Which is the best nursing intervention regarding complementary and alternative medicine *?

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Complementary therapies are used to supplement conventional health care practices. They include a wide range of treatment methods, such as herbal therapies and manual healing, including reflexology and acupuncture.

Complementary therapies are growing in popularity among the general public. Nurses have been asking CNO whether it is appropriate to provide complementary therapies, and what criteria exist to guide nurses in using these therapies.

The following scenarios address questions nurses have about providing complementary therapies:

I am a visiting nurse caring for a palliative care patient. My patient has been informed by the health care team that there are no more available “curative” treatment options and that the care plan is to provide comfort and support. The patient asks me to provide an unconventional treatment he has heard about, involving IV infusion of ozone. What are my accountabilities in this situation?

Nurses are obligated to explore the patient’s understanding of the treatment and the rationale for their choice. Nurses also must ensure the patient has the necessary information to make an informed choice.

In deciding to provide a complementary therapy, you are accountable for assessing the therapy’s appropriateness given the patient’s health status, and for having knowledge, skill, and judgment to competently provide the therapy.

If you are unable to obtain adequate information about the complimentary therapy to assess if it is a significant risk to the patient, you may refrain from performing the treatment and explain the decision to the patient.

It is within your role to facilitate, advocate, and promote best possible care for the patient. You are required to take action in situations where patient safety and well-being are compromised. This includes notifying the prescriber of concerns, consulting with the health care team and recommending an appropriate health care provider to perform the procedure if it is beyond the scope of your role and competence. You are also accountable to advocate for policies and procedures about complementary therapies that are driven by patient safety.

You must also document the consent obtained for any provision of treatment, including complementary therapies. Documentation must contain a complete record of nursing care provided and reflect all aspects of the nursing process including, assessment, planning, intervention and evaluation. Documentation demonstrates your commitment to providing safe, effective, and ethical care by showing accountability for professional practice and the care the patient receives. 

I work on a medical surgical unit and recently completed a Therapeutic Touch program. Some patients on my unit could benefit from this intervention. Is it acceptable for me to suggest Therapeutic Touch to them?

You may propose the use of Therapeutic Touch or other alternative therapies if you have sufficient information to believe the treatment would benefit the patient. Proposing this therapy must be done in collaboration with the entire health care team and be incorporated into the care plan.

You must also be aware of organizational policies regarding using complementary therapies. If there are no policies in place, you are encouraged to work with your employer to develop policies around the use of complementary therapies.

When recommending a complementary therapy, you are obligated to ensure the patient has the necessary information to make an informed choice. You also must obtain their consent prior to performing the therapy.

Documenting the consent obtained for any provision of treatment, including complementary therapies is required. Documentation must contain a complete record of nursing care provided and reflect all aspects of the nursing process including assessment, planning, intervention, and evaluation. Documentation demonstrates your commitment to providing safe, effective, and ethical care by showing accountability for professional practice and the care the patient receives. 

I work in a long-term care setting where some residents are prescribed herbal remedies by a physician who practices Chinese medicine. What are my accountabilities when administering these substances?

Nurses are professionally responsible to consider the patient’s health status and assess risks and benefits of providing a treatment. In order to competently provide the treatment, you need to be informed about the treatment’s purpose, action, and anticipated effects.

You are also accountable to obtain consent prior to performing the treatment and ensure the patient has appropriate information to make an informed choice. You should ask your patients if they understand what they are consenting to and if their questions about the proposed treatment have been answered. It is your responsibility to determine the patient’s understanding of the treatment, ensure that they have the necessary information to make an informed decision, and ensure that their questions about the proposed treatment are answered.

Documenting the consent obtained for any treatment, as well as developing a care plan is required. Documentation must contain a complete record of nursing care provided and reflect all aspects of the nursing process including assessment, planning, intervention, and evaluation. Documentation demonstrates your commitment to providing safe, effective, and ethical care by showing accountability for professional practice and the care the patient receives.

When deciding to perform a complementary therapy, consider the following questions:

• Is this an appropriate intervention for this patient?
• Is this intervention included as part of the recognized care plan?
• Have I consulted with the broader health care team about this intervention?
• Have I reviewed organizational policies about using complementary therapies?
• Do I have the authority to perform this therapy?
• Am I competent to provide this therapy safely and effectively?
• Do I understand, and can I manage the possible outcomes of this therapy?

Related links

CNO Practice Standards

• Therapeutic Nurse-Client Relationship, Revised 2006
• Professional Standards, Revised 2002
• Decisions about Procedures and Authority
• Documentation, Revised 2008

CNO Practice Guideline

• Consent

Other

• RNAO Best Practice Guideline Embracing Cultural Diversity in Health Care: Developing Cultural Competence

What elements are essential for the nurse to address to be able to deliver culturally competent care select all that apply?

How should the nurse conduct the health teaching session while considering the cultural diversity of a client?

Which should the nurse include when caring for a client of a different culture?

When communicating with a client who speaks a different language which best practice's should the nurse implement to ensure communication has been effective?