The use of a loud-speaker system permits those patients not strictly confined to their beds to visit other parts of the ward without interruption in their listening. Some patients enjoy music as a background to conversation or ward activities. The same switchboard may be used for musical programs and hospital announcements, and this may be desirable economically in some institutions. Strategically placed speakers may be channeled exclusively as a call system.
Laughter is a communal reaction. We rarely react completely to a radio joke if we are listening alone, but if several people listen simultaneously laughter becomes more pronounced and prolonged. Loud-speaker systems permit patients on the ward to enjoy music as a group. They also permit the greater use of background music. Eating with the encumbrance of head-phones is not desirable.
Each hospital will have to weigh these and other arguments of the speaker-phone dilemma and choose according to its individual requirements.
The most suitable number of channels for a small hospital is two. One operator can readily handle two channels. When the number of channels is increased above this the expense of installation and operation will increase, especially if recordings or transcriptions are to be used in addition to outside programs.
The operator of the public address system should be conversant with the Hooper or Crossley ratings of the more important programs and be certain to include the most popular at any one hour in re-broadcast.
Personalized Music
The more musically inclined or susceptible patient may not be satisfied with the routine musical program as furnished by the public address system or even his radio. In hospitals where the majority taste is for modern popular music, there will be a few who will hunger for classical. If a musical aide is available this may be accomplished by the use of a music cart. A box-like device on wheels such as is used for many purposes on hospital wards may be fitted with a record player and a rack for records and record albums. The music cart may carry some small instruments and other materials for bedside use. Music can be wheeled to the bedside for instruction, appreciation, diversion, or entertainment.
Instruction. Bedside instruction may be used as occupational therapy or for purely educational purposes. Small instruments such as the ukelele, mandolin, or even the guitar may be taught to the bed patient as upper extremity exercise. Instrumental instruction will usually have to be limited to patients in individual rooms. Occasionally wards will be arranged so that a day-room or sun porch is available for wheel chair or partially restricted patients, and there will be times when the patient may receive instruction there. There are some instruments which may be played with a minimum of instruction. Unfortunately most of these emit sounds which are quite annoying to all but the performer. The ocarina and harmonica may meet with some acceptance among young patients, but when older patients share the ward or adjoining room their feelings will have to come first. Some young patients will delight in the use of drum sticks on practice blocks, especially if they can use them during the reproduction of music on the public address system or the radio. If the block is made of rubber or some other noiseless material it will not be too annoying to neighboring patients.
Specially constructed “toneless” or “practice” instruments such as the violin without the resonator are of genuine value in diminishing neighbor annoyance. These may be built in the occupational therapy shop from discarded instruments.
Diversion. For those who desire diversion and music appreciation, the music aide may wheel the music cart to the bedside. By ascertaining the musical appetite of patients on the preceding day, the aide may stock the cart with the kind of recordings desired and play them for the interested patient and any of the neighboring patients whose interest she can stimulate. By making a few well chosen remarks before each record is played much interest can be developed and the patient will look forward to future visits. If patients express no special interest in music, albums may be passed out for browsing and played without predetermined continuity. If interest is greatly aroused the music aide may suggest supplemental reading and call on the librarian to visit the patient or supply some reading material from the music department collection. The commercially available program notes for sponsored radio programs should also be distributed.