In all the world, much is been talking about “Music in the ICU”, something very crazy not far away, no even imagine. And it is a wonderful thing.
Many efforts are made to bring the beauty of music to our ICU, because music accompanies us in conscious or unconscious way throughout our life, even before out birth. In a difficult time as been admitted in ICU fighting for life, music can be the best “medicine for the soul”.
But that does not mean that we are making music therapy
What is Music therapy?
In the United States, the definition most frequently used, raised in the American Association of Music therapy in 1980, and is this:
“Music therapy is the use of music to achieve therapeutic goals: recovery, conservation and improvement of mental and physical health”
Music therapy has been evolving and also by modifying its definition but in 2011 the World Federation of Music Therapy (WFMT) went on to define it as :
“The use of music and/or its musical elements (sound, rhythm, melody and harmony) by a music therapist qualified, with a patient or group, in the process designed to facilitate and promote communication, relationship, learning, mobilization, expression, organization and other therapeutic targets relevant, in order to achieve changes and physical, emotional, mental, social, and cognitive needs”.
And we are now trying to explain just how a person who is not even family, health of a patient, making a music therapy session in an ICU box, or how a nurse ends placing a DVD player among the connections of perfusion pumps, monitoring and the nozzles of the ventilator.
As well, these situations respond to the search for additional, non-pharmacological measures that help us manage the stressors, both environmental and psychological factors and which pose an “aggression” for our patients. We know that high doses for long periods of sedative and opioid analgesics are also associated with adverse effects. Sometimes the consequences are serious and these non-pharmacological measures would help us, not only to lower doses of drugs, but to make a less hostile environment of our units, establish new lines of communication with our patients and provide forms of expression and meeting with themselves, controlling anxiety, improves night rest… The possibilities are endless.
Today I tell you how we have started to work on our unit:
Music therapy in ICU is a complex work, that requires a rigorous study of each case.
With great humility and the desire to learn, we start creating a workgroup (a nurse, an intensivist and a music therapist). In an individualized music therapy session, the specialist (music therapist) works with the patient or his/her family, as we do a medical report and studies a “musical biographical history”, that is unique to each of us. Through this, fix a few therapeutic objectives between the health care team and the music therapist. In another part of the session, we explore the physiological reactions of the patient using tools of music therapy where a new channel of communication is created.
In the majority of cases, families are an important part of this process, at the same time becoming subject to therapy, because not only opens a way new expression and channeling of emotions with the therapist and the health care team, they feel they share the care of their patient.
Another part of our project, consists in the use of music as a nursing care, to establish the diagnosis of a problem (NANDA).
For example, fear or anxiety. A plan of care is detailled, defining expected results (NOC) and nursing (NIC) interventions necessary for its achievement. Here is where the music therapy or music use as care becomes an nurse intervention, counting on the advice of the music therapist.
Many ICU recently have begun to take their first steps around this exciting topic, but also some stir.
On the one hand amazement and bewilderment among music therapists and other, enough misinformation by health care providers.
And the last thing we would like is that misunderstandings spoil the beginning of this wonderful story of love, love for life and something we have in common these two worlds that are destined to do great things together.
An exciting job: helping the human being.
Dra. Maria Rojas
Intensivits.Hospital Comarcal Infanta Margarita, Córdoba