Sometimes, when patients in the wound care clinic at Henry Mayo Newhall Memorial Hospital in Valencia, Calif., are having a hard time, Jared Axen, R.N., will ask if they'd like him to sing something for them. Maybe a silky classic like Nat King Cole's "Unforgettable" or the perennial crowd-pleaser "Pennies from Heaven."

But Axen doesn't ask every patient because an important part of being a singing nurse means knowing when not to sing. "Morphine doesn't work for everybody and it makes some people throw up," says the slightly shy 26-year-old with cherubic blonde curls. "It's the same thing with singing."

For instance, Vietnam vets usually aren't crazy about serenades, says Axen, who last year was recognized for his musical outreach with a Hospital Hero award from the HospitalAssociation of Southern California. "But it's a good therapy for the older ladies who are stroke patients who've gone through a sudden change of status — and some of my cancer patients who have had enough time to look at the more serious things in life and are just looking for a way to go."

He's also shared his dulcet tones with some of the hospital's many patients who don't speak English. "They don't know what I'm saying, but they know what I'm communicating," he says.

David Hartzog, R.N., clinical coordinator at Henry Mayo, says Axen's singing is a welcome addition to the hospital. "All the patients he's done this with, they really appreciate it," says Hartzog. "Whenever he sings, it raises the level of patient satisfaction and care."

Axen, who grew up listening to old-time radio shows on family car rides, first blended music and bedside manner about two years ago, with a hospice patient who was in the final stages of cancer.

"She never had family come to visit her," Axen recalls. "Even though she was usually withdrawn, I was thinking that if she was mentally intact, she probably felt alone and scared."

At night, "after all the medications had been passed around," she would lay there with her eyes open. "So I'd go sit down next to her bed and talk to her," he recalls. "I grew up singing a lot of old hymns in my family, and I knew several old hymns. I don't remember what I sang, but I remember holding her hand and looking at her and singing to her."

He sang to her on three nights and was with her when she died. He felt a little awkward at first, singing in a hospital setting, but it seemed to help, so he kept doing it.

"A big part of nursing is about vulnerability," Axen says. "It takes vulnerability from both the nurses and patients to create a trusting relationship."

After his shift ends, Axen makes rounds to patients who've either requested a tune through email or told someone they'd like a visit from the singing nurse. Love songs from the 1940s and '50s are popular requests, as are Sunday School standards like "Jesus Loves Me" and "It Is Well with My Soul." "For some of these people, church for them was Sunday School and they didn't go after that," says Axen. "So that's what they know about church."

Axen brings a suggestion list — like the Macy's Santa Claus in Miracle on 34th Street who gave undecided kids ideas, he says, "so they wouldn't ask for something really big like an elephant."

When a request stumps him, he promises to return the next day, then consults the lyrics either in his mother's hymnal or on his iPad.

"Fortunately, between Google and YouTube, I'm able to learn most of the music relatively easily," he says.

Last year, Axen was especially popular with a patient called Grandma Ila. Her family recorded him singing favorite songs like "Yellow Rose of Texas," so she could listen to them over and over.

Grandma Ila died at home, listening to the music he had recorded. At the family's request, he sang "Hallejulah" and "Amazing Grace" at her memorial service. "It was a powerful experience," he says of his time with Grandma Ila. "I don't often get the opportunity to bond with a patient at that level."

Check out a YouTube video of Jared Axen singing to Grandma Ila, http://goo.gl/hYKfY.