With increasing consumer and professional interest in complementary and alternative therapies, nurses are increasingly adopting these practices into their practice to allow for autonomy and express a holistic caring philosophy.
Importantly, complementary therapy refers to practices used alongside, not instead of biomedical treatments; alternative therapies do not have evidence supporting their efficacy through clinical trials.
Definition
Over the past several decades, complementary and alternative therapies have seen rapid expansion. This includes herbal remedies, acupuncture, massage therapy, energy healing therapy and more. Many holistic approaches fall under integrative medicine’s purview; nurses have long recognized its significance while sharing it with their clients as part of integrative healthcare delivery systems. Nurses are well aware of its value while being in an ideal position to inform both public audiences as well as health practitioners of these forms of healing.
Nursing acknowledges the significance of physical, emotional, and spiritual wellbeing for an individual’s overall health and wellness. A holistic, caring philosophy has been part of nursing for centuries; nurses possess an invaluable opportunity to promote these therapies by understanding cultural and psychosocial influences on choices made regarding medical/healthcare practices.
Nurses (RNs) are frequently trained in various complementary and alternative therapies. According to a recent study, over 94% of 105 baccalaureate-nursing programs in the US provide didactic content about complementary/alternative practices; independent training may also be pursued for specific practices that fall under this umbrella; nurses must determine their suitability within their scope of practice before performing such therapies; the designation “complementary” refers to practices used alongside biomedical treatment instead of replacing it altogether; for instance progressive muscle relaxation as an adjunct therapy can work effectively in managing epilepsia cases.
Booth-LaForce and Halcon have identified an essential competency as being able to openly discuss complementary/alternative modalities with patients, evaluate safety and efficacy of selected techniques as well as educate patients about risks/benefits related to complementary/alternative modalities and facilitate client choice.
Education of clients is integral to making informed decisions regarding holistic health care. Giving information on interactions between herbal preparations and prescription drugs as well as impactful complementary/alternative therapies on prescribed treatments, as well as readiness assessments of particular therapies (for instance acupuncture may not be suitable if there is fear of needles).
Scope
Since 2001, complementary therapies have seen unprecedented popularity. Consumer interest in holistic practices stems from an eagerness to find answers for health issues which cannot be resolved with traditional Western biomedical healthcare techniques alone. Unfortunately, however, many complementary therapies remain unregulated and lack scientific foundation.
Nurses can guide consumers through the confusion surrounding alternative therapies, and facilitate safe use as part of biomedical treatment plans. But they must be prepared for potential skepticism that often accompanies recommendations; carefully evaluate emerging evidence; be sensitive to clients’ cultural beliefs; communicate in ways which respect those beliefs; and also consider emerging evidence when making recommendations.
Nursing’s longstanding tradition in using complementary therapies provides a firm grounding in how best to use these modalities safely and effectively. Nursing also has a track record in conducting research on selected complementary therapies, giving it a strong background for conducting further investigations of them – furthering knowledge base about effectiveness, while simultaneously helping integrate them into healthcare models.
Though many complementary therapies require professional intervention, a significant percentage can also be used on their own to manage specific symptoms (pain or anxiety) or promote overall wellbeing (vitamins, yoga or acupuncture). As some therapies may interact with prescribed medication regimens, health professionals must remain aware of all therapies utilized by a patient and how they interact.
As a health care professional, it is your duty to only perform or recommend complementary therapies within your scope of practice and are approved by you and your medical team as safe. If in doubt regarding whether to administer or recommend such a therapy, seek guidance from either your supervisor or physician for clarification; furthermore if there are concerns over interactions between complementary therapies and your client’s medication or condition – be sure to notify their prescriber right away!
Safety
More people than ever before are turning to complementary and alternative therapies – like acupuncture, massage and meditation – as a means of managing their health. Nurses play an essential role in helping our patients make informed decisions about their wellness; often this includes making sure it’s safe to try complementary therapies such as these. It is crucial that we know what to do if our patient attempts one that isn’t suitable, including when and how we should refer them for further treatment if necessary.
Before considering safety, it’s essential to remember the difference between complementary and alternative medicines. “Complementary” means they supplement traditional Western medicine; “alternative” refers to alternative approaches. Massage may fall under this umbrella since it helps relieve tension or alleviate pain while an acupuncture session would fall under alternative medicine due to it not typically being provided by doctors but as treatment for specific symptoms or conditions.
Though complementary and alternative therapies are becoming increasingly popular, evidence for their efficacy remains lacking. Furthermore, patients could be vulnerable to allergic reactions, misdiagnosis and drug interactions if practitioners who don’t possess proper training are untrained enough. It is therefore essential for nurses to be knowledgeable of all forms of complementary and alternative therapy in nursing so that they can provide patients with optimal care.
Many complementary and alternative treatments (CATs) can be self-administered, such as herbal remedies and meditation; others, such as acupuncture, chiropractic treatment and therapeutic touch, require professional assistance from professionals; yet others take an holistic approach that considers mind, body, and spirit are intertwined (e.g. yoga or tai chi).
Complimentary/alternative modalities offer nurses a unique opportunity to practice autonomously and demonstrate holistic care, making these techniques part of professional nursing’s scope of practice. Therefore, questions on these modalities are included on the NCLEX-RN exam in order to test nurses on them; yet many non-nursing professionals often teach and use these modalities leading some nurses to question whether or when these techniques belong within nursing’s scope of practice; taking time to explore nursing theory and taxonomies will reveal these techniques belong within professional nursing’s scope!
Conclusions
Nursing has long been recognized for incorporating complementary and alternative therapies into its practices, offering nurses a chance to be pioneers in this area of practice and safely provide these modalities to their patients. Utilization of such therapies requires specific knowledge and abilities as well as an appreciation of a patient as not just physical, but spiritual being; within clinical contexts complementary therapies often assist patients in relaxing or relieving stress which ultimately contributes to increased quality of life.
Nurses must understand the distinctions between complementary therapies and independent nursing interventions such as monitoring a patient or coordinating care, so as to effectively distinguish one from another. Furthermore, it is imperative that nurses obtain health histories on all their patients so that they may identify any therapies being utilized by these practices and then take appropriate measures to assess and evaluate them.
As nurses become exposed to complementary and alternative therapies through travel, work and other activities, it is imperative that they develop an in-depth knowledge about these modalities to ensure their safety and efficacy. However, this does not necessitate becoming certified in all forms of complementary therapy modalities.
Many BONs have begun to address the scope of practice issue for complementary and alternative therapies. At first, this was in response to individual nurses seeking an official opinion; over time however, some states issued general statements on this matter.
Studies of 50 BONs revealed that 25 have articulated policies or positions regarding complementary and alternative therapies within their scope of practice; 13 are taking initial steps toward this direction while 27 have not addressed it formally.
Nursing schools should include courses on complementary and alternative therapies like Tai chi, meditation, yoga and Reiki in their curriculums. Students will learn the principles behind each modality before learning how to incorporate it into professional nursing roles. Patients appreciate these skills; many often comment that after visiting health care providers who not only were competent at performing procedures but took time out to listen and communicate as holistic beings.
