Mind-body medicine training works on hospital staff, too
July 7, 2010 8:00 AM
JC McFarland, a registered nurse at Allegheny General Hospital, helps patient Ethel Taylor with calming techniques.
Larry Roberts / Post-Gazette
Volunteers Jeanne Weideman, left, and Liz Tafel-Hurley apply hands and pressure to Harriet Krystopolski as part of a Reiki treatment for pain at Allegheny General Hospital.
By Pohla Smith Pittsburgh Post-Gazette
The Positive Health Clinic at Allegheny General Hospital gets its share of people with an acute fear of needles. There have been patients who scream or even pass out during the nerve-wracking 15 minutes or more it takes to draw about 20 tubes of blood that will tell HIV-positive patients the state of their illness.
But registered nurse Terry Lang has found a way to help some of them get past their needle phobia: the deep-breathing relaxation technique she and 13 other AGH doctors and staff members learned in recent training with the famed Benson-Henry Institute for Mind-Body Medicine at Massachusetts General Hospital.
So far Ms. Lang has done relaxation breathing coupled with imagery, or visualization, of a nice place the patients would like to be with three of her needle-phobic patients. The results have been remarkable.
"The three I've done have been half-asleep -- in a place where they're half-awake, half-asleep," she said. "Once the needle is out, I tell them we're going to leave the nice place." After a few more breaths, she tells them it is time to awake.
"They feel really positive, relaxed, amazed at what's happened," she said. "They've been petrified of needles. ... [Now] they say, 'We'll never be afraid of having it done again.' "
And that's an example of what mind-body medicine, also called integrated medicine and used at both AGH and the University of Pittsburgh Medical Center, is all about. It's a recognition that the mind, body and spirit all work together in the healing process.
"I think that [the needle phobics' experiences] is a great example because the thing about this stuff is that it all sounds like a great idea, but people ask how practical is it?" said Dr. Betsy W. Blazek-O'Neill, medical director of AGH's Integrated Medicine Program and the person behind getting approval for the Benson-Henry Institute training. "In certain settings it's very practical. ...
"This stuff matters. A patient should not have to come in and have a horrible experience every time they have their blood drawn."
And a doctor or staffer should not be so stressed that it interferes with his or her interaction with the patient.
That's part of the mission of the staff who had the Benson-Henry training, which was paid for by a recent $250,000 grant from the state Department of Community and Economic Development: To not only do the relaxation technique with patients bedside and, eventually, with families in waiting rooms, but to do it -- and teach it -- to other staff.
With the grant, Dr. O'Neill also contracted wellness coach Laura Crooks for a year to work with staff on learning and practicing relaxation techniques. Stretched a long way by a department Dr. O'Neill said has always operated "on fumes," the grant also paid for equipment such as massage tables and biofeedback units and to remodel space for staff to use for yoga, Reiki and other relaxation or mind-body classes.
"I lead clinicians through two-minute relaxation exercises for stress management," said Ms. Crooks, a registered nurse with a master's degree in adult education. "I do some patients, but the primary focus is clinicians. My goal was to get some of the nurses and doctors to feel comfortable doing relaxation themselves, and then they would feel more comfortable teaching it to the patients."
She is just now beginning to hear that some of those staff have reached that point, where they are ready to work or are already working with patients at bedside.
Ms. Lang, who had prior experience with relaxation techniques such as yoga, is one of them. "The Benson institute gave us really in-depth training," she said.
Oncology nurse JC McFarland, who has practiced breath work and yoga for a number of years and who also took the Benson-Henry training, is another. "I'm so grateful to be able to introduce this," she said, expressing frustration that it takes so long to spread the word of its value.
During a recent shift, she did visualization and deep breathing with breast cancer patient Ethel Taylor, 70, of Penn Hills, and, later, with two nurses and a visitor.
"Let everything relax. ... Let the weight of your body let you fall into the bed," Ms. McFarland said to Ms. Taylor in a quiet, melodic voice. "As you relax ... begin by taking easy breaths ...
"Breathing in ... and breathing out. ... Breathing in ... and breathing out ..." Ms. McFarland's words had a soothing rhythm. "Breathing in ... and breathing out. ... In that little space between the breaths it is peaceful and calm and still."
Ms. Taylor continued to breathe to the rhythm of Ms. McFarland's words. The nurse told her to put her hand over her heart and feel the part of herself "that takes on challenges, the part that gives you the ability to survive, to stay calm or to feel good about yourself."
In that same melodic voice, Ms. McFarland told Ms. Taylor that several times during the day she should return her dominant hand to her heart and "connect with your inner strength.
"Now come back into the room with me. Bring peace, confidence and the pride you might feel that you were able to do this ... five ... four ... three ... two ... and one."
Ms. Taylor, whose cancer has metastasized to her bones, opened her eyes.
Later she said the breathing allowed her to feel "just the calmness over my body. This morning when I woke up I was scattered, but I knew I was going to have [breathing] so I felt relaxed. ... Now I have no cares. I have no worries. ... I don't have any pain at all this morning."
That kind of testimony is music to the ears of Dr. O'Neill.
"I wish people would realize how important it is, how worth it is spending money on," she said. "It's not a great time in medicine for what people consider extras. Everything is pared down to the bone now.
"[Integrated medicine] is cheap. All you need is people. You don't need a lot of equipment. All the equipment you need is like a CD player or a personal biofeedback machine that costs $80. You don't need multimillion-dollar MRI scanners ...
"My belief and a lot of other people's beliefs is if we did spend the money and incorporated this into everything we're doing for patients, it would save a tremendous amount of money."
Ms. Crooks said reaction from doctors and nurses she has approached has been mostly positive.
"Some of [the doctors] snicker," she said. "A few doctors seem very interested in it. Some will sit and do relaxation with us. Some of them ask if and when are we going to build a program that they can put in as a referral. They're interested for their patients' sake, not for themselves personally. Most say they believe it's a very good thing.
"There are some nurses who are very into it and some who remain skeptical. That's OK. That's where they are."