I've been thinking about this area for NPs and have sent a letter to a local university which offers NP programs asking for their input. I haven't fleshed it out completely but think that this would be a good area for NPs. In my case for example, I could combine my training as a Zen Shiatsu therapist with that of an NP. I've had over 100 hours of Traditional Chinese Medicine theory in addition to the bodywork training (total almost 700 hours). I realize that I could just get my NP and combine my training, but why not have a formal training for Alternative Medicine NP? I also have a masters in psych nursing so maybe the training in this area would focus on psych, acute care or FNP and Alternative Medicine courses. In my practice, I could now add more advanced assessment skills, meds, etc. as needed in addition to bodywork, imagery, meditation, etc. Any thoughts?
Vsummer, the question of course is WHAT constitutes sufficient evidence to employ a particular approach. One might view such evidence as a continuuem which ranges on one hand from only ancdotal stories of healing, to hundreds of progressive double blind studies, culminating in head to head comparisons with the best available conventional approaches (that is to say Phase III clinical trials) followed by FDA review. The problem with "the left" part of the spectrum is that there is such a paucity of evidence to support usage or attribute success to a particular intervention. On the other hand while "the right" part of the spectrum provides optimal evidence it is so lengthy and expensive (not to mention encumbered by buracracy and politics) that it PRECLUDES many potential excellent CAM interventions. I would suggest that there is a "middle ground" which involves serious scientific support that very well might include double blind studies, but which would fall short of the FDA "gold standard". Consider, something like the usage of "garlic" in the treatment of antibiotic, resistent pathogens. There is significant support for this approach, and in some areas it is even being employed by mainline physicians. However, it does not (and probably never will since it cannot be patented) have the sort of Phase I,II, and III clinical trial evidence that would make it a main stream intervention. The FDA "model" also tends to exclude approaches that rely upon "synergy" for their success. For instance there are agents such as angiostatin, and endostatin which have showed tremendous promise in arresting (and reversing) sold tumors in labratory animals when used in COMBINATION. However, they have only been tested in FDA approved clinical trials in ISOLATION where animal models (and the trials done thus far in humans) suggest they are EXOPONENTIALLY less effective. Unfortunately, FDA policy all but excludes testing more than ONE investigative agent at a time! Thus, approaches which rely upon multiple modalities for their efficacy are seemingly doomed to obsurity. Even mainstream agents such as Amifostine which is APPROVED for reducing xerostomia during radiation treatment for head and neck cancer IS NOT employed for preventing the esophogeal irritation and resulting achalasia/dysphagia which occurs during the radiation treatment of centrally located tumors, such as those that commonly occur in lung cancer! We are talking about the exact same process in terms of pharmocological action, and physiological damage only in a slightly inferior part of the body. I would submit that requiring TOO MUCH evidence can be just as damaging to scientific progress and patient outcomes as too LITTLE support.
Last edit by Roland on Mar 24, '04