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This site is for student nurses or nurses starting out. Letters to a Young Nurse are blog posts written like letters to help you find your way and make your journey as a nurse less difficult. 


The Power of the Mind

Updated: Jul 20, 2023

During my time as a travel nurse, I worked on a physical rehabilitation unit for patients who had suffered traumatic physical injuries and strokes. One man in his early 50's had a stroke which had left him partially disabled on the left side. On Saturdays or Sunday’s patient's families could come and take the patients out for lunch or dinner. This particular man, John, was on a blood thinner to prevent further strokes. His blood test for the medication, the protime came back at 1.5. John had planned to go out with his family that day, but the doctor told him that he could not leave the hospital. If he were to leave and fall or bump his leg, he could bleed to death. John became very agitated and began to argue with the doctor, telling him that his family was making a 2-hour trip to take him out to lunch. But then he became still and asked the doctor, "what level does my protime have to be in order to go out with my family?" The doctor thought for a few seconds and responded with “it must be between 2 to 3. A rise of 0.5 doesn't sound like much but it was a huge elevation and not something that could be achieved by the afternoon. The patient told the doctor to come back in 4 hours and draw the level again. He insisted that his level would be high enough to go out with his family that afternoon. John went to his room and turned the lights down low, played instrumental music and called a massage therapist who happened to be on the unit that day. He put a DO NOT DISTURB sign on his door and meditated for hours. Four hours later the lab tech drew his protime. All of the staff on the unit had heard about John’s goal and we all waited with anticipation to see if he could reach his goal. Half the unit thought he couldn't change the level and the other optimistic half knew he would make it and believed in seeing this miracle happen. Even the lab personnel were debating whether he would prove the doctor wrong. 30 minutes later the doctor called the patient to the desk and with a smirk told him he could go out on his pass that day. He had raised his level to 2.4!!!! When patients truly believe in change, when they are invested in making that change happen, then miracles do happen.

This brings up an interesting phenomenon called the “placebo effect”. In clinical trials when medications are being tested for efficacy and safety most trials are done blinded and use the real medication and a fake like a sugar pill. One group gets the drug, the other group gets the placebo. There are blinded and double blinded studies. A blinded study is when the researchers know what each patient is getting but the patient does not know. A double blinded study is when the researcher, nurse or physician administering the study does not know if the patient is getting the real drug or the placebo. If both groups have the same reaction with an improvement in symptoms or not, the drug is said not to be effective. Many studies get better results from the placebo. It is all down to the power of the mind.

A study published in Science Translational Medicine by Kim-Hansen, et al. looked at reactions of people to a migraine druG versus placebo or no treatment. This was not a blinded or double-blinded study, each participant knew what they were getting. One group got the migraine medication, one group got a placebo and a third group took nothing. The placebo was 50% as effective as the drug in reducing pain after a migraine attack. Why? The researchers supposed that the effectiveness of the placebo was the simple act of taking the pill. “People associate the ritual of taking medicine as a positive healing effect…the action itself can stimulate the brain into thinking the body is being healed,” And they go on to say that “the information provided to patients and the ritual of pill taking are important components of medical care.”

Is it right to tell a patient that they are getting a pain pill when you are actually giving them an aspirin For pain? No, definitely not. But if I tell a patient that this particular medication helped my pain better than other meds, is that enough for their brain to make it work? Sometimes it is. At least 50% of the time it works.

December 13, 2021

Kim-Hansen eat al., Altered placebo and drug labeling changes the outcome of episodic migraine attacks. Science Translational Medicine (1/8/14) 6(218) DOI:10.1126/scitranslmed.3006175

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