I am writing in response to the "Personal Reflection" article "Tactile Music Therapy at Night for Patients on extra corporeal membrane oxygenator (ECMO) in the Pediatric Intensive Care Setting" by H. Veronica Southby, which appeared in volume 25 (issue 4) of Dimensions of Critical Care Nursing.

I was very interested in Ms Southby's personal account of using music supportively for a young patient undergoing ECMO therapy in the pediatric intensive care unit (PICU) setting. The improvements she noted in the physiological parameters of heart rate and oxygen saturation are consistent with those that I observe regularly in my work as a music therapist on a PICU. I am pleased to know that she is aware of and values some of the therapeutic benefits of music in this intensive setting.

However, I must take exception to the use of the term "music therapy" to describe the intervention that Ms Southby was intuitively providing. Music therapy is an allied health profession, first established in this country in 1950, which uses clinical and evidence-based music interventions to accomplish individualized goals within a therapeutic relationship. Such services are carried out by board-certified music therapists who have completed an approved bachelor's or master's degree program, fieldwork, and internship in music therapy and sat for national board certification.

Ms Southby has good intentions for recommending the use of supportive music in the PICU, and some of her "Seven Methods for Effective Tactile Music Therapy in the PICU" are similar to practices that music therapists are currently implementing in PICU settings. However, music therapists in such settings have significant training in the effects of music on behavior and the evidenced-based practice of using music in medical settings that inform their work. Ms Southby's use of the term "music therapy," with specific suggestions for practice, may mislead other critical care nurses to think that they are providing "music therapy" when following her recommendations.

I commend Ms Southby for advocating for the use of music in the PICU and hope that critical care nurses and music therapists will increasingly work collaboratively to provide the most comprehensive care for their patients.

Claire Ghetti, MME, MT-BC, LCAT, CCLS

Jackson Heights, New York

The editor would like to encourage readers to write letters to the editor about the articles in Dimensions of Critical Care Nursing or about any topic of interest to critical care nurses. Letters should be sent to Vickie Miracle, EdD, RN, CCRN, CCNS, CCRC, electronically at [email protected]. Also, letters can be mailed to the editor at 424 Eastgate Village Wynde, Louisville, KY 40223. If you mail your letter, please send a hard copy of the letter, as well as a diskette containing the letter.