Alternative Medicine NP

javagirl · Mar 1, 2004

I think this would be a phenomenal area for NP's. Espec. since most docs won't touch the stuff. :chuckle

In NYC there are 2 programs that offer a MA or M.A. subspeciality in holistic nursing.

Diane Bourne · Mar 16, 2004

:cool:

I think nurses have always been drawn to healing in the most basic terms.

Patients want a choice in the health care avaliable not just "take a pill and it will be better". As patients are more informed in relation to their health doctors have lost alot of the "power" they once had.

Doctors I've found gernerally aren't interested in complementary and alternative medicine but patients are, so this could be an excellant area for nurses to progress towards, especially NP's.

Please let me know anything else about this.

Diane in UK.

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?

Roland · Mar 24, 2004

In addition to all the reasons listed above nurses practicing in alternative medicine might give traditional, allopathic, medicine a "kick in the booty" towards the field. This is especially the case if NP's (FNP or otherwise) can show RESULTS using these approaches. Perhaps such success might also attract the sort of serious, research that would validate some CAM approaches to the satisfaction of traditional medicine.

Vsummer1 · Mar 24, 2004

Evidence based -- key words here. If someone can get the studies done and PROVE the theories, and if you are the one to do it, then go for it! But to have a program based on unsubstantiated treatments will not work in mainstream western medicine and will be shot down by the powers that be.

There always have been, and always will be, treatments that truly work and treatments that don't along with people willing to pay money for them both. But until proven using scientific methodology we won't know which are which.

It sounds like you have the background to do some serious good here, and I hope you reach your goal.

Roland · Mar 24, 2004

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.

gwenith, BSN, RN · Mar 24, 2004

Roland I think Vsummer is talking about evidence based practice/medicine as found in the Cochrane library or Joanna Briggs Institute and I agree whole heartedly that this is the way to go - systematic reviews of evidence.

zenman · Mar 24, 2004

Re acupuncture for example:

Western medical science has demanded "proof" that needling works, yet there is no irrefutable proof that explains the way Western medical methods actually work on the organism as a whole. Western medicine, in fact, lags far behind the extended scientific concepts of modern physics. It seems one system is just "less ancient" than the other! It is also logically inadequate and wrong to subject Chinese medicine to a Western-based, reductionist investigation. The ancient Chinese model is no less reliable, less realistic, or less justifiable than the Western model.

Some acupuncturists want more research, while others say that since it has a long history why test something that has worked for so long. Some also fear that, for example, a study shows that certain points are effective for a certain condition, then the insurance company will only reimburse for those points. This is crazy since for ten people with a headache, the treatment may be different for each rather than Motrin for all.

gwenith, BSN, RN · Mar 24, 2004

At the risk of being flamed this is where a country like Australia can sometimes get teh research done because we do not have the insurance rebate issue - at least not the way you do.

We do have a BIG complimentary medicine industry over here and even the hospital I work for has a division of the pharmacy that will advise on interactions with chinese herbal medications and western medicine. If you want any links or further information drop me a line.