What occurs in a typical therapeutic music session
I can provide therapeutic music at the bedside in hospitals, hospice facilities, or nursing homes, as well as a patient’s home.
Here is a description of a typical session in a hospital for a patient who is not actively dying.
I talk to the charge nurse on the floor I’ve been assigned to. I ask who would benefit from some soothing music today. I’ve already made sure that I arrive on the floor at a time that is convenient for the staff.
I ask for anything the nurses can tell me about the referred patients and their conditions, within HIPAA requirements. A good example of information that is appropriate for me to know is whether or not the patient has a heart condition, which would call for music with a steady rhythm. Another example is if the patient is hard of hearing, which would necessitate louder playing than usual.
If there are too many referrals, I discuss why each person is being referred so that I can prioritize.
Requesting the patient’s permission
My harp is already tuned and ready to go. I take it to the first referral and knock softly in case they are asleep. I introduce myself and let them know that I have a harp with me. I explain that this is a service provided by the hospital. Would they like some soothing music today?
I tell them that it is okay for them to close their eyes or fall asleep. They can ask me to stop at any time. This helps the patient understand that this is not a performance, allowing them to receive this as healing music. They have permission to let go rather than “being polite” and staying attentive.
If they have visitors, I can play while they’re here, or I can come back. (Sometimes visitors are eager to have something else to focus on besides their loved one’s hospital stay.)
If the patient is non-responsive, I introduce myself and request permission in the same way. I explain that I will watch them while I play for any sign that they would like me to change the music or stop. If a non-responsive patient has a visitor, I request permission from that visitor as well.
About two thirds of the patients I request permission from agree to the service. Therapeutic music is one of the few things that patients have a choice about in the hospital. It can be empowering for them to exert some control over who is in their room. When that occurs, I thank them and move on to the next referral.
Setting up at the bedside
After I receive the patient’s permission, I bring my harp into the room. If their roommate is awake, I ask them if it is okay for me to play, or if I should close their curtain. I also have my own small stool, so I don’t need to rearrange any of the patient’s furniture.
I position my harp where I have a good view of the patient, and I assess their condition. A session is completely personal to the patient, focused on what they need right now.
Their state in this moment suggests to me whether I should play music they recognize or something unfamiliar, at a quick tempo or slowly, with rich harmonies or sparse accompaniment. Should the song be happy, sad, sleepy, invigorating, calming, tender, uplifting, grounding? Or should I not play any song, but just let simple notes ring out and fade away? Listen to some examples.
Creating a healing environment with the music
As I play, I continue to observe the patient’s condition, using the monitor if available, or otherwise watching their breathing, their expression, and their body position. How I play at the beginning of the session does not determine how I will play for the rest of it. I am constantly reevaluating the patient’s needs.
A lot of the research on therapeutic music indicates that it is important to play a type of music that the patient prefers. One of the benefits of having a trained, live musician is that I can determine which music gives the patient the best results. I watch their reactions so that I can play more of what is beneficial or stop playing something that doesn’t work.
When I started playing for patients, I was surprised at how rarely they ask what type of music I’m going to play. Since this is not a performance, I don’t ask them what they want to hear. My training as a Certified Music Practitioner is effective enough that I can choose the right music without conferring with them.
Completing and charting the session
Since different patients need different things from the music, the end result of a session is not always the same. If the patient needed to fall asleep, then, ideally, the session ends when they fall asleep. If the patient needed to calm their anxiety, then, ideally, the session ends when they relax. If the patient was in an unstable condition, then, ideally, the session ends when they stabilize.
A typical session lasts for 20 or 30 minutes.
When it is over, I thank the patient for allowing this service (silently if they are asleep), and I thank any visitors who were there. I exit with my stool and my harp.
I go to a logging station to record the session in the patient’s chart, including their state before and after and any other reactions. After that, I am on to the next referral.