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The Power of Music

Oncology RN finally gets patient to accept radiotherapy

Monday November 25, 2013
Maria Elena Perez, RN
Maria Elena Perez, RN
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From a distance in the waiting area I could see her restlessness, hands shaking and face twitching. It almost looked as if she was having a seizure but it was nervousness, anxiety building up as she waited for her radiation oncology consult. Her husband sat patiently next to her reading the newspaper. I called her name and she jumped out of the chair.

The initial nursing assessment took longer than usual. For every answer she gave me, she had a story to tell and a question for me in return. Will this hurt? Am I going to be radioactive? Am I going to get sick to my stomach? She was talking fast, constantly moving in the chair.

Three days later, having consented to the treatment the oncologist had recommended for her invasive ductal carcinoma, the patient, whom I’ll call Mrs. C.J., was back for her simulation. The simulation was a customized planning session involving a non-diagnostic CT to visualize structures and define fields. Treatment would start once all necessary calculations were determined and checked.

She was happy to see me and had taken anti-anxiety medication prescribed on the day of the consult. The radiation therapist directed her to the room where she could change but became concerned after seeing her trembling and twitching. He came to the nurses’ station and said, “Can one of you talk to Mrs. C.J. when she comes? She is so nervous.”

I was on a mission then. I knew the thought of getting radiation was very frightening for Mrs. C.J. We sat down in the exam room closest to the nurses’ station, the pediatric room. Mrs. C.J. kept holding her breast with her shaky hands every time we referred to it.

Once I had answered her questions, I felt relieved when she started talking about trivial things and not about radiation. She looked more relaxed, even had a few laughs. “Do children get radiation too?” she asked. Upon my confirmation, her eyes became watery. She held her husband’s hands and said, with determination, “If they can do this, I will do it.”

Later I heard her name being called to the treatment area. I saw her in the corridor escorted by the therapist and gave her a thumbs up. She smiled and signaled me back with crossed fingers, both hands.

Then, just a few minutes later, she was passing by the nurses’ station walking fast, head down, the therapist trying to catch up with her. “Couldn’t take the films,” he said. The next week, same thing. She became terrified when the linear accelerator machine came close to her.

When I spoke with her husband, he told me Mrs C.J. directed the Rosary Society, and her church was celebrating the patron festivities. “She is busy, and this is making her more nervous,” he said. “Too much stress.” Bingo! Spirituality and faith are her strengths, her comfort zone, I thought. We started talking about the activities her community was doing, her role and expectations. I felt our bond was growing stronger.

Mrs. C.J. agreed to come back the next day. I already was formulating a plan. I happened to have CDs with gospel music, which she had talked to me about, and when she came the next day I told her I had something to share.

“Listen to this,” I said, playing the CDs as she sat on the treatment table. She thanked me many times and started humming the song, closed her eyes and laid back on her immobilization mold, calm and still. After two failed attempts, she completed the simulation. She would go on to receive 28 treatments to the sound and rhythm of the songs that took her far away from the reality of the radiation machine.

When I reflect on my “wow” moments as a radiation oncology nurse, this is one of them. Such a simple thing empowered the patient so deeply. To watch her overcome what was almost irrationally scary and know that I contributed along the way was very rewarding.

We nurses know there is a fighter in each one of our patients, and we aim to foster that spirit. We support them with knowledge and respect, and we look forward to helping them during their journey through cancer.


Maria Elena Perez, RN, BSN, CPN, is a nurse in the Department of Radiation Oncology at NewYork-Presbyterian Hospital in New York City. Send comments to editor@nurse.com or post comments below.