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By Diane Sussman
April 13, 2000
Photos Courtesy of UCSF School of Nursing

"There’s more to life than just machines," said Valerie Sweig, RN, offering a partial explanation for what drew the former oncology and trauma unit nurse to the new Integrated Complementary Healing program for adult nurse practitioners at the UCSF School of Nursing.

Susan Janson, DNSc, ANP, RN, FAAN, professor and project director, Integrated Complementary Healing Program,UCSF School of Nursing

The program, which opened its doors to 10 students in September, is the first in the nation to incorporate long-considered fringe practices into a traditional nurse practitioner curriculum. And it’s doing so with the approval of the federal government, which supplied a three-year, $556,000 grant to fund the program.

In addition to formal clinical practice, students study imagery, energy healing, relaxation therapy, herbs, and dietary supplements. They also learn about acupuncture, chiropractic, homeopathy, and Reiki—although not with a view toward incorporating them into practice. "The subjects fall into two categories, but the ones we focus on are ones that fall into the scope of licensed nursing in the state of California," said Susan Janson, ANP, RN, FAAN. "They will only graduate with an awareness of areas that fall outside licensed areas, like acupuncture and chiropractic, which require separate licenses."

Augmentation

The new therapies are intended to augment traditional therapies, not supplant them. Program directors were careful to reinforce this distinction when they named the program "Integrated Complementary Healing" rather than "Alternative Healing." "The word alternative suggests patients using an alternative therapy," Janson said. "Our program reflects a philosophy that patients are seeking a way to integrate their therapies into their health care."

A primary goal of the program is to help nurse practitioners understand the cultural and cross-cultural factors that shape a patient’s experience. "But it also helps you understand your own culture and how you bring that to your care," said Donna Guyot, MS, ANP, RN, assistant clinical professor. Guyot teaches the class "Exploring Indigenous Healing," which is conducted in ceremony using drumming, chanting, sage, and storytelling.

"The class has been quite an eye opener," said Annette Perez, RN, a med/surg nurse at UCSF. "I’m starting to see that in order to give good care you really have to understand the world and yourself."

Patients already there

While the program might have seemed far afield 15 years ago, it is right in step with current consumer trends in health care. According to the National Survey of Alternative Medicine Use published in the New England Journal of Medicine in 1993, nearly one-third of respondents reported using at least one alternative therapy to treat a medical problem within the last year. Baby boomers constituted the highest number of users, with an estimated 50 percent reporting use of alternative therapies.

Furthermore, 72 percent of alternative medicine consumers did not tell their physicians about their alternative therapy use—numbers that Janson does not find surprising. "Patients say that when they mentioned alternative therapies to their doctors they met resistance, so they learned to keep it a secret," she said.

In Janson’s view, the complementary healing techniques being taught in the program are not far removed from what nurses do every day. "Imagery, touching, relaxation—these approaches have never been part of traditional medicine. But they have always been part of nursing," she said. "Integrating it is the new part, because patients are already using it."

Seeing is believing

Janson doesn’t need anyone to convince her that some alternative therapies have a place in nursing practice. She has seen the results firsthand in her work with patients with severe pulmonary disease. "These are patients who are medically treated as much as possible. They experience extreme shortness of breath but their pulmonary function tests are normal. And they can’t take another bronchodilator because they are already taking them. Yet they are breathing faster and faster."

In these situations, Janson uses imaging techniques, asking patients to focus on a tree whose leaves represent their fears and concerns. "Then we let each of the leaves blow from the tree and they start to slow down," she said.

Janson also recognizes that not everyone in the medical community welcomes the idea of mixing alternatives with mainstream. "We have a lot of support, but that doesn’t mean a lot of docs don’t think this is baloney," she said.

Sweig disagrees with the skeptics. "I feel like I am just beginning to learn what healing is all about," she said.