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Many hospitals are using some form of alternative therapy with inpatients, and the trend is also evident in the ED, says Karen Sheeks, RN, MS, CEN, a wellness consultant and educator at St. Joseph Health System Humboldt County in Eureka, CA.
"Some facilities use modalities such as therapeutic touch and imagery in the ED to assist patients with pain control and anxiety," she reports. "I know of one ED physician who exclusively uses imagery for suturing children, and his patients do not require local anesthesia for laceration repair."
Alternative approaches can empower patients, stresses Jay Kaplan, MD, FACEP, chairman of the department of emergency medicine at Saint Barnabas Medical Center in Livingston, NJ.
"These techniques can help patients to feel they can do something for themselves, which helps them take responsibility for their healing process with doctors and nurses as facilitators," he says. "That can only benefit patients."
Here are ways to integrate alternative medicine into your ED:
• Educate yourself about alternative therapies. "The National Center for Complementary and Alternative Medicine (NCCAM) at the NIH is an excellent resource," says Sheeks. "The NCCAM provides a clearinghouse of information on all current, controlled clinical trials involving the use of alternative therapies. There currently are 22 categories of therapies that the NCCAM is investigating. The Holistic Nurses Association is another wonderful resource for nursing education in alternative medicine."
• Form a multidisciplinary committee. "Mad River Community Hospital in Arcata, CA, has a complimentary medicine committee that meets monthly and educates nurses, physicians, and ancillary practitioners on different forms of alternative medicine," reports Sheeks.
Guest speakers present each month on a specific form of therapy and answer questions about its application in the hospital setting, Sheeks explains.
"As a result of this committee meeting regularly, the hospital nursing staff was able to create and obtain approval for policies and procedures for the use of alternative therapies in the hospital," she says.
• Integrate alternative and traditional methods. "The terms complementary’ or integrative’ are more accurate than alternative,’" notes Patty Campbell, RN, MSN, CCRN, ANP, CS, a Phoenix-based emergency nurse practitioner and assistant editor of the Journal of Emergency Nursing.
"The goal is to integrate the best of both worlds by using both alternative and traditional therapies."
Ask about alternative treatments used by patients. "Depending on the patient’s chief complaint, you should ask about the use of chiropractors, homeopathy, and acupuncture," Campbell recommends. "Because when it comes time to discharge that patient, it may be appropriate to use that as part of the treatment plan."
• Enlist administrators’ support. "You need to involve administration so they can support you with resources and training. A lot of people don’t realize how many things we can do in our everyday practice," says Kathleen Kelly, RN, an ED nurse at Navapache Regional Medical Center in Show Low, AZ. "Nurses do a lot of things already, such as laying of hands, giving patients alternative ways to deal with pain and stress, and talking to them about lifestyles. But policies and procedures should be backed up by administration."
• Use training programs. "In order to be experts in this area, nurses need to be trained in alternative therapies," says Kelly. "Training ensures what we’re doing is professional and meets the needs of the hospital."
• Recognize that alternative methods can save time. "There are so many issues to address in the ED in 10 seconds. People ask how we have time to do alternative methods," says Kelly. "But it actually saves time, because it alleviates the patient’s stress, decreases blood pressure, and slows breathing. The patient is calmer and more cooperative, so you can start dealing with the symptoms you see right away."
• Consider recommending alternative practitioners. "A patient came in with an inflamed thyroid, and had seen multiple specialists. The solution that was being presented to her was that she should have her thyroid taken out. She came in after having a medication reaction to her prescription, and I suggested she see an acupuncturist who could possibly help with her symptoms."
Patients usually appreciate such recommendations, says Kaplan. "A lot of times, nurses are concerned that if you recommend a practitioner who has a different approach, the patient will be upset. In fact, patients appreciate that and don’t like being told, There is nothing else I can do for you.’ Over time, build-up a referral list of alternative practitioners."
For more information about alternative medicine, contact the following:
• Patty Campbell, RN, MSN, CCRN, ANP, CS, 11830 Westline Industrial Drive, St. Louis, MO 63146. E-mail: Campbellnp@aol.com.
• Jay Kaplan, MD, Saint Barnabas Health Care System, Department of Emergency Medicine, 94 Old Short Hills Road, Livingston, NJ 07039. Telephone: (973) 322-5127. Fax: (973) 322-8055. E-mail: email@example.com.
• Kathleen Kelly, RN, Navapache Regional Medical Center, 2200 Show Low Lake Road, Show Low, AZ 85901. Telephone: (520) 537-4375.
• Thomas Moss, MD, BA, Family Care Fountain Hills, 11842 Desert Vista, Fountain Hills, AZ 85268. Telephone: (602) 675-4327. Fax: (602) 816-3120.
• Karen Sheeks, RN, MS, CEN, St. Joseph Health System Humboldt County, 6700 N. Highway 101, Suite B, Eureka, CA 95503. Telephone: (707) 677-3969. Fax: (707) 441-0177. E-mail: firstname.lastname@example.org.