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NP Scope of Practice - alternative medicine?

Posted

Specializes in Adult/Geriatric.

I am trying to figure out what the scope of practice is for NPs in terms of various alternative medicine modalities (i.e. aromatherapy, acupuncture, prescribing Chinese herbs, prescribing vitamins, Reiki, Guided Imagery, meditation, etc). I would like some input from you all as I am having a hard time finding this information.

I did some research online and it appears to me that you need a separate certification to do accupuncutre. Even an MD seems to need a separate certification. Am I right in this?

Does one need a certificate to practice aromatherapy? Or does being an NP allow you to give aromatherapy recommendations without the certificate? Same question for the herbs and vitamins.

I am especially curious about the legal requirements for prescribing Chinese herbs and whether an NP can do it.

Any information is appreciated

If you want to do acupuncture you really need to go to acupuncture school...usually 4 years. Physicians got into the business by having a short course which is basically a "cookbook" on which points to use. These programs are distressing to real Oriental Medicine physicians. I don't know about aromatherapy as I haven't sniffed that modality out yet. If had had $35,000 to spend I'd attend the University of Arizona's Integrative Medicine Fellowship. I doubt that I'd learn much more though as I have studied Zen Shiatsu, Tai Chi Tuina, Chi Nei Tsang, Qi gong, Reiki, meditation, Asian nutrition, shamanism, etc.. so I have basically designed my own course. Basically you'd have to see if each modality required a license in your state. In the future I'm planning on a practice in Integrative Psychiatry, which includes a lot of "stuff." PS: Chinese Herbs is a bugger of a course and one that Oriental Medicine students sweat over. Look at the curriculum of an acupuncture school and you'll see it's no walk in the park.

Physicians and Chiropractors can use acupuncture on a limited basis after a short certification program, but NPs cannot. Otherwise, you need to complete the full acupuncture degree, as zenman said. There are no specific requirements for practicing aromatherapy, so as long as you know how to use it, you can incorporate it into your practice. You might also want to look into Homeopathy. Homeopathic remedies are mostly harmless, so they don't require prescriptions or any specific license to recommend them. Herbs, on the other hand, can be harmful, so you would need to be educated as a Doctor of Traditional Chinese Medicine or as a Naturopathic Physician if you want to prescribe those.

Edited by Miss Molly
spelling

In the future I'm planning on a practice in Integrative Psychiatry, which includes a lot of "stuff."

Zenman, would you mind elaborating on what you are defining as an "integrative psychiatry" practice and the elements or modalities you envision it will include?

Also, is this practice something you are planning to do with your APN license or would you need additional certifications/training?

While I am still in the preliminary stages of my PMHNP journey, this concept was something I was interested in for myself somewhere down the line. Hearing that is something that you are considering as well makes it seems like an even more viable option and I am sure you have some good and practical ideas on what this would entail.

Feel free to private message if you like and thank you in advance for your time and insights.

MegRyanGirl

Specializes in Adult/Geriatric.

I don't know about aromatherapy as I haven't sniffed that modality out yet. If had had $35,000 to spend I'd attend the University of Arizona's Integrative Medicine Fellowship. I doubt that I'd learn much more though as I have studied Zen Shiatsu, Tai Chi Tuina, Chi Nei Tsang, Qi gong, Reiki, meditation, Asian nutrition, shamanism, etc.. so I have basically designed my own course. Basically you'd have to see if each modality required a license in your state. In the future I'm planning on a practice in Integrative Psychiatry, which includes a lot of "stuff." PS: Chinese Herbs is a bugger of a course and one that Oriental Medicine students sweat over. Look at the curriculum of an acupuncture school and you'll see it's no walk in the park.

My goal is to become an integrative/holistic NP. I saw some holistic programs for NPs (NYU has one for example), but they don't seem to provide you with knowledge to actually prescribe herbs. I am not sure which school is reliable for this. Whether it's homeopathy using traditional European herbs, or using Chinese herbs, they are all still considered herbs (in my humble opinion :specs:). I want to be able to prescribe herbs or antibiotics depending on the situation and would like to find a program that teaches you about the interactions between the herbs and the conventional medication. That's the most important thing to me.

University of Arizona's fellowship looks very good but I am not sure if it will provide the information that I am looking for that I just mentioned. It may very well be perfect for me. Does anyone know of a person that went to that program? The cost is definitely an issue.

I've studied aromatherapy on my own and have been practicing it on friends and family for about 10 years now. Zenman, you should definitely "sniff it out." :lol2:

As for acupuncture, I would rather refer my patients to a practitioner than do it myself. The schools in NY seems to require you to be an acupuncturist before you learn Chinese herbs and the whole program comes out to 5 years, but I found a certificate program in NJ that doesn't have that requirement and is much shorter.

