Complementary Therapy (CT) & the Staff Nurse (Article 3 of 3)

How to Move to An Integrative Approach of Complementary Therapies (CT) in Nursing

& the Healthcare System as a Whole

In order to look at a transformation of the Westernized healthcare system here in Ontario and Canada nurses will need to avail themselves of some of the information and education on CT. In 2009-2010, I had the opportunity to do a RNAO Advanced Clinical Fellowship on the “Introduction and Integration of Complementary Therapies in Acute Care.” My focus included looking at the current CT literature and research; the current practice/integration of CT in Canada and around the world; providing treatments to patients, staff and their significant others, and to determine how we need to disseminate this information to contribute to this change. What I learned first was the best way to teach nurses about CT was to have them experience them. For those who were not willing to actually experience it, I let the impact on the patients they serve to convince them of their value and place as an option of care. Overall the nurses and doctors I had the opportunity to work with during this time, including some who were very sceptical at the start, were not only moved by the work I did and the outcomes that were achieved, many started to refer patients to me, and still do today. Many of you may have tried a massage, herbs, or seen a chiropractor (types of CT) though I encourage you to go a step further and try one of the many other types that are available and mentioned in the Part 2 article; you may be surprised at how it may contribute to your well-being and that of your patients.

Many organizations (hospitals, hospices, long-term care, etc.) have CT being provided by volunteer services. To date this author has not found a CT program in an acute care setting where it is an integral part of the care plan or pathway, or where staff is hired to provide the therapies as we can see in a variety of programs in other countries, such as the United States. One example in the USA is occurring in Minnesota with their ‘coronary bypass’ patients where three Healing Touch treatments are being provided (day before, day of and day following their procedure). Due to the positive outcomes found through the Level I research done at that facility from 1999-2003 (such as a decreased length of stay by one day, and statistically significant decreased anxiety scores), they ultimately employed two full time Healing Touch practitioners. In 2003, they reported a savings of more than $500,000 due to the impact of a decreased length of stay. This is only one of many examples in the world today. Our local Hospice in Windsor, ON has a strong program lead by volunteers that incorporate the use of Therapeutic Touch and The Radiance Technique, both types of biofield therapy, for use with their patients at home, at the hospice or within hospital; they cannot keep up with the requests given the positive outcomes clients report. The Hospice also utilizes a holistic approach with a variety of modalities, such as art therapy.

So you ask, what can be used within the hospital? First, you have to know the standard from which your own organization will allow various CT to be incorporated, if one exists. If it does not then it is time one is established; at least start the conversation. Within my own practice as a RN, I have used my skills to help alleviate pain and anxiety with patients through the use of Healing Touch, Reiki and/or Therapeutic Touch. I recall one evening years ago where I had an elderly patient who sustained a fall and had subarachnoid hemorrhage. The Neurosurgeon was in the OR, and he requested we try to not sedate the patient so he could effectively evaluate him once he completed his present case. The patient was confused, agitated and occasionally aggressive. Medications were being used frequently and his sedation level was not consistent with each use. With permission from the ED Physician, and the family, I decided to try Healing Touch. Many who had not been exposed to energy work were surprised when I was able to avoid using any medications through the next 2 hours by providing a biofield therapy. It did require me to do a short treatment (5-10 minutes) about every 30 minutes, which was effective overall. At first my colleagues shook their heads as I seemed to gently touch him and wave my hands over him; though the evidence of its effectiveness was in my being able to keep the patient relatively calm. Since then I have provided treatments throughout the hospital when requested, though some nurses still remain sceptical.

Another RN who is a CTNIG member and our Niagara Liaison, Robert Gouldstone, has frequently used acupuncture or acupressure points to ease his patient’s pain and/or nausea and vomiting while working. Given the introduction of Bill 50 in 2006, RNs are allowed to practice independent Medical Acupuncture and are supported by the College of Nurses of Ontario. Medical acupuncturists are trained in the use of 360 points, with the advanced knowledge of anatomy and physiology for precise location. At McMaster Hospital, Hamilton acupuncture has sometimes been used as the only anesthesia for minor surgery. Are there instances that you could see acupuncture useful for analgesia or antiemetic use?

