Advanced Clinical Practice Fellowship: The Introduction & Integration of Complementary Therapy i

EXECUTIVE SUMMARY on RNAO FELLOWSHIP

Fellow: Kim M, Watson, RN, DPHN, MScN, Holistic Practitioner: Energy/Biofield Therapy, Hotel-Dieu Grace Hospital/HDGH Mentors: Jacqueline M. Andrew, RN, MScN, Director of Quality and Professional Practice, & BPSO Project Coordinator, HDGH;

Sharon Allen, RN (EC), RN, MScN, NP for Palliative Care, Pain, & Symptom Management, HDGH; Darka Neill, RN, BScN, RNAO CTNIG/Complementary Therapy Nurse Interest Group-Founder & Past President, current Editor of CTNIG Newsletter; RN at The Hospital for Sick Children.

The Fellowship:

This RNAO ACPF provided a unique opportunity to explore and develop the introduction and integration of complementary therapy (CT), specifically biofield therapy (better known as energy work) in acute care. Though in this experience I was the recognized authority in the use of CT, especially in energy/biofield therapy (BT), I benefited from my two mentors at HDGH who were experts in their respective fields, who could think outside the box, see the value in what I did and my vision, as well they had key critical thinking skills, networking and contacts within the organization, LHIN, and the province. As well Darka Neill, another Mentor, has walked my path as a healer/energy worker, and is a leader in CT in Ontario.

The overall goal was to introduce and integrate CT in an acute care setting to ensure nurses’ and clients’ needs were met in this fast growing area of care, and to meet the CNO CT Practice Guideline. The HDGH 6th Floor was targeted as a focus unit; it was comprised of 2 units that had Medical, Surgical, Oncology and Palliative Care clients. Requests for treatments were accepted though from any unit (such as the Pre-Operative Bay of the OR, PACU, Psychiatry, ICU, ER, and Cardiac Care).

Following is a short synopsis of the 4 objectives that lead the work I completed:

1. Analyze current knowledge, literature and research related to the use of CT in acute care. An extensive literature review was undertaken throughout the fellowship (related to the 4 types of biofield therapy: Healing Touch, Therapeutic Touch, Reiki and Radiance; and the use of CT in Canada). The articles and web sites reviewed were shared with various stakeholders, especially where current, rigorous research was found, with measureable outcomes (such as length of stay, or decreased pain or anxiety scores). Research is occurring in both the public and private sector. Over the last year there has been an increase in research funding to determine the outcomes of this type of care. There is still a need for high quality studies which can help establish the benefits and positive outcomes. There is also a call to study if the level of the practitioner involved has an impact, as well as to determine if there are any adverse effects (to date none have been identified). Some types of biofield therapy have not been studied, or if they have they have not be published. Overall, biofield therapies have been reported to show promise as a supportive therapy for many patient problems and concerns, and has shown to support a spiritual, holistic perspective.

2. Identify / evaluate current CT programs, organizations and practitioners for acute care clients. Professional relationships were established and strengthened with various members of CT associations (CHNA/Canadian Holistic Nursing Association; CTNIG – Darka Neill; HTI/ Healing Touch International; area leaders in biofield therapy (Hospice Radiance Instructors; and the TTNO/Therapeutic Touch Network of Ontario). To date, in Canada, there have not been any programs where biofield therapy is provided as an option of care, though most facilities are open to it as if the patient brings in a volunteer to provide it. Presently in the USA there are multiple established programs with biofield therapies not only being provided, but ordered; some as a protocol within a pathway (such as the coronary artery bypass program in St. Paul, Minnesota, where Healing Touch is provided 3 times around their surgery, and has shown to decrease the length of stay by almost 1 full day in the outpatient group, saving about $2,000.00 per patient, and in all groups it was found to significantly decrease anxiety scores as compared to the control and visitor group).

