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Originally Published: Common Sense July/August 2018
The ED is a naturally stressful environment, where sensory overload is the norm. At any given moment, you can simultaneously be handed two stat EKGs while receiving an EMS refusal and have a consultant return a page. As a senior resident, I have taken to reflecting on this and how I will approach this in my own independent practice going forward. In doing so, I have found that I have already subconsciously been finding my own ways of mitigating my own stress. One of my favorite methods of doing this on-shift is music.
In one of the EDs we staff, there is a cordoned-off area for the physicians. It is pseudo-open. What I mean by that is there are door-less entryways so staff are pretty consistently passing through, but overall, it is an area where the attendings, residents and medical students can discuss cases, place orders, write notes and such. I am not a fan of laptops so I typically sit behind a desktop computer. After signing in and (depending on the acuity of the day) getting settled in, one of the first things I like to do here is open my Spotify account and tee up and album. Lately I have been starting with Guardians of the Galaxy, Volume II soundtrack. As the shift goes along, I will adjust the music (genre, artists) to fit the mood. The tunes will vary from country to classic rock to hip-hop, Corey Smith to Wu-Tang Clan. I take requests. This is something that takes a minimal amount of time, but after coming out of a long arrest or otherwise complex poly-trauma, just hearing a brief snippet of the dulcet tones of Freddy Mercury crooning out “Don’t Stop Me Now” will help right my ship.
At another ED we staff, everything is much more open. Thus, playing even low-volume music is somewhat inappropriate, where patients and families are just a few feet away. So I will try and steal a minute or two and put in one headphone and get a quick tune in.
As I was doing a quick Google-search to see how much (if any) research or even editorials/anecdotes along these same lines are out in the world, I found a few interesting things: With the recent push for wellness, there is no lack of recommendations for de-stressing after a shift or outside of work. Things like controlled breathing exercises, yoga and other organized activities are popular. However, there is not much related to listening to music on-shift.
Music in the ED is not something novel. There are attendings and other residents in my own program (and undoubtedly countless others) that play music throughout their shifts. Today, I simply want to write about something that I have personally found to be therapeutic and a quick and easy pick-me-up.
I am sure most of us can recall rotating on surgical services and reflect on how different attending surgeons would play music in the OR, as a means of aiding focus and their overall mental state during operations. This dates back to as early as 1914, where a surgeon named Dr. Kane brought a gramophone into his ORs.
Diving deeper, I even found things related to music therapy in the ED for patients. With respect to older patients, for whom an ED visit may be an especially stressful situation, there is even a clinical trial at Columbia University looking at music and its anti-anxiolytic potential.
I come from a background of the “hard sciences.” Music therapy was not ever much on my radar growing up. However, I was exposed to music early on, through sports (work outs and pre-game) and continued pursuing good music via concerts, festivals, etc. While I am no professional on the effects of music therapy, it is definitely something I will carry with me as I go off into the world of independent emergency practice. As I head off to an afternoon shift, I am looking forward to that next track.