Getting in Tune with Patients

In 2011, Cleveland Clinic’s Hillcrest Hospital began a music therapy pilot program for a handful of hours each week. That program has since grown: The regional hospital now has a full-time music therapist working with patients in nearly all its units and an outpatient cancer center. Later this year, another part-time music therapist will join her.

“Over the time I’ve been here, the nurses, physicians and social workers have had an opportunity to see music therapy in action,” says Hillcrest Hospital music therapist Stephanie Morris, MT-BC. “In seeing and experiencing how it benefits both patients and families, they have grown to believe in it.”

A clinical approach to music

Music therapy is clinical and evidence-based use of music interventions by credentialed professionals to accomplish individual patient goals. It can be used to help a variety of patients. For instance, music therapy may reduce anxiety in a trauma patient, provide sensory stimulation for an older adult with Alzheimer’s disease, or relax a person with chronic pain. “We use music to facilitate a therapeutic relationship – a relationship between the music, the patient and the therapist – to reach whatever goals have been set,” Morris explains.

Caregivers in Hillcrest Hospital’s ICU frequently request a music therapy consult. In one case, nurses called Morris in to work with a patient who had multiple stab wounds. “We needed to photograph her wounds for forensics and do dressing changes,” says Samantha Pon, BSN, RN, assistant nurse manager in the ICU. “That’s the first case where a lot of our nurses saw the music therapist interact with a patient. They were amazed at how music helped calm the patient. It touched the nurses to the point where many of them were crying.”

When Morris is called to see a patient, she reviews the patient’s medical condition and history, then assesses their current needs. Sometimes she sees patients only once, like the young girl in the ICU. Other times she makes multiple visits to a patient. She develops treatment plans and objectives related to the medical diagnosis. Music therapists have an array of interventions, including songwriting, music-assisted relaxation, singing and instrument playing. After each consultation, Morris documents outcomes of the session in medical, not musical, terms.

“Music can be very emotional for people and bring back memories,” says Morris. “I once had a patient who had a very quick, emotional reaction to a song that even she did not anticipate. It made a huge difference having a therapist there. I was able to stop the music and process it with her.”

Making a difference in patients’ lives

Morris works 30 hours a week at Hillcrest Hospital, seeing patients in specialties ranging from pediatrics to neurology. She also works 10 hours a week at the hospital’s outpatient cancer center, often forming close connections with the patients.

This year, Morris helped a 67-year-old patient with pancreatic cancer write a song about his life as a legacy to his family. She met with the patient and his wife about 25 times. Each week, he would bring in notes, they would talk through the ideas, and the patient and his wife would compose the lyrics. “That’s where the therapy comes in to play,” says Morris. “Any finished product is an added bonus.”

Morris helped the patient select accompanying music – folk music reminiscent of the 1960s. Then they recorded the song, with the patient singing the lead and nurses from the cancer center singing backup. “When you’re faced with a difficult diagnosis and probable end-of-life situation, you review your life and wonder what your purpose has been. His song reflected that,” says Morris. The patient recently died, and his wife asked Morris to sing the song at his funeral.

There’s more than anecdotal evidence that music therapy makes a difference. Morris has reviewed pre- and post-session data on patient fear, tension, pain and relaxation. “Across the board, there was a decrease in each of these areas,” she says. Morris and Pon will present these findings and talk about how music therapy is used at Hillcrest Hospital at the ANCC National Magnet Conference® in Atlanta this year. Their podium presentation, “The Development of an Evidence-Based Music Therapy Program,” will be held at 2:30 p.m. on Oct. 7.

“Music therapy is a wonderful addition to Hillcrest Hospital,” says Pon. In 2014, Morris had 902 referrals from the hospital and 571 music therapy sessions. “Stephanie really advocates for our patients, and it’s fabulous to see collaboration between her and all the other caregivers help our patients,” says Pon.