Alternative medicines may be your patient’s cup of tea

They are not as intimidating as they appear

Complementary therapies or alternative medicines are growing in popularity in the United States, and patients may be initiating some of these treatments while in home care.

Some say complementary therapies give nurses an opportunity to return to what nursing really is all about, which is treating the whole person by providing emotional, spiritual, mental, and physical support.

When nurses integrate complementary therapies into standard practice, this gives patients a holistic type of support and shifts some of the burden of health care onto the patient, says Maggie McKivergin, RN, MS, HNC, executive director of American Holistic Nurses Association in Flagstaff, AZ.

"So the home health educator helps the person understand all the options available to them in their healing," McKivergin says. "Then they help the person discern the right pathway to take in a journey toward health."

The 17-year-old association provides nurses with a philosophical framework that recognizes that disease is not an isolated event but is instead a part of how a person responds to life, McKivergin says. "Then we support nurses by helping them first of all to heal themselves and understand what that’s about," she adds.

"A lot of nurses are becoming numb because of what’s happening in health care, and it takes a lot of courage to choose to heal yourself," McKivergin says.

She adds that many nurses may also experience personal emotional or physical pain due to traumas in their own lives. That emotional pain could be caused by their perception that health care is changing in a very negative way, and until they acknowledge and finally accept that pain, they cannot heal themselves. McKivergin says the American Holistic Nurses Association offers self-healing help to nurses.

This "heal thyself" philosophy also extends to patients, who will have to take charge of their treatments, particularly when deciding to use alternative measures.

There is a vast array of alternative treatments from which to choose. Here are a few:

• acupuncture;

• Chinese medicine;

• homeopathy;

• naturopathic medicine;

• therapeutic touch;

• zone therapy, which also is called reflexology.

"Rather than just giving a patient pain medicine, there are modalities of healing touch, different massage techniques, aromatherapy, and different ways to help a person discern different ways to address their pain," McKivergin says. (See resources for alternative pain treatment, p. 43.)

Some modalities are simple, and nurses may use them in any type of setting or situation. These include showing patients how to control their breathing. This distraction gives people who are in pain a tool to control, says Pamela Bennett, RN, BSN, managing director of the St. Elizabeth Medical Center Pain Management Center in Boston and the president-elect of the American Society of Pain Management Nurses in Pensacola, FL.

Nurses can give patients a great gift through appropriate touch and through listening, Bennett adds.

"For most people receiving home health care there is a common factor of isolation, and it’s a huge thing," Bennett says. "Often families are afraid to touch a patient in pain because they are afraid to hurt them."

But just touching a patient’s hair or touching the patient’s shoulder or arm in a manner that communicates caring is a huge gift to that person, Bennett adds.

Likewise, listening is very important, she says. "Let patients express what they’re feeling, and have them look into their pain, so to speak."

Family members and others may not be comfortable talking about death, but a nurse can do this for the patient.

Use of therapeutic touch

Then there are pain relief modalities that some nurses will choose to study and use with patients. One such modality is therapeutic touch, which was invented in the early 1970s by a nurse named Dolores Krieger, who was a professor of nursing at New York University, and by a self-proclaimed natural healer named Dora Kunz. It looks similar to the religious healing practice of "laying-on of hands," but does not have a religious context. Despite its name, therapeutic touch does not require a practitioner to actually touch the patient. Rather, the practitioner holds his or her hands several inches above the patient’s body and moves them parallel to the patient’s body. (See description of how therapeutic touch works, p. 37.)

"Studies have shown that therapeutic touch relieves pain, reduces stress, and increases healing," says Mike Marsh, RN, BSN, CETN, a hospice staff nurse with The Hospice of the Florida Suncoast in Largo, FL. Marsh teaches therapeutic touch to nurses at St. Petersburg Community College in Florida.1

But what does the practitioner do? "In a nutshell, we’re in a very focused, quite meditative state, letting loving, healing energy flow through us to the patient," Marsh says.

If home care nurses were to take time to learn the technique, they could do this for patients in about 15 minutes, Marsh says. "When you need something, and you’re grasping at straws and have nothing to offer, it’s a wonderful modality."

Marsh first took a class on therapeutic touch because his wife had chronic pain, and he wanted to see if this technique could help her. "After a 15-minute session, she said, ‘Mike, that’s the first time I’ve been without pain in two years,’" Marsh recalls. "I became committed at that point to become as knowledgeable about the process as possible," he adds.

Marsh calls it a palliative technique, not a cure. Therapeutic touch may provide temporary relief, but it doesn’t cure the source of the pain. He has often used therapeutic touch on his hospice patients and their families at their requests.

"I’ve had decreases in blood pressure, decreases in pulse rates, decreases in rapid breathing after a session, but that doesn’t happen all the time," Marsh says.

In a recent case, Marsh used therapeutic touch on a patient who was in a hospital’s intensive care unit and was unresponsive. The patient’s daughter had called the hospice to find someone who could perform therapeutic touch for her mother. He spent several days with the patient and her family and used therapeutic touch on various members of the family, as well.

"They would be so relaxed, that they’d be about to fall asleep after a 10- to 15-minute session," he recalls.

Reference

1. Samarel N. The experience of receiving therapeutic touch. J Adv Nurs 1992; 17:651-657.