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What? Your hospital doesn’t have a Traditional Chinese Medicine Practitioner for patients who need cupping, acupuncture, or herbs for dampness and wind? The closest that most hospitals get to alternative medicine is a TV channel for guided imagery. You know the one—it shows lush scenery as beautiful music plays to distract patients while a trembling nursing student with an IV needle learns to differentiate tendons from veins.
Understanding Alternative Medicine!
First of all, nurses need to realize that there is a wide spectrum from fraudulent to miraculous for this topic. Many CAM (complementary alternative medicine) modalities are validated by research but simply don’t fit into the fast pace of our conventional health system, while other approaches are heavily marketed but have little evidence of usefulness. For more on that, you’ll have to read the book The Grecian Garden: A Natural Path to Wellness. Public interest is exploding to the point that many multi-level-marketing companies are trying to jump on the natural health bandwagon–usually with inferior products. Which ones do you want the scoop on?
Branches of Alternative Medicine
It is true that there simply isn’t enough data for the health products lining the walls of grocery stores, and people are wasting billions of dollars yearly on supplements that only complicate their health problems. There is much more to natural health than keeping GNC in business, however. To simplify, CAM consists of natural products and various practices often blended together. These practices can be biologically-based therapies such as herbal medicine; mind-body therapies such as meditation; manipulative and body-based therapies such as Rolfing (focuses on the fascia); energy therapies such as therapeutic touch (everyone’s favorite nursing diagnosis); or systems of care such as Ayurvedic medicine (Hindu approach incorporating mind, body and spirit).
Research is sparsest for energy therapies, which use lasers and magnets and emphasize the avoidance of electromagnetic frequencies and radiation. Despite the difficulty in quantifying the effects of energy medicine, it is a system of care. Another popular system, homeopathy, is based on the philosophy that like cures like. It delivers extremely diluted substances to achieve healing. Naturopathy is based on the theory that diseases can be successfully treated or prevented without the use of drugs, by diet, exercise, and therapies such as massage.
On the opposite end of the spectrum from energy and homeopathic approaches is functional medicine. Although functional philosophy resembles CAM in its individualized approach, the treatment methods used in functional medicine vary from vitamin and herbal supplements to advanced genetic testing. Functional medicine may also incorporate unique treatments with conventional pharmaceuticals, such as long term IV antibiotics for chronic Lyme Disease. Despite successes in combining traditions, the differences in historical development, ideas and practice settings make it difficult to combine conventional medicine and CAM. It’s sort of like those yogurts with a handful of dying probiotics tossed in. It doesn’t taste as good as regular yogurt, and the bacteria population isn’t diverse or robust enough to actually change a health condition. And, you’ll still have to urgently visit the restroom exactly when all your patients gleefully press the call light.
Alternative Medicine Philosophy
CAM providers view symptoms as clues to underlying causes rather than problems to eradicate. This relates to working with the body to heal itself and finding root causes of illness. Even if taking an herb or nutritional supplement for headaches proves as efficacious as aspirin, a CAM provider may delve deeper into dietary and emotional issues rather than just recommending white willow bark.
Of greater concern than choosing natural products for artificial ones is the substitution of unproven therapies for effective ones. Nurses may perceive natural approaches to health with suspicion after caring for failed attempts at natural home births in the neonatal ICU or communicable, preventable diseases in the pediatric ICU. Because CAM systems are rarely effective in divisible portions (which would ignore their holistic philosophy), part of the problem is the attempt to take a Western approach. The quintessential example is substituting a homeopathic remedy for a vaccination. Although both homeopathic remedies and vaccines purport to contain tiny amounts of a toxin, they are not equivalent or even remotely comparable.
The CAM community also perceives problems with Western medicine. For example, the concept of masking symptoms of indigestion with pharmaceuticals rather than making dietary changes to address core issues is incompatible with CAM philosophy. Finding the line between empowering patients and depending on lifestyle changes to improve health, or relying on science and medicine to cure disease, requires critical thinking and an appreciation for biomedical ethics.
Now about that Patient…
Understanding how patients perceive both CAM and traditional healthcare improves nursing communication with all patients. Advocacy and empathy are most important, since CAM depends on patient empowerment and involvement in care. Also, any answer choice on the NCLEX that mentions advocacy or empathy is probably the correct answer. As nurses learn about CAM therapies, they should remain objective while providing the best care available for their patients. There probably isn’t a cupping policy at your hospital. That doesn’t mean you need to write one, or consult some obscure protocol to see if Phenergan is compatible with ginger essential oil. How do you deal with these issues at your hospital? I realize I haven’t defined all the terms I used in this nice chat we’ve had, so feel free to ask questions in the comments (such as, “Uh, so what works and is too late to get a refund for my magnetic energy bracelet?”).
Nick Angelis, CRNA, MSN, is the author of How to Succeed in Anesthesia School (And RN, PA, or Med School) and regularly writes or presents continuing education articles on a variety of boring or fascinating topics. Thankfully, he also has a thing for fiction, non-fiction guides for students and clinicians, and satire closely resembling non-fiction. Nick works as a nurse anesthetist in the Florida Panhandle and enjoys playing several sports poorly. You can connect with him on Twitter or Instagram.
Melanie Angelis, MS CAM, is the author of The Grecian Garden: A Natural Path to Wellness and the owner of Nourished in Eden. Melanie began her career as a teacher, but after researching her way to health naturally from a variety of puzzling conditions, she pursued a Graduate Certificate in Holistic Nutrition and Masters of Science in Complementary and Alternative Medicine from American College of Healthcare Sciences. She offers educational workshops and works individually with clients to improve their health with many of the modalities mentioned in this article.
Angelis M. “Therapy for Wellness.” In: The Grecian Garden: A Natural Path to Wellness. Pensacola, Fla.: Indigo River;2016:133-136.
Angelis N. CAM vs Traditional Medicine. Advance for Nurses. Retrieved from NursingAdvanceWeb.com