November 2000 Vol. 16, No 11
Kaiser hospital offers mind-body workshop
for surgical patients
Gynecologic oncology patients leaving the hospital in 3 or 4 days after a total abdominal hysterectomy — a day or two less than usual. A patient who has had a craniotomy for a meningioma awakening in the recovery room asking for strawberries and wanting to go home.
There are effects anesthesiologist Jean Henney, MD, says she has seen since instituting psychological preparation for surgery.
Henney has championed a program at the Kaiser Foundation Hospital in Santa Clara, Calif, to offer workshops, tapes, and affirmations to patients who want to prepare psychologically for their procedures. About 200 patients have participated since May.
The hospital is using a program developed by Peggy Huddleston. The one-hour workshop is given by nurses trained and certified by Huddleston, a psychotherapist and researcher. She is conducting research on outcomes of the program with several Harvard teaching hospitals.
Tools for healing
A core group of nurses and other professionals have taken the two-day training to conduct the program, which has 5 steps:
- relax to feel peaceful, using relaxation tapes.
- Visualize your healing through healing imagery
- Organize a support group of family and friends
- Use healing statements during surgery
- Meet your anesthesiologist to establish a supportive relationship
The program is offered through the anesthesia preoperative clinic. Patients are informed about it in the surgical clinics and during their preoperative phone call.
Interested patients can sign up for a workshop, which is given twice a day for $25 and includes Huddleston’s book and audiotape.
Patients use the books and tapes at home to continue their preparation. On the day of surgery, those who have requested the service are noted on the surgery schedule. Patients bring their tape and tape player so they can listen in the preoperative area. They may be paired with a trained volunteer who can reinforce their healing statements. Patients request that their healing statements be repeated in the OR.
“All of the anesthesia personnel are familiar with the program and willing to say the healing statements,” says Dr. Henney. “Many do it anyway.”
Patients are encouraged to listen to their tapes in the recovery unit and during recuperation at home.
“Results have been overwhelming,” says Virginia Field, RN, MBA, CNOR, manager of perioperative services. Since May, the hospital has received more letters than usual from patients, all positive.
Along with Dr. Henney, Field and Shelley McKee, RNC, MN, CNOR, the perioperative educator, are developing a model to collect data on outcomes.
Takes a champion
What does it take to get a program off the ground?
“A champion,” says Field. Having Dr Henney lead the effort was important in securing support of other physicians. She added that the medical director of the OR and the anesthesia director support innovation.
“You need a critical mass of interest within the organization,” Dr Henney comments. she has promoted preoperative preparation for 7 or 8 years but is just starting to see interest take off.
The hospital funded the training for the staff because it sees the potential benefits and is about to approve funding for running the workshops full time.
“I think there is the potential that this will be cost shifting,” Dr Henney says. Eventually, she thinks preoperative psychological preparation may be funded from what is saved by patients’ more rapid, smoother recoveries.