3. Implement CT: biofield/energy therapy treatments and education for patients and staff in acute care at HDGH. This was where the most fun occurred for me – doing the work! I decided to provide treatments for staff as well as patients, thereby helping to educate staff and key stakeholders through the experience of what energy work can provide. A total of 62 treatments were provided; 34 to patients, 27 to staff, and 1 to a patient’s family member. Only 2 patients reported no change or improvement with the treatment. Staff expressed that it was empowering to have another option of care for those in pain or demonstrating increased anxiety, without having to resort to more medication. Many of the staff, patients and families expressed their amazement at its effectiveness.

4. Create a plan on how to disseminate findings, initiate program(s), and evaluate the impact of the use of CT in acute care. Through a variety of methods I was able to communicated what I was working on, such as: a) presentations and education to the Board of Directors, the Professional Practice Nursing Team, at various Nursing Staff Education Days, Student Nurse groups, and one-on-one; b) The Communications Department hosted a Media Event on October 27, 2009 for staff and the public, which resulted in a news spot on the CBC TV News, and an article in the Windsor Star); c)bulletin and display boards, d) a variety of handouts and other educational materials, e) Staff Survey, and more. I had the opportunity to share my fellowship at the University of Windsor’s Biannual Conference (January 2010) and the 4th Annual RNAO Knowledge Exchange Symposium (February 2010). To date I have submitted three abstracts for 2010 conference presentations. Just by showing up and doing the work, I have been spreading the word. One clear visible way this has occurred was to have my story written up in our hospital foundation’s magazine, called the ‘Chronicles of Caring,’ and to be the cover shot. It is my hope to speak further on this in the future. I also had the opportunity to publish a January 2010 web article on ‘Healing Touch’ along with Lisa Anselme (Director of Healing Touch International), and Dr. Diane Wind Wardell, RN, PhD, (HTI Research Chair & Associate Professor at the University of Texas); which can be found at: http://thefirstcanadianhealthcareconference.ca/index.php?/Healing-Touch . It is my intent to publish more on this option of care and the impact it can have within the acute care population. More work needs to be done so healthcare workers can be enlightened on how biofield therapies can help their patients. Overall, just by doing the work created more talk and interest, than anything else I could have done!

The Next Step: I knew going into this fellowship that my work would not easily be completed during this time, that is why I chose to stretch it out, as exposure is so vital. And though my fellowship is done, my work is not, it is just beginning. An integrative approach to care, including various complementary therapies, is inevitable in Canada. It is my vision to see we are leaders, rather than followers as it progresses within the acute care forum. With the next call for proposals, I will be submitting another proposal to integrate a Biofield Therapy program at HGDH. It is with the hopes of completing a small research study at the same time to support its use.

Other key activities that will persist after the end date of the fellowship given the support of key leadership individuals include:

1. Re-establishing our relationship with Hospice Volunteers to provide treatments for palliative and oncology clients;

2. Provide workshops in Healing Touch, and facilitate other programs for staff in various biofield therapies;

3. Present at various conferences and inservices (some are in the works, such as a presentations to the Professional Practice Nursing Team, and in March one for all health sciences students at St. Clair College, and in May further presentations to staff at HDGH). With all the information I have collected and wisdom I have gained, we are now ready to develop a policy on CT: Biofield Therapy.

Personally I am in the process of submitting all my requirements for my certification in Healing Touch (LEVEL VI), and intend to commence the work to become a Level I Instructor. Over the next year I will become more active with the professional associations, RNAO Complementary Therapy Nurse Interest Group/ CTNIG, and the Canadian Holistic Nurses Association/ CHNA. I hope the work I am doing will ensure complementary therapies do evolve in the acute care arena. Perhaps I will convince the University of Windsor or St. Clair College to be a leader and offer an option course on Complementary Therapy. More than anything, I will do the WORK!!

THANK-YOU TO EVERYONE WHO SUPPORTED & ASSISTED

ME DURING THIS FELLOWSHIP. AS I HAVE ALWAYS SAID

“I DO NOT DO THIS WORK ALONE!” NAMASTÉ