Here in Canada we are just in our infancy of truly transforming to a holistic integrative healthcare system, though we have begun the change, this we cannot deny. It is at this time I ask all nurses to investigate, experience and ask the questions on how we can move to this approach and be open to the ways it will help us in the healing of the patients we serve. Remember an integrative approach is more than just providing a type of CT to a patient, it involves a paradigm shift in how we see and care for that patient and their families, as well as ourselves. We need to collect the evidence to show us how to do this. “Evidence-based practice should involve the use of evidence derived from a broad array of sources – the patient, the patient’s significant others and caregivers, all types of studies from the research literature, the nurse’s experiences, and the nurse’s clinical judgment” (Jackson, 2012). So as you care for your patients, be open to the ways in which they care for themselves, and their families without judgment or ridicule to ensure our patients trust us with their information. You may be surprised how many share how or what else they are doing in their path to wellness.

Attending a presentation on complementary therapies is an opportunity I have provided nurses within my community over the last few years. I have had the help of various CT practitioners in my area who provided mini-treatments to the nurses who attended, then I provided various talks related to CT, such as ‘Being the Next Big Thing In Healthcare’ or ‘Research on CT Today.’ We also had various booths for the nurses to visit of various modalities, resources or businesses. If you are interested in having a talk in your area, please contact me and perhaps the CTNIG can arrange one in your city or workplace. Until you get to attend a presentation or workshop, there are also some very good textbooks and journals that are now available for nurses to learn more about CT and a holistic integrative approach to care, you only have to start to search for them. I was pleased to see that the Canadian text we used when I taught Complex Health at the University of Windsor (2009-10) had incorporate various holistic approaches to care, including a chapter on complementary and alternative medicine.

It is through a holistic approach we will have a larger perspective on how to serve our patients and our healthcare system as a whole. To further serve your needs in learning more about various modalities being advocated by integrative practitioners (physicians and nurses) I would recommend you review, and possibly join one of the many of the associations that are doing the work. Start by visiting the web sites of the RNAO-CTNIG (www.rnao-ctnig.org) and the CHNA (www.chna.ca), associations for nurses here in Canada. A leading nursing association in the USA is the AHNA (American Holistic Nurses Association) (www.ahna.org) which is a very organized and advanced nurses group advocating a holistic approach to nursing; their resources and education are excellent, even for the novice. You do not have to practice complementary therapies to belong to one of these groups, you only have to support their vision and mission. If you are interested in research, than the place to start is with is National Center for Complementary and Integrative Health (http://nccam.nih.gov), a branch of the NIH (National Institute of Health). IN-CAM is the Canadian affiliation for them. One document I can recommend you start with was published in 2014 by The Ontario Society of Physicians for Complementary Medicine called “Safety First. Dispelling Myths About Complementary Therapies.” It includes various articles by various practitioners about different types of CT. It is available for free at People’s Right to Integrative Medicine (PRIM) at www.peoplesrim.org. It is time, so be proactive and avail yourself of the information available out there, that likely your clients already know about.

If you require any other information, do not hesitate to contact me:

Kim M Watson, RN, MScN, Holistic Practitioner at kwats56@hotmail.com

Kim M Watson, RN, MScN is a biofield therapist, or energy worker (Reiki Master, Healing Touch & Therapeutic Touch Practitioner) in Windsor, ON. She currently works in an Emergency Department Trauma Unit, and is a Clinical Instructor for the University of Windsor. She is the President of the RNAO-CTNIG~Complementary Therapies Nurse’s Interest Group www.rnao-ctnig.org; the Ontario Representative for the CHNA ~ Canadian Holistic Nurses Association www.chna.ca; and a Member of PRIM, IN-CAM and the AHNA. Kim provides various education and presentations across the province on a holistic approach to Integrative Healthcare.

References:

Jackson, C. (2012). “The Role of healing modalities (complementary/ alternative medicine) in holistic nursing practice.” Holistic Nursing Practice, 26(1): 3-5.