Peak Rhythms




 Press Release for Health Rhythms™ Research

July 2004



Study Finds Group Recreational Music-Making Program

Relieves Stress and Burnout in Nursing Students


Protocol Has Potential to Save Billions for Schools and Hospitals


MEADVILLE, PA—A new research study has found that group Recreational Music-making significantly reduced burnout and improved mood states among first-year nursing students, with projections for reductions in dropout rates, and the potential to save hospitals and nursing schools billions of dollars annually.

The study was led by neurologist Barry Bittman, MD, medical director of the Mind-Body Wellness Center in Meadville, PA, and published in the International Journal of Nursing Education Scholarship (vol 1, issue 1, 2004). It demonstrated a 28.1 percent reduction in Total Mood Disturbance (a standard research index) that correlated with a six-session program of facilitated musical participation for 75 first-year nursing students at Allegany College of Maryland.

Recreational Music-making is distinct from “regular” music making in that it promotes the enjoyment and well-being of the participant and the group, rather than performance-based outcomes. Of particular importance is the fact that participation does not require musical talent or training. RMM bridges expressive and cultural divides in ways that verbal activities alone cannot. The Merriam Webster dictionary notes that the word “recreation” is derived from the Latin root “recreatio,” meaning “restoration to health.”


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First year nursing students at Allegany College of Maryland participated in six weekly one-hour RMM sessions. The program was based upon the Remo HealthRHYTHMS Group Empowerment Drumming® protocol and included five-minute Yamaha Mind-Body Wellness Exercises®. At times during the protocol, participants were asked to express their feelings non-verbally using drum and percussion instruments to respond to a series of 12 questions. Standardized surveys were used to determine burnout and Total Mood Disturbance (TMD) levels.

Based upon the study’s findings, an independent research firm projected that the average nursing school could retain two more students per year by employing the Recreational Music-making protocol. This translates to a $16,800 annual savings for the typical 105-student program and $29.1 million a year for all U.S. nursing schools, resulting in more than $29 saved for every dollar invested.

In the hospital environment, the same analysis suggested even greater potential economic benefits. It has been established that nursing turnover costs the average 280-nurse acute care hospital $3.8 million annually. This program could potentially help these facilities retain seven more nurses each year, for an average annual savings of $322,000 per hospital or more than $1.5 billion for the entire healthcare industry – yielding $564 in savings for every dollar invested.

“While many people are aware of the nursing shortage in this country, most do not realize the full impact of this problem or how deeply it affects quality care,” said Bittman. “In order to ensure quality healthcare for future generations, it is imperative to institute cost-effective programs that prevent burnout before the student reaches the clinical environment. The prospect of using Recreational Music-making as a means to encourage mutual support and self-care at a critical stage in a nurse’s educational process should be considered an integral component of professional development, as well as a rational investment in sustainable quality healthcare.”

In fact, the shortage of nurses is a global problem. Enrollments in American baccalaureate nursing programs declined 19 percent between 1995 and 2000, and from 1995 to 2002, 26 percent fewer graduates took the national American Association of Colleges of Nursing licensure exam.

“The relationship between emotional burnout and the decision to leave the nursing profession is supported by hard data as well as common sense,” says Allegany College of Maryland Director of Human Services and Integrative Health, Cherie Snyder, co-author of the study. “While academic and economic reasons are in part responsible for nursing school dropouts, stress and burnout are much graver problems. The process of creating a supportive caring environment must be emphasized in every academic program. We’ve discovered that Recreational Music-making is an enjoyable, evidence-based approach for modeling the humanistic, whole person skills that should be integrated into career and personal practice.”

The impact of nursing school attrition extends far beyond the student ─ it also has an adverse impact on faculty morale. Nursing turnover at hospitals can also reduce the level of care. A 2002 study by the Journal of the American Medical Association determined that the overall risk of patient death rose about 7 percent for each additional surgical patient above four assigned to each nurse.

“As you can imagine, this nursing crisis has inspired a variety of attempted remedies, yet an approach that makes a real difference and is cost-effective has been elusive,” says Allegany College of Maryland Director of Nursing, Fran Liebfried, one of the study’s co-authors. “What differentiates this Recreational Music-making protocol from other strategies is that it offers an effective, affordable way to ease the problem while emphasizing the foundational principles at the very root of the nursing profession. That in turn improves life not only for nursing students and nurses, but also for patients who will ultimately receive their care.”

These findings build upon a Recreational Music-making study published last year by a research team led by Bittman, which found similar effects in an interdisciplinary workforce at a long-term care facility. The economic impact analysis was performed by Tripp-Umbach Healthcare Consulting, an independent consulting group based in Pittsburgh, PA.

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