Monday, June 26, 2017

Do Nurses Have a Role in Complementary Therapies?

Last year during the Olympics, the practice of cupping was brought to the forefront. Many athletes were spotted sporting large round welts on their their back, shoulders, and upper chest that were caused by cupping. This caught the attention of the sports analysts and reporters, and the Western world quickly became interested in this new-to-them practice.

Cupping is an old traditional form of Chinese medicine, often used in conjunction with acupuncture. I went for acupuncture last week to help deal with a headache I had since January. It was a sinus-type headache but tests and scans showed that there was no infection, allergies, inflammation, nothing. So, I returned to an acupuncturist I'd visited a few years before. I forgot that she did cupping after the acupuncture session:

Cupping mark on my shoulder

It doesn't hurt while cupping is done and while it looks like a nasty bruise, it's only tender if you press hard on it. It looks awful but - my headache is virtually gone. It's down to about 10% of what it was before. I'll be going for another session later this week. So was it the acupuncture? The cupping? Both?

Practitioners claim that cupping can treat many disorders, including asthma, arthritis, GI upsets, and chronic pain, among others. Generally, the practitioner heats the air in a cup, usually with a flame, and the cup is placed on the skin. This produces suction. It’s believed that this suction promotes blood flow to the area, resulting in better health. When the cup is removed, a red or bruising mark may be left behind.

Regardless of what we may personally believe about complementary and alternative medicines, patients are using them. An article I wrote for Oncology Nursing News in 2015 stated that, “53% of American adults used CIT [complementary and integrated therapies] at some point in their lifetime, and 42% said they used it within the past year. People with cancer reported even higher use: 65% of cancer survivors used CIT at some point, and 43% used it within the past year.”

As nurses in North America, we generally work in facilities that focus on evidence-based medicine. Some facilities have developed integrative therapy departments, where patients can benefit from complementary medicines, such as acupuncture or massage therapy, along with Western medicines. These include facilities such as Johns Hopkins, Cleveland Clinic, and Mayo Clinic. I wasn’t able to find any similar departments associated with Canadian hospitals, although many major cities do have integrative medical clinics. So what do we say if patients ask us our opinions on complementary medicine?

The College of Registered Nurses of Nova Scotia published guidelines for nurse practitioners and registered nurses on the topic. The document reviews the nurses’ role in therapies, the nurses’ ethical and professional responsibilities, and how nurses might have a role in practicing complementary therapies. The college concluded: “Registered nurses and nurse practitioners can be actively involved in the delivery of CAHC therapies or simply help clients access appropriate information and make treatment decisions. Regardless of their role, RNs and NPs must be well informed and possess the appropriate knowledge and skills to provide safe care. Having evidence informed knowledge of potential benefits and risks of particular therapies is crucial. As RNs and NPs strive to provide comprehensive care for their clients, they must always ensure that they practise CAHC within the context of a nursing framework and within their standards of practice and code of ethics.”

Personally, I believe in some types of complementary medicine, but not necessarily alternative medicine. I have used acupuncture and massage therapy with good results. Complementary means that the treatment is in conjunction with evidence-based medicine practices. Alternative implies that the treatment is instead of. However, regardless of our own beliefs, it is vital that our patients trust us enough that they tell us if they are undergoing other forms of treatments or therapies. They may be more willing and open to telling their nurses than their doctors, for fear that their doctors will insist that they stop their treatments. As nurses, we can help them understand why it’s important that they be open with their treating physicians.

Do you see a role for nurses in complementary health practices?

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