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September 28, 2001
By Dr. Ruth McCaffrey
Mr. Johnson is recovering from surgery. He is in a hospital room with strange noises, unusual odors, and the voices of other patients who are moaning and nurses who are talking. Pain and fear are very present in his room and reduce the energy he needs for healing. Mr. Johnson worries about his health, his ability to return home, and his ability to care for his wife at home. As he lies in bed, these fears become more and more intense until they consume all of his energy. He is unable to relax or rest due to his worries.
The nurses provide excellent care by offering nourishment, pain medication, assisting with ambulation, and teaching him about his surgery, but he spends many hours alone and afraid in his hospital room. This is not an unusual case and demonstrates how the hospital environment can be detrimental to the healing process.
Florence Nightingale described the major responsibility of nursing as that of putting the patient in the best place for nature to work upon him or her for healing (Nightingale.1859/1946, p. 6). A psychologically positive environment can be viewed as a component in the healing process and provides an integrative network of physical, spiritual, and psychological factors that have an additive effect in the creation of a healing or healthy place (Dossey, Keegan & Guzzetta, 2000). Establishing an environment where healing can occur should be a priority in daily nursing care.
Music can be used to positively manipulate the hospital environment to foster spiritual, psychological and physical healing. Sound is an integral part of any environment and may have an impact on health and well being. Florence Nightingale provided music as part of the healing process for injured soldiers in the Crimea, and described how her nurses used voice and flute melodies to provide a beneficial effect on soldiers in pain (1859).
Music is a non-invasive safe therapy that has demonstrated effectiveness in reducing pain, stress and feelings of isolation (Chlan, 1998; Guzzetta, 2000; Jacobson, 1990; Ortiz, 1997). Listening to music is thought to release endorphins, the body’s natural opioid pain relievers, associated with pleasant emotions and pain relief. In studies using music as a therapy, patients have said that music improved motivation, elevated mood, and emphasized feelings of responsibility and control (Jacobson, 1990; McCaffrey & Good, 2000).
Persons respond to music with a complex mix of psychological and physiological reactions, in part based on past cultural, and association experiences (Campbell, 1997; Good et. al, 1999). As part of the healing environment, music playing devices should be available and patients should be instructed in their use. The patient’s musical preferences should be taken into account and patients should be encouraged to bring favorite music from home. Nurses could encourage patients to listen to calming music when they are restless, more stimulating music when they must ambulate or when they feel down and music they especially enjoy to transport their minds away from the feelings of pain.
People are making creative choices to better their lives and environment. These choices create self-empowerment. Fostering the use of music to create an environment in which a patient is able to sound their inner landscapes of body, mind, and spirit can lead to a realization of health and wholeness.
References
Campbell, D. (1997). The mozart effect. New York: Avon Books.
Chlan, L. (1998). Effectiveness of a music therapy intervention on relaxation and anxiety for patients receiving ventilatory assistance. Heart and Lung, 27(3), 169-76.
Dossey, B.M., Keegan, L. & Guzzetta, C. E. (2000). Holistic nursing: A handbook for practice. Gathersburg, MA. Aspen Publications.
Good, M. Stanton-Hicks, M. Grass, J. Anderson, G. Choi, C. Schoolmeesters, L. & Salman, A. (1999).
Relief of postoperative pain with jaw relaxation, music and their combination. Pain. 81, 163-172.
Guzzetta, C. (2000). Music therapy: In Dossey, Keegan & Guzzetta, Holistic nursing a handbook for practice. Gathersburg, MA: Aspen Publications.
Jacobson, H. (1990). Music and the mind. The Journal of Music Therapy, 4(4), 345-356.
McCaffrey, R. & Good, M. (2000). The lived experience of listening to music while recovering from surgery. Journal of Holistic Nursing 18 (4). 378-390.
Ortiz, J. (1998). The Tao of music. York Beach, MA: Samuel Weiser, Inc.
About the Author
Ruth McCaffrey ND, ARNP is an Associate Professor of Nursing at Florida Atlantic University College of Nursing in Boca Raton, Florida. She has an undergraduate degree in music as well as nursing; a master’s in nursing from Florida Atlantic University and received her doctoral degree at Case Western Reserve University. Dr. McCaffrey practices as a nurse practitioner at Palm Beach Family Practice in West Palm Beach, Florida. Currently Dr. McCaffrey is researching the effects of music and art on post-operative hip patients funded by a grant from the American Holistic Nurses Association.
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