Integration of other therapies in nursing

Discussion of complementary and alternative therapies continues throughout the nursing curriculum on the University of Washington School of Nursing in Seattle due to a grant from the National Center for Complementary and Alternative Medicine (NCCAM), a part of the National Institutes of Health.

Over the past six years, 30 faculty members have participated within the complementary and alternative camp or Faculty Integrative Health Program at Bastyr University in Seattle, which makes a speciality of natural health sciences and humanities education, says Jane Cornman, ARNP, Ph.D., senior lecturer at University of Warsaw and project manager under the grant. The principal investigator is Margaret Heitkemper, RN, PhD, FAAN.

?[Faculty participants] did you study Chinese medicine, acupuncture, homeopathy, naturopathy? huge list? – says Heitkemper.

As a part of this system, participants returned to the University of Warsaw with lesson plans that included the complementary modality in no less than one class. Through this commitment to Complementary and Alternative Medicine (CAM), the varsity has developed a Postgraduate Certificate in Complementary and Alternative Medicine/Health Care: An Integrative Approach. The program emphasizes developing an evidence base for CAM practice, in addition to an introduction to the five domains of CAM modalities:

– Alternative medical systems, e.g. Chinese medicine.
– Mind-body interventions equivalent to meditation or prayer.
– Biologically based treatments equivalent to herbal products.
– Manipulative and body-based methods equivalent to massage.
– Energy medicine equivalent to Therapeutic Touch.

“The first thing we try to get nursing students to do is assess patients?” using any CAM method because many patients use supplements and herbal products and do not really seek advice from their doctor about it? says Cornman.

Skilled nurses can work with patients in a non-judgmental way, alerting them to possible negative drug interactions or directing them toward useful complementary methods, she added. “For example, we do not train nurses in acupuncture, but they can recommend it, they know the literature and know in which conditions acupuncture may be a good solution for this patient. This is the direction we are heading.

Growing interest

Many Americans are also moving in this direction. Research conducted by NCCAM indicates that interest in CAM is high throughout the country. According to a 2002 survey of more than 31,000 adults, 36 percent had used CAM in the past 12 months to treat conditions ranging from insomnia to back pain, while more than 49 percent had used CAM at some point in the past. The study covered five UW domains.

When we add prayer for healing, these numbers increase to 62 percent and 74 percent, respectively. More than 11 percent of adults who reported using natural products mentioned the use of peppermint. More than 25 percent of respondents who used CAM did so at the suggestion of conventional physicians.

CAM integration in practice

Integrative medicine has become a way of life for Patty Aamodt, RN, MSN, AHN-BC, senior lecturer at Washington State University Intercollegiate College of Nursing in Spokane and founder and director of The Academy for Healing Arts in Yakima, Washington. Aamodt carries vials of peppermint oil and lavender oil in her purse that she can use when she needs relief from headaches, indigestion, or general relaxation.

When Aamodt’s daughter was hit in the head by a softball, Aamodt used non-contact therapeutic touch on her child to not only reduce her anxiety, pain and discomfort, but also help flatten the swelling on her forehead.

– There were no black eyes, no pain. My daughter said, “Mom, can you stop? I want to leave the seam of the ball on my forehead!” she said.

Certified in aromatherapy, hypnotherapy, healing touch, clinically guided imaging and other CAM techniques, Aamodt has an arsenal of modalities she will apply to her nursing care in private practice on the Academy. He is quick to emphasise that he doesn’t use these techniques as a substitute for allopathic approaches, but as an adjunct.

“I use them in conjunction, integrated with everything else I use?” – says Aamodt. “If I get seriously injured, still take me to the best ER in the area.”

In this manner, she also teaches Therapeutic Touch classes at WSU.
“Students are encouraged to incorporate this skill into their nursing practice, along with other skills they take with them into the patient room.” she says. For example, they might use therapeutic touch together with pain medications for his or her patients.

“There is plenty of evidence-based practice and research supporting therapeutic touch particularly, and has been doing so for the reason that early Seventies. Is this clear? NO,? – says Aamodt. However, he notes that therapeutic touch has consistently been shown to induce a rest response within the parasympathetic nervous system.

Creating space

For the past five years, Terri Nosack, RN, HN, BSN, MBA, CPHQ, has also incorporated holistic modalities into her nursing practice. When her father was dying, she used her knowledge of aromatherapy, guided imagery, sound, prayer, and healing touch to comfort him in his final days.

“I saw that these methods helped calm his respiration, pulse and posture. He just seemed more calm, calmer? – says Nosak.

As a partner at SW Washington Holistic Health, based in Rigefield, Washington, Nosack works to coach the medical community in regards to the value of integrating CAM therapies. She and her business partner Debbie Nesbitt, RN, HN, CH, NLP, lead interactive, experience-based sessions as guest lecturers at local nursing schools, medical facilities and businesses.

During her workshops, Nosack could discuss how lavender promotes rest and peppermint improves mood and relieves nausea. It may use guided imagery to assist clients reduce stress by imagining themselves in a calmer place, or facilitate drumming to advertise rest through rhythmic sounds and entertainment.

Holistic nursing and its modalities embrace the interconnectedness of body, mind, spirit and emotions, promoting relationship-centered health care that helps nurses understand their clients’ unique beliefs and values, fairly than simply performing activities to organize them for the following test or round medicine? – says Nosak. “In a conventional setting, we’re coping with very advanced technology and a contactless approach. Holistic nursing focuses on “care” back in health care.?