Holistic Nursing: A Revolutionary Approach to Improved Patient Care

By Lynn Keegan, RN, PhD, HNC, FAAN

Alternative and complementary therapies are no longer on the fringe; today they are widely available and widely used. In a 1997 study, 42.1% of those surveyed used at least some type of alternative therapy, and most visits were for chronic conditions such as back problems, anxiety, depression, and headache.1 A decade ago, few patients used acupuncture, massage, and healing touch. Now, millions of patients regularly seek these and other nontraditional therapies. Extrapolating the results of a 1998 study to the U.S. adult population, Americans made 629 million visits to alternative medicine practitioners in 1997, exceeding total visits to all U.S. primary care physicians.2 Medical schools are teaching students about these therapies; hospitals and other health organizations are offering the services; and in some states, laws require health plans to cover complementary and alternative treatments.

Nurses and Holistic Therapy

Holistic nursing and health care has been most effective in ameliorating chronic, long-term disease. Instead of medicating a patient and sending her home, the holistic nurse considers all the effects of an illness—integrating an approach that will give the patient peace of mind with her condition. As a result, many patients seek health care providers who operate from a holistic perspective rather than practitioners who work within the limitations of the traditional or conventional model.

Nurses working in a supportive environment can incorporate many noninvasive complementary modalities alongside conventional therapies in their healing work. In addition, many hospitals have seen the benefits of integrating holistic healing into the health care system and have provided room for it. Nurse managers in hospitals, physician offices, and other health care settings are now faced with the task of incorporating complementary and alternative medicine into practice.

How to Establish a Complementary/Alternative Practice

When establishing an environment for practice of alternative and complementary therapies in an existing health care agency, nurses and nurse managers might consult the following six-step plan.3

1. Learn about the laws and regulations of Complementary/Alternative Practice (CAP) in your state.

Talk with your state health commissioner and learn about CAP policy mandates and/or legislation.

Find out about your state medical and nursing association positions.

Ascertain if there are any centers/schools that offer credentialing courses; assess range of offerings and activity level, etc.

Identify person(s) responsible for strategic planning, health plan administration, or growth strategic group.

2. Assess local activity with regard to CAP.

Find out if there are freestanding CAP centers in your community. How do they operate? Who are their practitioners/clients? What is their fiscal management/collection plan?

Visit and analyze the operations of preexisting centers, both uncredentialed and credentialed.

3. Conduct formal marketing research to test the marketplace.

Ascertain the level of acceptance and interest among the community, physicians, and other providers in the area and the number and frequency of community education, conferences, seminars, CME/CE, etc.

Ascertain the hospital’s cultural acceptance and views toward the following methods of care: wellness/preventive services and programs, hospice, midwifery, osteopathy, chiropractic, dietetic/ nutritional services, chaplaincy services.

Learn about the political/administrative situation and any other considerations that may have posed a delay to previous attempts to implement CAP.

Assess the results to measure community/hospital readiness.

4. If the preceding steps produce a favorable response, proceed to delineate and choose among the many modalities of care. (See More on Alternative and Complementary Therapies at right.)

Consider placing therapies on a spectrum encompassing "conservative, controversial, and esoteric" (perhaps using different colors to represent in-house practitioners, area practitioners, etc.).

5. Compile results and present to hospital administration with a proposed plan-of-action.

Integrate the responses to the measured political, marketplace, and readiness results.

Every hospital has its nuances and "the best approach" may differ widely.

Discuss plan-of-action and determine which CAPs best adopt to and/or align with your hospital.

6. Following the assessment and analysis, if there is an embracing response, return to the spectrum of modalities of care, created earlier in the process.

Consider the viability of creating an on-site complementary and/or alternative therapy treatment room as a pilot project.

Allocate funding.

Begin offering services.

Evaluate after pilot period.

Revamp/alter program based on pilot project.

Institute full-fledged hospital program of CAP.

Advantages of Implementing a CAP Program

Any individual or group can seek to evolve the practices of an existing hospital or health care agency. The advantages of doing this include:

Improved client satisfaction—the hospital is viewed as innovative.

Enhanced community outreach and publicity for the hospital.

Increased ability for consumers to become involved in their own health care.

Cost-effective benefits associated with greater wellness and early prevention.

Additional profit center, often private pay.

Projections for the Future

Dramatic changes are in the making for the delivery of health care. There will be increasing numbers of freestanding integrative health clinics and wellness centers, hospitals will move to develop in-house alternative care programs, and individual practitioners will upgrade and augment their alternative/complementary skills with continuing education programs. The 21st century will be an exciting time for many innovative changes. Be sure you and your facility are part of the movement v

References

1. Eisenberg DM, et al. Trends in alternative medicine use in the United States, 1990-1997: Results of a follow-up national survey. JAMA 1998;280:1569-1575.

2. Anonymous. Chronic conditions spur use of alternative medicine in the U.S. Geriatrics 1999;54:15-16.

3. Keegan, L. Healing with Alternative and Complementary Therapies. Albany, NY: Delmar Learning; 2000.