The nursing profession is enriched everyday by new research and technology. Health care providers research to find better care options for their patients. Pressure exerted by insurances companies due to policies, restrictions in procedures, procedure's length, and limitation in the costs, are pushing these researchers to advance further. Music therapy benefits end-of life facilities to find relief with this pressure. Research done by Romo, R., & Gifford, L. (2007) used a population of eight patients that received music therapy through nursing intervention, while receiving hospice care. The median length of stay was 21 days; the cost of medicine was reduced as much as $2,415 for those using music therapies to treat for pain and comfort compared to those using standard care (Romo & Gifford, 2007 pag. ). Studies conducted by Lim, P., & Locsin, R. (2006), found that the use of music as a nursing intervention was not just helpful as a pain therapy, but can also be a tool to reduce the cost of care when offered to patients under hospice care. Additionally, the use of music therapy, areas like pain management, behavioral health, stress management, communication, and quality of life, can be improved (Lim & Locksin, 2006).
Increasing budget constrains have made make pain management even harder for both the patient and the facility's administration. The study made by Nowels, Kutner, Kassner, & Beehler, (2004) states that the cost of care rises faster than Medicare's routine care per diem rate; also because everybody involved in receiving care wants the most costly care available for themselves or their love ones, thinking that it will bring the best treatment outcomes even though there is not enough data to prove this theory (as cited in Romo & Gifford, 2007). When Romo & Gifford, 2007 conducted their research they calculated the cost of medications, the total number of hours for RNs, LVNs, and HHAs, each visit to a subject patient, interdisciplinary team meetings, cost of the medications, plus miscellaneous; the standard cost compared with the use of music therapy outcomes show that "the total cost of patients in MT was $10,659 and $13,643 for standard care, resulting in a cost savings of $2,984. The MT program cost $3,615, yielding a cost benefit ratio of 0.83." (2007 p.4). This is an attractive figure for those motivated by profit, like institutions struggling to complain with insurance policies, and with patient demands for the best care available. The nursing diagnostic related to this specific population is pain. Pain would need to be assessed and rated, and the nurse will assign as acute or chronic; in either case music therapy can be applied to relax the patient and lower the pain. All of these can be done without the use of pain medicine, decreasing the cost of care.
Lim & Locsin, 2006, approaches music therapy as a nursing intervention; of the studies they used, four of them used the Gate Control Theory of Pain by Melzack & Wall (1965, 1968). Lim & Locsin, 2006 also used certain variables to identify the effectiveness of music therapy to control pain. The most important variables were: instruments, type of music, music preference, duration and frequency of music as intervention, types of pain, and significance levels of using music as intervention for pain (Lim & Locsin, 2006). Notice that all the variables on this study can be implemented and managed by the nurse. Lim & Locsin, 2006 conclude that pleasure, joy, and calmness was among the beneficial effects of music therapy which apply to patients receiving hospice care, and may reduce the risk for falls and staff injuries due to patient's agitation and restlessness. Less pain medication is used to control patients' conditions, which reduces the cost of care (Lim & Locsin, 2006). A nursing diagnosis of deficient knowledge can be apply to patients in need of these beneficial effects; the nurse can educate the patient and the family about music therapy effects and let them choose to accept music therapy as a treatment to manage pain, or to prefer the standard medicine therapy. Education is very important, so the patient should not lack knowledge regarding pain management options available to them.
In conclusion, music therapy should be part of the optional treatments available for pain and should be offered by physicians and administered by nurses, similar to the interventions provide by a nutritionist, who aids medical treatments and outcomes. If pain is identified as chronic or acute, the nurse can reduce the use of medicines just by playing the patient's favorite melodies by the bed side, or at any situation as needed. The use of music therapy as a nursing intervention will save a considerable amount of money to the institution and ultimately will get better outcomes for the patient. Lim & Locsin, 2006 suggested that studies such as the ones they cited are accessible to the public and increase the opportunity to put music therapy in to practice. These papers also provide awareness among patients and facilities regarding its benefits. So there is plenty of material which the nurse can find helpful to teach and educate hospice care patients in need of better outcomes when pain is the issue. Music therapy can definitely make our patients receiving hospice care more comfortable and our work easier; in addition institutions will obtain a cost benefit ratio of 0.83, which is an attractive figure to keep in mind.
