Music as medicine
Music has the far reaching potential to indirectly improve communication between staff and patients, with the music acting as a bridge to communication, something staff and patients can share together when other conversation may be limited or difficult.
I was able to explore the potential of music and the arts to improve training in communication and the delivery of compassionate care after being awarded a travel fellowship by the Winston Churchill Memorial Trust. The award enabled me to visit the United States, where I spent a week at one of the largest comprehensive arts in healthcare programmes in the world: Shands Arts in Medicine (AIM) at the University of Florida.
Established in 1996, Shands AIM is renowned worldwide for pioneering the delivery of the arts in health care, and providing daily art experiences for the hospital population.
What originally began as an investigation of how art might help reduce stress in the healthcare environment is now an embedded philosophy of care that centres on the belief that art is an integral component of healing and wellness.
As a psychotherapist trained in the use of the arts, and a nurse who fully appreciates and is at home with this philosophy, I was delighted to have the opportunity to work alongside a team of 16 artists at Shands AIM.
The team of professional artists, which comprised of visual artists, musicians, dancers, writers and an art and dance therapist, work in partnership with caregivers to help them meet clinical goals. Most have worked at Shands AIM for many years, some since the programme's inception in the early 1990s, and Shands AIM director Tina Mullen, and assistant director Jill Sonke, have been providing inspirational leadership for 20 years.
The week was packed full of wonderful creative, artistic and heart melting experiences, including dance classes for people living with Parkinson's disease, art activities in the renal unit for children and adults awaiting dialysis, and a creative writing group for people affected by cancer.
One particular experience really illustrated how ‘art opens the heart’, encapsulating the transformative power of the arts and providing an answer to the question ‘Why use the arts in healthcare?’
Ricky, one of the musicians, invited me to accompany him on his ward rounds. Entering the wards with his guitar is an everyday occurrence for Ricky, one that he treats with the utmost sensitivity and respect. On entering the oncology ward, I observed how he was warmly welcomed by the staff. They chatted before moving on to suggest patients who might enjoy some music.
The very ordinariness of a musician being thoroughly integrated into the clinical life of the ward is what was so extraordinary for me. Ricky is not just a visiting performer but a regular member of staff, acknowledged for his place in the healthcare system.
I followed Ricky as he knocked on the doors of patients’ rooms to enquire if they would like some music or a song. In the first room we entered, it was clear that the patient was in an advanced stage of illness. Ricky skilfully elicited a response, and the patient nodded ‘Yes’, and they decided on John Denver’s Country Roads. Ricky began to play and sing in rich, mellow, tones.
In his book The Volunteer Soldier of America, John Logan said ‘music is the medicine of the mind’, and German philosopher Arthur Schopenhauer claimed that music as a non-verbal art form more directly expresses the inner life because it goes deeper than pictures, deeper than words.
His argument is backed up by research proving the link between music and physiological arousal. Music can communicate feelings and capture the essence of the emotional experience exactly, and bring order out of chaos.
The power of music to penetrate the core of our being was evident; the patient visibly relaxed in the bed, her eyes rolled upwards in what seemed like ecstasy, and tension appeared to ebb from her body. The transcendent power of the music and Ricky's soothing voice seemed to provide a ‘holy instant’, which enveloped the three of us. In this liminal space, or ‘instant’, there was a sense of infinity where ego melted away, and there was no patient or carer, no sickness or pain but a true communitas. The language of soul replaced words in true communication.
As the patient emerged from this musical anaesthesia and palpable balm, she told Ricky that he had given her the first peace she had known in two days. She visibly brightened, her mood uplifted by the music, and started to chat about some of her life experiences.
The impact on clinical care and the immediacy of the effect was not limited to the patient. A nurse, on hearing the strains of music outside the room, quietly entered to join us and listen to the second song.
There is a growing body of international research showing the benefits of music on health. Numerous trials have shown that music can help lower heart rate, blood pressure, and help relieve pain, anxiety and improve quality of life. Music can be incredibly useful for somebody who is in a situation where they have lost a lot of control from their external environment. It can give them back a sense of control, as well as creating a calm personal atmosphere.
Nowhere more were the benefits felt than on that Monday afternoon in a room on the oncology ward in Shands AIM at the University of Florida. Hopefully, the emerging research will lead to experiences similar to the ones I witnessed here, and become the widespread norm in healthcare environments around the world.
I am deeply grateful to all the staff at Shands AIM, who made the professional development residency an unforgettable experience by sharing their wisdom, practice, and skills in such a loving and deeply compassionate way.
I would like to acknowledge and thank The Winston Churchill Memorial Trust for making this wonderful opportunity possible.
About the author
Olwen Minford is a nurse, trainer and psychotherapist. She began her career working in intensive care in Belfast at the height of ‘the troubles’ in Northern Ireland, before moving into palliative care and later gaining a masters in integrative arts psychotherapy. Olwen is a steering group committee member of the RCN pain and palliative care forum, and has extensive experience facilitating end of life care in hospitals, care homes and community settings. Her specialist interest is in ‘dismantling the taboo around death’. She believes passionately in the transformational power of the arts, and runs experiential workshops in incorporating the arts in healthcare. Email: firstname.lastname@example.org