18. An alternative approach
Older People's Forum
(MFD) That this meeting of RCN Congress discusses the role of the nurse in alternative and complementary therapies
Debate report
“Do nurses have a role in alternative or complementary therapies?” asked Iain McGregor, RCN Older People’s Forum Vice Chair, opening a lively debate.
“As a public health professional, I believe very strongly in evidence-based health care,” said Linda Bailey, Public Health Forum. “Let’s be clear there is no evidence for homeopathy – you’d be better off sprinkling people with magic fairy dust,” she said.
Andrew Toogood from the Doncaster branch agreed that there isn’t any evidence, but he believes that alternative or complementary therapies can work for some people.
David Jones, Greater Bristol branch, said that as someone who is a patient of complementary therapy he is a great advocate for it being used in mental health. “I wouldn’t be here today if I hadn’t have had CBT [cognitive behavioural therapy],” he said.
Nykoma Hamilton, from Fife, said that we needed to be clear that some therapies do work – head massages, for example, but “homeopathy is a complete and utter sham”.
“We need to define what complementary therapy is,” said Lisa Crooks, Gloucestershire branch, who suggested we are brainwashed into thinking some things are right just because some evidence supports it.“Let’s do some work on this, Congress,” she added.
Lynne Marshall, Hull and East Yorkshire branch, said one of the problems is there isn’t enough funding to gather evidence, and urged the RCN to push for more funding for research.
Nurse and complimentary therapist Kiera Jones, Swansea branch, said that she feels the RCN has a responsibility to push for more research into complementary therapies. “Drugs aren’t always the answer,” she said.
Margaret Devlin, Southern branch, Northern Ireland asked: “If these complementary therapies work, who are we to say don’t do it?” while Fiona Taylor, Mid Yorkshire branch, said she had personally witnessed some of the positive effects they can have.
Final speaker Margaret Fletcher, CYP Professional Issues Forum, urged Congress to support any drive into researching the impact of alternative and complementary therapies, while Iain McGregor closed the debate saying he looked forward to further work on the item.
Background
The term ‘complementary medicine’ is used to describe therapeutic techniques or treatments that are not part of conventional medicine, but are instead used in addition to conventional medicine. Examples include reflexology, hypnotherapy, homeopathy and osteopathy. Alternative medicine is different from complementary medicine as it is used instead of conventional medical treatment. Many organisations, such as those associated with cancer, do not advocate alternative therapies due to the lack of scientific evidence and subsequent risk to patients.
Complementary therapies are commonly used in today’s society to help conditions such as stress, anxiety, chronic pain and the increasing prevalence of long-term conditions. However, their use within health care is variable and dependent on a number of factors, including the patient’s medical condition, the patient’s or their carer’s awareness/views on complementary therapies, the opinion of health care workers in contact with individual patients and the health care provider’s organisational position. Many therapies are funded privately by patients however some may be provided on a limited basis by health care organisations or through charitable support.
Nurses have a key role in supporting patient education and information to enable informed decision making. Opinions and knowledge of therapies may be gained through nurses’ own experiences and exposure to media (either well or poorly informed). It could be viewed that such therapies support the needs of patients where conventional medicine or treatments are deemed ineffective or lacking. Is it reasonable to consider a nurse’s role is to be fully informed about each therapy and their effectiveness for different conditions in order to support patients in their decision whether to use such therapies?
A major issue impacting on nurses’ ability to support a patient’s decision is the scarcity of evidence on the effectiveness of therapies. While the challenge of rigorous evaluation of therapies is acknowledged, the ability to discuss pros and cons confidently with patients requires evidence and knowledge, to ensure that personal opinion and assumptions do not result in possible harm or financial loss to patients.
There are no national strategies for alternative and complementary therapies in the four UK countries. In Northern Ireland research was commissioned in 2012 by the Strategic Support Fund for Groups Working with Victims/Survivors of the Troubles, administered by the NI Community Relations Council (NICRC), which demonstrated that complementary therapies are one of a number of effective tools in treating trauma-related illnesses. As a result the NICRC has called for the best possible holistic service to be offered to victims and survivors, as well as supervision and support for therapists.
Complementary and alternative therapies are currently not included in the NMC’s standards for pre-registration education and there is no standard for post-registration education as this is dependent on the individual therapy and associated qualification body. Nurses wishing to practice in this area are required to meet the NMC regulator y standards for complementary and alternative therapies.
References and further reading
Nursing and Midwifery Council (2012) Complementary and alternative therapies London: NMC. Available at: www.nmc-uk.org/Nurses-and-midwives/Regulation-in-practice/Regulation-in-Practice-Topics/Complementary-and-alternative-therapies/ (Accessed 13/3/13) (Web).
O’Regan P, Wills T and O’Leary A (2010) Complementary therapies: a challenge for nursing practice. Nursing Standard, 24 (21), 27 January, pp. 35-39.
