Incorporating guided imagery into surgery areas

Audiotapes provide self-direction for easing stress

After learning about the benefits of guided imagery for surgery patients at a conference and visiting an open-heart program that had incorporated the complementary therapy, staff in the cardiovascular service line at York (PA) Health System decided to offer it to open-heart surgery patients. "Guided imagery helps the patients relax and even decreases the amount of pain medication they are using. Research has uncovered many benefits to guided imagery," says Barb Delio-Cox, RN, MSN, clinical nurse specialist in the cardiovascular service line at York.

To launch the effort, several inservices were scheduled for staff, including physicians and surgeons. Diane L. Tusek, RN, founder of Guided Imagery in Willoughby Hills, OH, conducted the teaching. Tusek provides staff training in guided imagery and sells audiotapes and CDs with guided imagery exercises.

Patients receive tapes before surgery

The hospital purchased a stock of tapes, and patients scheduled for cardiac surgery are now sent a letter explaining the program. Those who are interested alert the educator when they come in for the pre-op teaching. At that time, the educator explains what guided imagery is and how it might benefit the patient.

She also gives the patients the tapes and asks that they begin listening at home before the surgery. On the tapes, listeners are guided through stories that help them confront and work through stressful issues. The tapes also have a music-only segment.

Patients listen to the guided portion of the tape in preparation for their surgery. Following the surgery, nurses place the headset on the patient in the recovery room with the music-only tape playing. Patients are given written instructions encouraging them to listen to the tape twice daily until discharge. They are also encouraged to listen to the tapes when they are feeling anxious or to help with sleep. The nurses remind the patients to use their tapes. Posters in strategic areas explain to nurses how patients should be using the tapes.

"We encourage our patients to continue listening to the tapes at home after discharge. Many of our patients have problems sleeping when they go home, and some have found these tapes helpful in achieving sleep," explains Delio-Cox.

Currently, about 20% of the open heart surgery patients are using the tapes, but the program was only launched in the fall of 1999. Staff hope to set aside time to review charts and collect data on the patients who used the guided imagery tapes. They want to determine if the patients using guided imagery need less pain medication.

"It appears that some patients do require less pain medication, but we have nothing documented," says Delio-Cox.

For more information on using guided imagery tapes for surgery patients, contact:

Barb Delio-Cox, RN, MSN, Clinical Nurse Specialist, Cardiovascular Service Line, York Health System, 1001 South George St., York, PA 17405. Telephone: (717) 851-3472. Fax: (717) 851-4206. E-mail: bdeliocox@

Diane L. Tusek, RN, BSN, Guided Imagery, 2937 Lamplight Lane, Willoughby Hills, OH 44094. Telephone: (440) 944-8929. Fax: (440) 944-1830. E-mail: imageryg Web site:

Note: Diane Tusek offers staff training in guided imagery and consulting on how to initiate a guided imagery program. Guided imagery tapes and CDs are also available. A set of two adult tapes or one CD costs $16.99 plus $4 shipping and handling. The children and adolescent tape is $11.99 and the CD is $16.99 plus $4 shipping and handling.