What’s complementary medicine about? Medical staff, public want to know
What’s complementary medicine about? Medical staff, public want to know
As clamor for complementary therapies grows, so does need for education
The Department of Complementary Care at Longmont (CO) United Hospital exists today because of a grass-roots community effort. In 1993, the senior advisory council asked the hospital to provide services outside of conventional medicine, such as Tai Chi, massage therapy, yoga, meditation, acupuncture, and herbal medicine. The council, consisting of community members who volunteered to participate, explained that although seniors have the most chronic diseases, they get the least help and are put on more and more medications.
To support their cause, the council conducted a community fundraiser to send the manager of the senior membership program at the health care facility to China to study Chinese medicine and aging in China. "The purpose of the trip was not to become certified; they wanted me to get a glimpse of how another culture was dealing with aging. When I returned from China, I was converted," says Michelle Bowman, BSN, RN, C, manager of complementary care/senior wellness at Longmont United Hospital, which became a Planetree facility in 1998.
As consumers clamor for complementary therapies that are holistic in nature, more and more health care professionals have seen the light and are integrating complementary therapies into their health care systems. The methods for this integration process vary, but education is a key component of all efforts for both staff and consumers.
Without education, many physicians see complementary therapies as alternative medicine, such as prescribing herbs instead of medications. "The medical mind sees something wrong and tries to determine how to fix it. In the holistic community, we view disease as an imbalance in the body, mind, and spirit, and we work with the person to bring that balance back using every modality available," says Renee Pierce, ND, health guide coordinator/complementary medicine champion at Banner Health Arizona in Gilbert. (For more information on making a case for complementary therapies, see article on p. 88.)
While patients want complementary therapies, they often also want a quick fix because they still have the Western medicine mindset, which holds that if something is wrong, you look for a remedy to fix it, says Pierce. "With the emergence of capsule herbs, the public is going out to health food stores thinking natural products can’t hurt them. They believe the answer is in the pills," she says.
What do people need to know? At Longmont United Hospital, Bowman doesn’t make a lot of claims about complementary therapies, but lets the use of the therapies reveal the benefit. For example, at the cancer care center, all patients who come in for radiation treatment on Mondays can have a 30-minute massage accompanied by live music on either harp, keyboard, or guitar provided by the music therapist on staff in the complementary care department.
On Wednesdays, patients at the center are offered a 30-minute healing touch session provided by a practitioner who is a registered nurse. "Our goal is to decrease the stress and provide a calming environment. Other than that, we make no claims, and just tell the patients it is part of their care. We want to make the patient feel appreciated and valued as a human being," says Bowman.
The physicians usually are appreciative when the patients are happy, and they, in turn, become sold on complementary therapies. When Bowman introduced massage therapy into the pre-op area, she had one of the 14 massage therapists on staff do a literature search and put together a notebook on the medical benefits of pre-op and post-op massage therapy. The notebook is kept on the unit for surgeons to look at if they are wary of the practice. (To learn the steps for integrating complementary medicine into the medical system, see article on p. 88.)
However, when Bowman approached the surgical staff, she didn’t show them research studies. She told them the purpose of the presurgery massage was to improve the quality of the patient’s care. There were cases when the massage resulted in the use of less anesthetic and pain medication, but these claims were not made. "The best way to change conservative viewpoints in regard to these modalities is to move them into areas where you can have the highest impact and they will not be threatening, and then let them speak for themselves," advises Bowman.
One of the best ways to convert staff from skeptics to believers in complementary medicine is to let them experience it, says Pierce. Therefore, the committee working on the project arranged to make a presentation at the annual meeting of hospital administrators throughout the health care system. The administrators were given the chance to experience massage therapy, herbs, spiritual healing, Tai Chi, and yoga at the conference. With the support of the administrators, each hospital selected a complementary medicine champion who serves as the liaison to the system in implementing the various modalities according to what works in each community, explains Pierce.
The same technique was used to sway the physicians on the ad hoc committee assembled to form the complementary therapy department at the health care facility where Pierce works. "The team of physicians said that they were supportive but they did not have the knowledge to guide the hospital, so they looked to the naturopath and mind-body person on the committee to teach them quickly," says Pierce. The two disciplines organized a half-day seminar that covered naturopathic medicine, acupuncture, Chinese medicine, and mindfulness.
To educate the public about complementary medicine, Pierce frequently conducts community outreach classes and holds brown-bag lunch lectures at the hospital. Topics include the healing power of touch, healing the emotional heart, and herbs and nutritional supplements.
At Mercy Healthcare Sacramento (CA), members of the integrative medicine steering committee are incorporating information about complementary therapies into the system through existing methods, says Marcia Taylor-Carlile, RN, CDE, team leader for healing environment. For example, Taylor-Carlile is working with the clinical dietary staff and pharmacy staff to produce patient information sheets on herbal and vitamin supplements and their potential interactions with drugs.
"The general public thinks that if something is natural, it must be safe, and they are mixing a lot of their medications with herbs fairly indiscriminately, and we have concerns about safety issues," explains Taylor-Carlile.
They also created a holistic channel on the closed-circuit television system at the health care facility. The channel is devoted to music, images for relaxation, and such complementary therapies as breathing exercises, imagery, and muscle relaxation exercises to help ease anxiety and pain, says Taylor-Carlile. (To learn how guided imagery was added to a cardiac surgery program, see article on p. 90.)
Introducing patients to the complementary therapies that are available to them works best when you have a physician champion, says Bowman. One obstetrician on staff at Longmont United Hospital has the complementary therapy department do an orientation once a month for all his new clients about the therapies available during their pregnancy, labor, and postpartum period. The orientation includes information on studies that support the therapies.
His patients learn that every woman who delivers at the hospital is offered massage, and 98% of patients take advantage of the service. Aromatherapy also is available. Couples receive massage therapy training during childbirth education classes, and all moms get a $10-off coupon for infant massage following the birth of the baby. "We have been breaking the records for birthing since we started the massage program. A lot of our services attract people who want some of those options," says Bowman. nFor more information about educating both staff and the public about complementary therapies, contact:
• Michelle Bowman, BSN, RN, C, Manager, Complementary Care/Senior Wellness, Longmont United Hospital, 1840 Mountain View, Suite 3, Longmont, CO 80501. Telephone: (303) 651-5188. Fax: (303) 485-8218.
• Renee Pierce, ND, Health Guide Coordinator/ Complementary Medicine Champion, Banner Health Arizona, 1325 North Fiesta Blvd., Gilbert, AZ 85233. Telephone: (480) 503-9640. Fax: (480) 503-9633. E-mail: [email protected].
• Marcia Taylor-Carlile, RN, CDE, Team Leader for Healing Environment, Strategic Learning Development, Mercy Healthcare Sacramento, Mercy American River Hospital, 4949 Engle Road, Carmichael, CA 95608. Telephone: (916) 484-2117. Fax: (916) 484-2227. E-mail: [email protected].
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