NP Scope of Practice - alternative medicine?

[MegRyanGirl]

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

[nursetim, NP]

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

you know a lot of people use EBM like a club. Wasn't actos EBM? Wasn't thalidomide? How about eggs this year? Good or bad? Fat good or fat bad? Statistics that we seem to cling to so dearly, can be manipulated to say what ever the investigator wants the stats to say. I'd use them as a guideline.

I tend to like old school, let food be your medicine. I ask my patients to eat raw garlic when they are battling colds, chicken soup etc.

i believe in herbals, but as they are not regulated, I don't trust them. If I had the money to send them out to be tested for content, then I'd trust them more.

[elkpark]

you know a lot of people use EBM like a club. Wasn't actos EBM? Wasn't thalidomide?

Actually, thalidomide is a classic, perfect example of EBM (and government regulation) working (in the US, that is). In the late 1950s, when the "thalidomide baby" tragedy was happening, it was available in the rest of the world, but the FDA had refused to approve it in the US specifically because it hadn't been tested on pregnant women and the risks were unknown (unfortunately, the world soon found out what the risks were). There were some "thalidomide babies" born in the US, but nowhere near the numbers born in Europe and Canada and they were born to women who had gotten their thalidomide somewhere else. Thalidomide was eventually approved in the US, much later (in the late '90s, I think?), and only for a few v. specific uses with tight safety controls.

Unfortunately, the FDA standards and procedures have been watered down quite a bit since then, at the insistence of Big Pharm and its friends in Congress, which is why we see growing numbers of "bad" drugs making it onto the US market.

[Hi2Jenn]

I think it really depends on which state you are in and which modalities you are looking at prescribing. The obvious issue with herbals is their lack of regulation. However, you can work in conjunction with a master herbalist. You perform the diagnostics and the herbalist provides the remedy. Whatever you do you need to be able to back up with education. Many people will debunk what is non allopathic. however, I have found that we have only researched such a small, small percentage of things. If there isn't evidence it doesn't mean it doesn't work. It just means we don't know. If there is no money, no one will pay. They finally did a study comparing synthyroid to armour. Guess what? They both work. Ta da.

Also most NP programs consider "Holistic" to be treating the whole patient. What you are talking about is more Integrative medicine. Good luck.

[Alexandraw44]

Ah that age old saying. I am always scratching my head when nurses, NPs or doctors say that. Do you not know that a lot of our pharmaceuticals are derived from plant constituents? Do you not know that the 2016 noble peace prize went to two scientists who used a plant called "sweet Annie" (artmesia annua) that is now used for a anti malaria drug because that's what the tribal people have used for centuries. Have you not read about the scientist in 2017 who found a plant that might fight antibiotic resistance. Don't you think as practioners we have to be open to everything in order to give good patient care. There a accredited colleges that offer a bachelors in herbal studies and plant chemistry. If you can't realize in 2017 how important plants are to human health than you might want to do some basic research.

[nurse4life4ever]

NPs are trained to provide evidence-based care. If you can find high quality and evidence-supported alternative treatment, then you can safely ensure your patients will not be harmed due to hear-say. However, if you suggest treatments without good evidence to support it, if patients suffer any harms, you are due for the harms you make. Granted that many treAtments are not evidence-supported, you will be okay if it follows the standards or policy recommendations of trusted organizations.

[JellyDonut]

NPs are trained to provide evidence-based care. If you can find high quality and evidence-supported alternative treatment, then you can safely ensure your patients will not be harmed due to hear-say. However, if you suggest treatments without good evidence to support it, if patients suffer any harms, you are due for the harms you make. Granted that many treAtments are not evidence-supported, you will be okay if it follows the standards or policy recommendations of trusted organizations.

I remember I think it was in a Fitzgerald review where she prescribed a medication for an off label use but noted or included the EB article to justify the decision. I always remembered that just in case...