Integrating Complementary Alternative Medicine: A Nurse's Challenge

Complementary alternative medicine, otherwise known as CAM, is being integrated into health care practices, and has gained increasing popularity with patients. Complementary alternative medicine is, "a broad set of health care practices, therapies, and modalities that address the whole person-body, mind, emotion, spirit- not just signs and symptoms, that can replace or may be used as complements to conventional western medical, surgical, and pharmacological treatments" (ANA, 2007). Nurses face the challenge of integrating alternative health into their care. Especially since at least 1 in 3 Americans utilize methods in alternative medicine as primary or complementary care (Borkan and Frenkel, 2003). Nurses have high skepticism about the effectiveness of alternative therapies due to lack of knowledge and education about alternative therapies, an easily rectifiable problem. By integrating alternative health care with conventional medicine, in theory and education, into the nursing curriculum, nurses would be able to reach and help patients better.

Alternative health care took a rise in the 1980s and took off in the 1990s, according to Integrating Complementary Therapies. Alternative medicine therapies include care systems like Ayurveda, homeopathy, naturopathy, and acupuncture. Using mind-body systems like mediation, yoga, music and dance, also using biology based therapies like vitamins, minerals, and herbs. These systems use all natural ways to heal and keep the mind and body whole and healthy.

A popular alternative therapy like acupuncture, which is one of the oldest healing methods in the world, is part of traditional Chinese medicine. Its aim is to restore and maintain health with thin-hair like needles used to stimulate certain parts of the body to release toxins (ANA, 2007).

Yoga a mind-body practice that is one of the top 10 used CAM practices used for health purposes (NCCAM, 2009). An ancient Indian practice yoga combines physical postures, breathing techniques and medication to achieve relaxation and healing to the body and mind.

Homeopathy, or otherwise known as homeopathic medicine, was originated in Germany and has been in use for over 200 years. Homeopathy is used for wellness and prevention of diseases, it used as a method to treat and prevent diseases and conditions. Homeopathic treatments are individualized based on genetic history, personal history, and current physical, mental and emotional symptoms (NCCAM, 2009).

Naturopathy is a system of healing that is popular in many countries, including America, it uses both modern and ancient techniques. Naturopathy is used for treatment, prevention, and maintenance of the body; or otherwise referred to as "natures cure". Patients use therapies like gentle exercise, dietary changes or additions, and herbs to restore the body (NCCAM, 2009).

Aroma Therapy, a more recent addition to alternative health, uses essential oils from plants like flowers, herbs, or trees that is used to improve the physical, emotional, and mental well being of a patient. It is often used either by inhaling the scents or applying the oils on the skin; these smells send a chemical message to the brain- affecting moods and emotions (NCCAM, 2009).

With the increasing popularity of alternative health care, nurses are facing the challenges of integrating alternative health into their conventional care and practice. In a study done by Oxford University it was found that there about 67.6% of patients have had at least one form of CAM treatment done in their lifetime (Frenkel and Borkan, 2002). Patients are exploring alternatives that nurses have no education or knowledge about and could possibly affect conventional care patients receive. Nurses often dismiss alternative treatments as useless and a waste of time and money. This attitude has led patients to avoid disclosing information about any CAM therapies they might be receiving. When patients sense an impression of disinterest or fear a negative response from the nurse, they hold back information that could be important to their care. Patients value the input of the nurse and fear they will lose their respect if they mention CAM therapies, since many nurses frown upon it.

Other diagnosed patients who want to pursue alternative health care or complementary health care seek the nurse for advice on treatment options and guidance. Patients seek complementary or alterative care for a variety of reasons, one being cost. While alternative methods can take at least a few sessions, they usually end up being more cost effective. Usually because when used as CAM it can promote quicker healing time, be used as preventive measures or decrease pain. Patients also feel safer using alternative methods because they are "natural" and have minimal side effects.

Some use complementary alternative medicine as a way to prevent further complications, or control their current condition. Many alternative therapies focus on repairing and maintaining the body and mind at its natural balance. Others might simply find it beneficial not only for their health but for their quality of life. All of these ways helps a patient feel in control of not only themselves but their condition or disease because they are actively taking part in these methods (ANA, 2007).

