Nurse Massage Therapists as Natural Bridges
Americans’ dissatisfaction with the state of their health was well established when a 2003 study revealed that 2 billion dollars was spent out of pocket on alternative and complementary healthcare practices. It became clear the sophisticated tools that current biomedicine offers – pharmaceuticals, surgery and technology – while life saving in acute situations, were not effectively addressing chronic disease which according to statistics cost the American healthcare system 277 billion in that same year. North Carolinaranked 33rd in health in that ranking. (The Milken Institute)
Note, I was living in NC when I first wrote about this.In the years since that study, mainstream medicine, recognizing the challenges of chronic disease management, has begun to embrace the concept of Integrative Medicine. Two definitions follow:
Integrative Medicine (IM), according to the Consortium of Academic Health Centers for Integrative Medicine, is “the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, and makes use of all appropriate therapeutic approaches that are informed by evidence. It is important to differentiate IM from complementary and alternative medicine (CAM), which is associated with IM therapies for which much of the evidence is still unsettled.”
A second definition:
Integrative Medicine can be described as orienting the health care process to create a seamless engagement by patients and caregivers of the full range of physical, psychological, social, preventive, and therapeutic factors known to be effective and necessary for the achievement of optimal health throughout the life span. Integrative medicine envisions a health care system that focuses on efficient, evidence-based prevention, wellness, and patient-centered care that is personalized, predictive, preventive and participatory.
Integrative Medicine and the Health of the Public: A Summary of the February 2009 Summit
Now a third definition, which seems to temper the first’s statement regarding complementary and alternative medicine, comes from the NationalCenterfor Complementary and Alternative Medicine (NCCAM). NCCAM (per its web site) is the Federal Government’s lead agency for scientific research on complementary and alternative medicine (CAM).
“Integrative medicine combines treatments from conventional medicine and CAMfor which there is evidence of safety and effectiveness. It is also called integrated medicine. An approach to medicine that combines treatments from conventional medicine and CAM for which there is some high-quality scientific evidence of safety and effectiveness.” NCCAM “groups CAM practices into four domains, recognizing there can be some overlap. In addition, NCCAM studies [alternative] whole medical systems, which cut across all domains.” Whole Medicine Systems are those such as homeopathy, Chinese medicine and naturopathic medicine. The four domains are 1) Mind-Body Medicine – the most embraced domain; witness Duke’s mindfulness training and integrative coaching programs 2) Biologically Based Practices including herbs, vitamins and foods. 3) Manipulative and Body –Based Practices of which chiropractic medicine, massage and naturopathy are mentioned. 4) Biofield Therapies, includes practices “intended to affect energy fields that purportedly surround and penetrate the body” Examples of these modalities are Qi Gong, Reiki, and Therapeutic and Healing Touch. Increasingly, hospitals are incorporating these practices, especially as related to cancer care.
As we ponder the changes that Integrative Medicine brings forth, it is worth noting that long before that 2003 study was done, nurses had a long history of integrating health promoting practices and holistic principles, recognizing that healing relationships – most often relegated to the counselor’s office – are instrumental in regaining health. Their holistic approach also recognizes that no two patients are the same and have, therefore, unique healthcare needs; furthermore, those needs and circumstances may change, thus frequent re-assessment is needed. Unfortunately, most doctors’ offices can no longer afford to have a nurse adding her expertise to a patient’s routine care, and the care that hospital nurses provide must often be focused on the technology they are overseeing, leaving little time for developing healing relationships. The physician is focused on providing an accurate diagnosis and the best biomedical care possible in a time frame that challenges establishing effective relationships as well.
Reflecting back to that 2003 study and the inclusion of mind/body interventions within hospital systems, it may be that medicine is finally catching up with consumers, embracing what millions have decided for themselves: there remains a place for systems and practices that have been around for millennium along side the medical care system we have known for the past 200-300 years. But until there are medical systems that do provide the seamless care hoped for, consumers may all benefit from creating their own ways of combining them.
This creates a real niche for nurse-massage therapists in creating a credible entry point for the consumer. I, in fact, rarely describe myself as a nurse massage therapist in my promotional material. I identify myself as an Integrative Health Nurse providing “ bodywork, education and support.” As a nurse, I am qualified to educate my clients about whole medicine systems and their availability and independently teach body mind practices, inform of all options for their healthcare as well as guide them through body-mind practices, use bodywork modalities and well as biofield approaches. For many years, I have bristled at the question, “How does it feel to have left nursing?” I have always responded, “I have not left. I have come home.”
Ethlyne J Davidson, RN, CMT
Lynchburg,VA
434-237-1016