Does anyone know of a reliable school for homeopathy?

Zenman, would you mind elaborating on what you are defining as an "integrative psychiatry" practice and the elements or modalities you envision it will include?

Also, is this practice something you are planning to do with your APN license or would you need additional certifications/training?

While I am still in the preliminary stages of my PMHNP journey, this concept was something I was interested in for myself somewhere down the line. Hearing that is something that you are considering as well makes it seems like an even more viable option and I am sure you have some good and practical ideas on what this would entail.

Feel free to private message if you like and thank you in advance for your time and insights.

Here's a book I have that you can check out on amazon, especially the contents:Integrative Psychiatry (Weil Integrative Medicine Library): Daniel A. Monti MD, Bernard D. Beitman MD: 9780195388374: Amazon.com: Books

I've already had training in many alternative areas, but plan to take some more nutrition classes since I'm working with bariatric patients. Already had a course in Asian nutrition. I'm still figuring out exactly what modalities I'll use but it will be heavy on drug and non drug therapy as well as shamanic practices.

ivanh3

Specializes in ER and family advanced nursing practice.

My goal is to become an integrative/holistic NP. I saw some holistic programs for NPs (NYU has one for example), but they don't seem to provide you with knowledge to actually prescribe herbs.

You can certainly learn more about holism through formal and informal training (IMHO, most nursing programs incorporate holistic concepts into their BSN, MSN, and doctorate programs). Although there are actual certifications for holistic nursing you don't have to be certified to incorporate holistic care into your practice both as an RN or NP.

Ivan

Hi zenman. I am a bariatric pt, also an RN with BSN. I had lap band surgery and am still struggling with the nutritional aspect. I would love to hear about your practices. I am very open minded and am practicing meditation and "stuff". Would you mind contacting me? do you have a web site? my email is Lssrd7@gmail.com

Thank you!

So the question at hand wasn't really answered is it within a nurse practitioners scope to recommend or prescribe herbal remedies as treatment?

edmia, BSN, RN

Specializes in Emergency, ICU. Has 10 years experience.

So the question at hand wasn't really answered is it within a nurse practitioners scope to recommend or prescribe herbal remedies as treatment?

It was answered but got lost in the thread. To prescribe Chinese medicine you need to be trained as a Traditional Doctor of Oriental Medicine or as a Naturopathic Physician. Completely different modalities and not in the scope of NP practice.

Sent from my iPhone -- blame all errors on spellcheck

cayenne06, MSN, CNM

Specializes in Reproductive & Public Health. Has 10 years experience.

I'd caution anyone interested in "alternative" medicine to do their research before recommending or performing these types of remedies. Some are relatively harmless and have potential for good (aromatherapy, for example), but much of what is called "alternative/complementary/integrated medicine are, at best, an unethical waste of a patients money, and at worst, can cause harm. There are some elements of "alternative medicine" that are fact based, and these are readily adopted by mainstream medicine- stress reduction, exercise, and a balanced diet come to mind.

Snake oil salesmen have some great press nowadays. Holistic, preventative medicine is not the exclusive domain of alternative providers. I think those of us in health care have a responsibility to critically examine the evidence and steer our patients towards therapies that work.

You know what they call alternative medicine that works? Medicine!

I hope nobody takes offense at this point. That was not my intention. I come from a background very steeped in woo, and it's been a long journey to realize that if I am concerned about the profit-driven motives of Big pHARMa, maybe I should also take a second look at the exploitative practices of Big Supplement, the chiropractic lobby, etc.

It amazes me to see health care providers subscribe to pseudo science. There is absolutely no empirical peer reviewed research that shows Homeopathy is effective for anything. Acupuncture is only equivalent to a placebo effect. Chiropractors claim to be able to treat acid reflux, diabetes, etc. But the only thing the evidence points to is them effectively treating low back pain. if "alternative" medicine worked it would be called medicine.

Skeptic

Just realized I said some of the same exact things you did lol

Just realized I said some of the same exact things you did lol

Well, that makes 2 people who seem to be confused!

I would recommend checking with the BON before starting rxing any alternative therapies; you don't want to end up inadvertantly getting your license in trouble.

Which part am I confused about?

Which part am I confused about?

Just as i thought….

cayenne06, MSN, CNM

Specializes in Reproductive & Public Health. Has 10 years experience.

Just as i thought….

????

I am not confused. Maybe my opinion differs from yours but that doesn't mean I haven't thought about this issue and arrived to my conclusions based on the available evidence.