The Intentional Use of Music

Over the past few years, I’ve had the opportunity to witness and experience our local professional orchestra in various ways from masterworks concerts, pop series, family concerts, and other community engagements. My husband has worked on staff for a number of years, and it’s been an interesting experience to attend concerts and programs, hear about the inside work from the staff and musician perspective, and witness it all as a music therapist. My husband and I are both dreamers when it comes to the use of music and how it benefits others. We share many points of view, despite my work being within the clinical use of music in healthcare, and his work in helping the orchestra enrich the culture of our community. For the first time, my husband and I were able to collaborate together between our organizations in a joint community event. The orchestra came to support my hospital in providing a free concert to our outpatients, families, and staff.

In addition to the concert, a few musicians volunteered to play on the units for a short period. The concert and on-unit performances are something the orchestra had done in the past, but was not something I personally was able to experience as one of the hospital’s music therapists. In the many years of dreaming, scheming, and collaborating , my husband and I were able to witness together something that fell into our vision for the intentional use of music within our community. One of the things that I think is incredibly important, but often neglected, is our support of the caregiver when it comes to music therapy. As a music therapist, we are not there to only support and take care of our patients, but we support the entire family unit. This is the heart of family-centered care. But even outside of the family, the caregiver includes the nursing staff, physicians, allied health professionals, and the support staff. Every person who works within a hospital is someone who cares for the patient, despite their role.

This is a phenomenon that is not always recognized, especially for those who do not work in the hospital. It is often difficult to see how an environmental services person supports a patient until you witness the care they provide in taking care of the environment, a patient’s room, and the relationship they build with the patients and families. It then becomes clearer when you consider how much this staff person witnesses a decline of a patient from the day to day, or the success of their recovery. It is easy to see how a nurse is affected by their care of patients over time, but this same sense of fatigue, heartbreak, or overwhelming sense of compassion can be felt by all employees within a hospital.

If you consider the importance of how the caregiver cares for the patient, how important then is it to care for the caregiver?

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While I accompanied one of the musicians from the orchestra to one of our units, I warned her that we would need to check in with the nursing staff before she began to play. I had already spoken to the charge nurse in the morning, explaining to him what we would be doing and for how long. He was hesitant, stating that they currently had a patient on the unit who was very sensitive to stimulation. Over-stimulation can become dangerous for patients who are critically ill, and I reiterated that my role as the music therapist was to be a liaison between the musician and the hospital, and that we were happy to make adjustments as necessary. The charge nurse agreed and we planned to play on the intensive care unit. When we arrived to the unit, I again checked in with the staff, and they were hesitant. They reported today had not been going well for that particular patient, and they were worried the volume of the instrument would be too over-stimulating. The musician attempted a few notes, and the staff immediately agreed, the music would be too much for this particular patient at this time.

Luckily, our musician was incredibly flexible and understanding. I escorted her to another unit and explained to her why the staff had requested us to not play at this time. We instead went to our general medicine unit, where I chose an end of the unit I knew had patients and families who would benefit from hearing the musician play. I had already worked with one of the families earlier in the day, and knew how well that particular patient responded to music. The musician began to play, and immediately the unit was filled with ambient sounds of her cello, playing various children’s and folk songs. One family came to the doorway, with a sibling giggling and playing hide and seek with the musician. The family I had worked with earlier in the day opened their door and gasped in surprise. Despite being unable to communicate verbally and feeling so anxious that he was engaging in some self-harming behaviors, music provided an outlet for this patient to relax, feel comfortable, and find some normalization in his environment. The family thanked me, the staff, and the musician for coming and told us that this experience had brightened their day.

As I walked the musician back to the lobby, I explained to her that her music gave this particular patient an opportunity to express. In the day full of stress, confusion, and limitations, her music allowed him an outlet to relax, find joy, and have a moment of normalcy. His experience of the music also allowed his family to find respite and relief while also experiencing the music directly for themselves as well.

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As I reflected over the experience, I thought of the conversations my husband and I have had over the years on the role the orchestra plays within the community, and the role it could play in the future. I was again struck of the power of intentional music. When we use music intentionally, whether for ourselves personally, or clinically within music therapy, music shifts from entertainment towards purpose. Intentional music becomes a tool that serves our health and well-being.