| Continued from Page
2
It’s the little
things
You
say complementary,
I say integrativve |
| A
number of terms are bandied about in reference
to approaches outside of conventional Western
medicine. The National Center for Complementary
and Alternative Medicine, a center for the
National Institutes of Health, defines some
of them as follows:
Complementary medicine
is used together with conventional medicine.
An example: using aromatherapy to lessen
a patient’s discomfort after surgery.
Alternative medicine is used in
place of conventional medicine. An example:
using a special diet to treat cancer instead
of surgery, radiation, or chemotherapy as
recommended by a conventional physician.
Integrative medicine combines
mainstream medical therapies and complementary
and alternative medicine (CAM) therapies
for which there is some high-quality scientific
evidence of safety and effectiveness.
The national center groups CAM therapies
into five categories:
1. Alternative medical systems
built upon complete systems of theory and
practice, such as homeopathic medicine or
traditional Chinese medicine.
2. Mind-body interventions
to enhance the mind’s capacity to
affect the body, such as meditation, prayer,
and music. These are practiced through support
groups and cognitive-behavioral therapy.
3. Biologically based therapies
using substances found in nature, such as
herbal products and dietary supplements.
4. Manipulative and body-based methods
based on manipulation or movement of parts
of the body, such as osteopathic manipulation
or massage.
5. Energy therapies involving
use of energy fields, such as Reiki, therapeutic
touch, or use of magnetic fields.
Holistic nursing is another
term often heard in connection with CAM.
According to the American Holistic Nurses
Association, “holistic nursing embraces
all nursing which has as its goal the enhancement
of healing the whole person from birth to
death. ... Practicing holistic nursing requires
nurses to integrate self-care, self-responsibility,
spirituality, and reflection in their lives.”
Melissa Gaskill
|
“You don’t have to start from scratch”
in introducing alternative care, Dossey said,
but she warned “[t]he institutions that
are most successful at changing to an integrative
model of care do so gradually, first with an interested,
committed group of their staff. These teams are
permitted to create a prototype, and eventually
expand their vision to the institution as a whole.”
Nurses don’t necessarily have to wait for
institutional change either. Many CAM therapies
require no special training or certification and
only small changes in existing practice.
“There are so many things nurses can learn
to do simply and easily,” Guzzetta said,
“like intentional pressure, touch, and distraction.
If you go in and talk to a kid about his birthday
party, that’s distraction.”
Many nurses do this all the time without thinking
about it, she said. The key is being present in
the moment and engaging with the whole patient.
Classes on specific CAM therapies are offered
by The American Holistic Nurses Association and
other groups. Information is available through
web courses, journals, workshops, and organizations
for various modalities, such as the American Music
Therapy Association [www.musictherapy.org] or
the National Association for Holistic Aromatherapy
[www.naha.org].
Applying CAM therapies in critical care doesn’t
necessarily mean more work and, in fact, can mean
less.
“It isn’t taking an extra five minutes,
but changing the way we do things,” Guzzetta
said. “If you have a patient in pain and
are giving them powerful medication, just touching
their hand, reminding them their jaw is clenched,
telling them to picture this powerful medication
going directly into their veins — that doesn’t
take any more time than drawing up the med and
injecting it, but you’ve combined it with
touch and imagery.
“That is the kind of stuff we could be
doing all the time.”
It is common knowledge that even a potent pain
medication won’t work if the patient doesn’t
think it will, Dossey said. “Letting the
patient know the medicine is being given intravenously
and will be in the system and work very fast can
be powerful,” she said. “Think about
how easy this is. It’s not something you
tack on later, but becomes a way you give medication.”
The goal is caring for the whole person, according
to Kreitzer. “It’s not just about
the therapies, but about how we create an optimal
healing environment,” she said. “One
that includes everything from the physical environment
to who are the care providers and how they provide
care, to what kind of therapy we provide, conventional
and unconventional.”
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