A young person sits on the edge of a bed with headphones on. I recognise the artist from the cover on the screen. It is a composite, not any one patient, but I have seen it many times.
Some of the people I nurse are Christian by culture and not by practice. They may have been christened, they may wear a cross or a rosary, and if you ask, they will tell you they are Christian. They do not use the Church’s language and they are not looking for it from me. Their spiritual lives are real all the same. They just happen elsewhere.
Starting where they are
Spiritual care is part of nursing, yet research keeps finding that mental health nurses do it less than they should. They are unsure whether it is welcome, and they worry about telling a spiritual need from a symptom. I understand both worries. But if spiritual care begins with a vocabulary the patient does not share, it will not begin at all.
For many younger patients, the place to start is music. Electronic dance music has long been studied for its ritual, its sense of belonging and its moments of ecstasy. Emo rap does different work. It is vulnerable, it laments, and it looks at death more directly than most of us are comfortable with. Young people are already doing spiritual work in these songs, whether or not they would call it that.
Why a Catholic nurse
I am a Catholic, I am fifty, and I have worked as a mental health nurse for many years. I have loved dance music and hip hop for much longer. The 2017 memorial for Lil Peep, with his image projected onto the Houses of Parliament, introduced me to a whole generation of artists, and I have kept listening. Dance music has also been one of my ways of connecting with patients for as long as I have done this work.
My faith helps here, but only as restraint. What I draw on is accompaniment, hospitality, lament, and a sense that the sacred turns up in unexpected places. What I must not do is use someone’s music as a way in to teaching them doctrine. If a patient asks me honestly about faith, I answer honestly. If they want a chaplain, I arrange it.
What it looks like in practice
Mostly it is small. I ask about the song. I sit with a lyric about death and do not rush to risk language. I also complete the clinical risk assessment that has to follow, because a conversation about a song never replaces it. Sometimes we listen in silence. I stay alert to the difference between spiritual experience and psychosis, and when the two blur, I take it to the team.
Suicide and overdose run through emo rap and through the deaths of several of its artists. I treat those facts plainly. I do not romanticise them, and I do not treat the music as a danger in itself.
Limits
There are real risks. An older nurse can appropriate a young people’s culture, and patients can tell. Boundaries matter. Some patients are secular or belong to other faiths, and this is not for them unless they want it. This is also one nurse’s account, not evidence that it works. I offer it as a way of paying attention, and as a question worth studying properly.
The idea underneath is simple. Before we ask what patients believe, we can ask what they are listening to.
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