and practice in the medical setting, as Cathie Guzzetta, RN, PhD, HNC, FAAN, a nursing research consultant at Children’s Medical Center Dallas, discovered during a study on music therapy for acute myocardial infarction patients.

Guzzetta said the study made at Catholic University of America, published in 1989 in Heart & Lung: The Journal of Acute and Critical Care, showed patients reported that music therapy helped them get through the anxiety and depression of an acute illness, improved their sleep, and reduced their time on respirators. The study helped sway those who had been resistant to using music therapy at Children’s.

“That opened up the door for critical care nurses to do some of these therapies at the bedside, integrating them with the best practices of medicine,” said Guzzetta, who prefers the term “integrative” to complementary care (See sidebar).

Graham used this research to gain approval for an informal study at UC San Diego, where she is collecting data on the effectiveness of live music, as opposed to music recorded on tapes and CDs.

Helpful distractions

At the University of Minnesota, a similar study seeks to determine whether music therapy can reduce the length of time on ventilators and, therefore, length of stay. That could reduce costs and help prevent complications, important considerations these days, said Mary Jo Kreitzer, RN, PhD, director of complementary and spiritual care at the University of Minnesota Academic Health Center and associate professor at the university’s School of Nursing.

“In the critical care environment, we can’t afford to consider just standard nursing care when there are other options that will help with patient outcomes,” Kreitzer said.