Professional Conflict

Wednesday morning, July 31, 2013....cloudy, humid and SUMMER!

I have given a lot of thought to my Session with my current patient yesterday.  She suffers from Alzheimer's and I have had 2 other Sessions with her previously.  They have been very successful and have created great joy for her Daughter and myself, experiencing these positive reactions.

Yesterday when I arrived, and the patient was in the Dayroom, fairly calm and when I told her I was there to play music for her (Patient is Blind) she just smiled and squeezed my hand..so happy.  I took my Harp to her room and I found her roommate was really fidgety and restless (she is very sick with Cancer).  I spoke to her and tried to calm her.  I asked her if she wanted me to play music on my Harp and she responded with a big smile and said "yes, I love your Harp Music".  I then asked her if she liked Hymns, to which she smiled and said "oh yes, I love Hymns"  So this conversation with this roommate changed my planned Session for my scheduled Patient.  I was going to play general Music, up to 80 BPM but decided that the roommate would benefit more from slower, yet familiar music.  I also decided to add several hymns to the Session and to keep my selections a bit more simple than I usually play for my Patient.  I expressed these changes to my Patient's Daughter and she completely understood and agreed that the roommate was in greater need at that moment.

Unfortunately, the Session was interrupted continually by the Companion, chatting and asking questions and sharing her stories, which were so funny, however not appropriate for the setting.  I noticed during the first half of playing that my patient was not as relaxed as usual.  She wasn't agitated, but wasn't "one with the rhythm" either.  The roommate was very content and eventually drifted off to a very deep sleep, Yipeeee!

This situation is not uncommon during a Session.  You can have 1 person in the patient's room or you could have 50...there are constant interruptions by medical staff, visitors and family members.  The best approach for me is to keep on playing, trying to ignore and continue to focus on the Patient.  For me the conflict comes when it is the Companion doing the disruption in this intimate setting.  How do I address this?  Do I speak to the Daughter or do I go directly to the Companion.  Do I say nothing?  Is it unprofessional of me to ask that communication be kept to a minimum and perhaps take the conversation out of the room?  We are in a small, crowded environment with the background noise of the machinery, air conditioning and hallway activity all around us, and nothing to be done about these distractions.   But I feel I am able to create a relaxed and peaceful environment despite the unchangeable distractions.   I did notice that my Patient was trying to listen to the conversation going on in the room, as well as the Music.  She may not communicate, but I feel she is aware.  Her body language is amazing....the more I am with her, the more I understand her reactions.  She and her roommate deserve the best I can offer in Services......

I will share my situation with my Mentor from the Course Certified Clinical Musican, today when we speak.  I am sure she will have good advice from her years of experience in this field.