Educational DIMENSION Nurses at Community Hospital Welcome Guided Imagery Tool Robert Miller, ND When patients suffer from pain, anxiety, or other concerns, nurses play an impor- tant role in easing their fears. This article describes the use of guided imagery to help patients. Key word: Imagery (Owens Cur Can Nuss 2003:22(5}225-226) ‘When patients experience pain, anxiety, or other con- cerns, nurses have a new drug-free tool that helps patients while making the nurses more productive. The nurses puts a special compact dise (CD) in the patient's personal CD player provided by the facility, gently places the earphones over the patient's ears, and turns it fon. After listening to a CD from The Tranquilities Hos- pital Series—a unique blend of Guided Imagery, scrip- tural reassurance, environmental sounds, and tradi- tional hymns—patients are often less anxious, less worrisome, and much more comfortable. Guided imagery is a selt-help technique many people find | effective in reducing mental | | |— and physical stress. Guided Imagery is a self-help technique many peo- ple find effective in reducing mental and physical stress. By following suggestions on the CD, patients will create their own mental images to help them relax and learn to manage mental and emotional stress or specific phys- ical symptoms. For example, a wall symbolizes fear. On the CD, a soothing voice guides the individual to pic- ture images of the wall being knocked down by ocean waves, symbolizing the individual's ability to free hisn- selffherself of fears and anxieties. Environmental sounds, sophisticatedly recorded with binaural micro- phones, dramatically involve the listener in the visual imagery. This imagery is quite effective in helping patients deal with the many fears often experienced in a hospital setting. Nurses can use these nightly. Patients may be appre- hensive as to whether the CDs will be beneficial though the apprehension typically fades. “I can see the anxiety disappear and the calm set in right before my very eyes,” said Kathleen Shirk, RN, night supervisor at Ephrata Community Hospital ‘The Tranguilities series has been effective in a wide variety of settings, including: relief of pain or anxiety before surgery, helping patients relax and sleep during evening hours, easing pain after surgery, and lowering blood pressure and helping patients adjust to breathing/respiratory devices. Shirk said the effect of the CDs is most dramatic in helping ease the anxiety of “sundowners” and other aging-related conditions. The elderly respond very well to the CDs. Some older patients become very confused, particularly after surgery. It is beyond their control and is an after effect Of the anesthesia. “Playing the CDs works better than September/October 2003 225>" Clergy from various denominations reviewed the materials and endorsed the project. sedation in easing their confusion,” said one nurse for 28 years. “The CDs are more effective than a lot of medications.” When Alzheimer’s patients become con- fused, haldol was the medication of choice. Now nurses place a CD and hold the patient’s hand. This can be a better resort than medication. (One nursing assistant said the CDs made her job less stressful. She said it was particularly helpful with ne patient who frequently pressed the patient call but- ton. This assistant suggested the woman listen to a Tranquilities CD. “In 15 minutes, she had rang six times. She was told that we could not come in each time because she may be taking us away from others. The CDs worked.” The patient did not ring the call button for 90 minutes, ‘A chaplain at the hospital helped develop the Guided Imagery series. It was inspired, in part, by her own encounter with breast cancer, She believed the develop- ment of a Guided Imagery series would help patients access their faith resources and be an effective healing tool. The chaplain recognized the importance of integrat- ing faith and spirituality into the healing process and sought to facilitate this through the use of the CDs. Clergy from various denominations reviewed the materials and enthusiastically endorsed the project. Each CD has three tracks; each track is approximately 20 minutes in length. The first track includes scripture and an invitation of God's presence. Track two omits these references, Track three includes only the music and environmental sounds for relaxation. The CDs do more than just help patients to relax. They empower them to invite a reassuring and comforting presence into their own personal struggle. The principles this series utilizes, such as timeless Scripture readings and tradi- tional hymns, are very powerful. The hymns are tunes that resonate with many people—ones that virtually everyone, regardless of faith, will recognize. Each bedside contains a packet of CDs and a CD player with earphones. Each of the CDs focuses on a major component of a successful hospital stay. These 226 Dimensions of Critical Care Nursing @® Vol. 22/No. 5 ‘+ Health & Healing, which enables patients to picture and imagine themselves well, actually “jumpstarting” the healing process; ‘* Comfort, which focuses on easing pain through soft gentle masic and the sounds of the rain; * Peaceful Rest, which helps patients overcome the hos- pital setting and to find rest; * Courage, which empowers patients to address fears often associated with illness, * injury, or surgery; and * Serenity, which helps patients overcome their worries. ae ee Serenity helps patients overcome | their worries. All of the staff nurses, therapists, social workers, managers, and housekeeping personnel are trained in the use of the CDs. When a patient is restless or con- cerned, staff or physicians often suggest that the patient listen to the CDs. Typically, the patient is more calm and relaxed (and often asleep) after listening to one of the Tranquilities CDs in the privacy of his/her own hos: pital bed. The staff and the hospital are beneficiaries as well. Because many studies have shown that relaxed patients heal faster, che hospital may generate financial savings. The staff are able to direct more of their atten- tion where it is needed because anxious or stressed patients turn to the CDs for help instead of calling on them. The nurses feel more productive because they view the CDs as an extension of their care. The hospital is supportive because the CDs are more cost-effective than any drug and reflect very posi- tively on the hospital's image. For example, a recent ‘group of surveyors were extremely impressed with the program because it reflected positively on the hospital's ‘commitment to quality care and demonstrated an added dimension of that care. More information about the Tranguilities Series for Hospital Patients is available online at www.tranquili- sies.com, via e-mail at info@tranquilities.com, or by contacting the author at (717) 721-6998. ‘ABOUT THE AUTHOR Robert Miller, ND is President, Gilead Enterprises, Inc ‘Address correspondence to: Robert Miller, ND, Tree of Life Health, 247 'N.Reading Road, Rohrata, PA 17522 (e-mail: mille@tolhealth.com).Copyright of Dimensions of Critical Care Nursing is the property of Springhouse Corporation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.