My first job was at a facility that catered to children who were blind and had additional physical and emotional handicaps. One of the most interesting things I learned was how music played such a great part in the lives of these children. The bass from the speaker could be felt by those who also suffered from being deaf. They would love to sit next to the speakers and feel the vibration. Music was used so often when we cared for these children. Upbeat songs were used when getting ready, soothing songs when preparing for a meal or bedtime, and rhythmic melodies were used in education and routine building. I found that the music made the day.
My patient, J, was mentally delayed and had cerebral palsy, which caused him to fall often. He insisted on walking around at his group home at all hours, so being in a hospital bed was challenging to him. He was also deemed legally blind and nonverbal but during my assessment, it was quite clear that J was acutely aware of his surroundings. J had multiple instances of aspiration pneumonia related to his poor eating techniques and difficulty in teaching safe swallowing. His eating patterns were also inconsistent, so he had a Percutaneous Endoscopic Gastrostomy Tube, PEG, placed to provide nutritional support. Unfortunately, per his history, he was not laying and or sitting long enough for the tube feeding to infuse. He wanted to be on the move at all times. J was admitted to the hospital with two diagnoses. One, for another aspiration pneumonia and the second, for an accidental removal of his PEG tube.
My assessment revealed an abdomen that was warm and tender to touch, mildly distended with active bowel sounds. The puncture site from the previous PEG tube was relatively intact and did not have the medical staff concerned. J was treated with antibiotics for pneumonia and the PEG tube site was being monitored but no treatment was being rendered. J was subdued and cooperative during the first several days of his admission but as he started feeling better he becomes "antsy". He began yelling out intermittently, attempting to kick his legs out of the bed, and when he was most frustrated, he would punch himself on the side of the head. My assessment did indicate bruising to the right side of his temple. I was initially able to calm him with talking calmly. Unfortunately, talking to him was becoming less and less effective as he started to recover. I remembered how music helped in my previous job so I began humming and singing songs that I had remembered. J's physical outburst became less aggressive and ultimately stopped. He also started to smile and faintly nodded his head in the same tempo of my humming. I had reached the core of J and knew that the music would help our team with his continued care.
I was taking care of another patient and J became self-abusive and was yelling out. I was not able to sing or hum for him, so I pulled up my music library on my phone and placed it on his pillow. His behavior changed to calm and smiling. When I was able, I returned to J's bedside and began to clap to the rhythm of the music. He laughed out loud and attempted to clap his hands. I reached out and had him slap my hand to the rhythm of the music. I then took his hand and had him slap his leg to the rhythm of the music. He was all smiles. Any time that I had to walk away from the bedside I placed my phone by J and let the sound of Justin Timberlake keep him calm.
J was eventually discharged back to his group home. About a month later I was dropping a patient off in the pre-operative area of outpatient surgery. I overheard a nurse attempting to start an IV on a patient and she was having a difficult time getting the patient to cooperate. As the nurse was attempting to calm the patient, I heard her call out the name "J". I then heard her ask for help because the patient began hitting himself in the head and yelling out. I walked around the desk to find my J. He was crying, looked scared and was punching himself on the side of the head. I instantly ran to the bedside and told the nurse that I had cared for him and that music worked wonders. I told her to start humming while I got my phone to play his favorite song. The pre-op nurse began to hum to the patient and like he had in the past, the self-abuse started to subside. I was able to pull up what I found to be one of his favorite songs on my phone and began to play it. A minute into the song, all the physical outburst had stopped and he was tapping his leg in the rhythm of the music. The nurse was able to start J's IV while we sang "Seniorita" by Justin Timberlake. Before we knew it, most nurses in the immediate area were humming or singing and J was able to get his preoperative orders completed. I checked back with the nurse later in the afternoon and she reported that J was able to have his surgery to replace the original PEG tube and returned home with no complications. Whenever I hear "J's song", I smile to myself. I think of J and the comfort he found in music during a time that he was unsure and afraid.