Most nurses today fail to provide information or options for their patients, because they have not been educated or exposed to alternatives. This could lead to problems with patient communication, information, treatment and fully being able to help the patient.

Even nurses who have been exposed to CAM in nursing schools have little knowledge, because it is usually offered as an elective class that looks at the basics and offers no in-depth knowledge about CAM practices. "Alternative health care in a complex practice that has over 100 modalities and thousands of supplements in forms of foods, homeopathic medicine, and vitamins" (Frenkel and Borkan, 2002).The solution to this would be to have nursing schools offer a wide variety of classes that are required in the curriculum while also offering electives as well. Giving an understanding on the bio-feedback on alternative health and how it can be used with conventional medicine would benefit nurses no matter what field they are in. It is vital that nursing curriculum integrates alternative health care and complementary health care so nurses are better equipped to answer patient questions and understand treatments patients may be receiving. Since so many people are either using alternative methods, using supplements, or are taking herbs that could possibly interact and be dangerous when combined with any conventional methods. Nurse awareness of these interactions could save patients from complications and or death.

Another reason to integrate alterative health into nursing curriculum is that CAM is an emerging field that requires not only physicians but professional nurses. The most recognized role of nurses is known to be caring, which is exactly what complementary alternative health care requires. In alternative health practices nurses need to look at a patient in totality: mind, body, emotions, spirit, social/cultural, relationships and environment when treating or just understanding the factors (ANA, 2007). Making them perfect for not only directing patients to alterative health care providers but being able to be a CAM provider, opening up a realm of possibilities for nurses.

According to An Approach for Integrating Complementary Alternative Medicine into Primary Care, visits to CAM providers exceeded visits to conventional care providers by more than 243 million visits. More than twenty-one billion dollars was spent on alterative care practices in the United States alone. This study was done in the early 20^th century when the industry had just taken off and right now we are at the peak of alternative care. Increasing popularity has not only drawn patients to it but researchers into this booming field.

There have been more and more studies to show the positive effects and benefits from alternative care alone and when used with complementary care in patients. Excessive studies are being conducted on the benefits of CAM methods and go as detailed as the benefits or cures of foods like turmeric.

I believe that integrating alternative health care into the nursing curriculum as mandatory work could be beneficial to nurses in many ways. Many patients today express their dissatisfaction over using conventional medicine on its own and look for a more natural solution. Using CAM would allow for broader treatment options, closer patient-nurse relationship, and active patient involvement in care. It would also increase the knowledge of nurses, their effectiveness in treating their patients, and giving nurses an edge in their fields. Using complementary health care in the education of nurses would help further studies in the field and provide more opportunities for nurses. Also, beyond using complementary alternative medicine as a source for helping nurses or patients, it serves as a starting point for current and future studies as well as emerging careers.

References

Frenkel, M.A., & Borkan, J.M. (2003). An Approach for integrating complementary- alternative medicine into primary care. Family Practice, 20, 324-332. doi: 10.1093/fampra/cmg315

Holistic nursing: Scope and standards of practice. (2007). Silver Spring, MD: American Nurses Association.

National Institutes of Health; NCCAM. (2010, February). Health. In National center for complementary and alternative medicine. Retrieved from http://nccam.nih.gov/health/atoz.htm

Peters, D., Chaitow, L., Harris, G., Morrison, S. (2002). Integrating complementary therapies in primary care: A Practical guide for health professionals. Retrieved from http://books.google.com/books?id=MF7llFtDaEwC&lpg=PP1&dq=complementar

y%20nursing&pg=PP1#v=onepage&q=complementary%20nursing&f=false

Sparber, A. (2001). State boards of nursing and scope of practice of registered nurses performing complementary therapies. Online Journal of Issues in Nursing, 6. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPerio mplementaryTherapiesReport.aspxdicals/OJIN/TableofContents/Volume62001/No3Sept01/ArticlePreviousTopic/C