is there really a place for holistic medicine in the "real"nursing world

CharlieRN · Jul 19, 2005

"Holistic" is a really broad term. It covers everything from nutrition to witchcraft. I don't like it as a term because it is letting a lot of "woo-woo" get into the practice of medicine. It makes quackery sound respectable.

Call what you want to do "nutrition counseling", get yourself some certification as a nutritionist, and go for it. Nutrition is a valid area of scientific study. See to it that what you teach is supported by good research. In this day there is no excuse for teaching "old wives tales" as if they were just as good as solid research. A registered nurse should understand what science is and how the process of increasing our scientific knowledge base works.

If you find you have beliefs for which you can't find scientific support, then maybe what you need to be doing is research studies. You don't need much in the way of qualifications to do research. Just a willingness to be rigously honest, patient, keep accurate records, and don't jump to easy conclusions. A little creativity in figuring out double blind studies to test the claimed "holistic" effects, would help too.

It was a student who proved that "theraputic touch" was hooey. She showed that 21 professional practitioners of TT could not even detect the supposed "human energy field" they claimed they could feel and manipulate to cure and comfort patients. The only special equipment she used was a cardboard screen and a towel. If they could not see her they scored no better than chance on guessing if she was holding her hand near them or not. Best of all her results were recently duplicated by rresearchers in France.

**canoehead, BSN, RN** · Jul 19, 2005

Holistic doesn't necessarily mean "old wives tales"

Having good nutrition, dealing with body stressors, counselling and rituals can make a big difference in the body's resources. If people feel stronger mentally and ready to deal with their illness it may improve their outcome. Even if it doesn't- if only they find the experience of illness less devastating, well I can get behind that.

And, another thing, just because insurance won't cover it doen't mean its not beneficial. Lots of times people's definition of alternative is whatever the insurance company says it is.

DRTCBear · Jul 21, 2005

And another student who proved that Emily Rosa's research on TT was scientific misconduct, a publishing fraud, and that poor little Emily is still clueless - years later, about research, design of experiments, and data analysis. You really ought to do your research homework before spouting off... Research is not for the weak and simpleminded!

bear

It was a student who proved that "theraputic touch" was hooey. She showed that 21 professional practitioners of TT could not even detect the supposed "human energy field" they claimed they could feel and manipulate to cure and comfort patients. The only special equipment she used was a cardboard screen and a towel. If they could not see her they scored no better than chance on guessing if she was holding her hand near them or not. Best of all her results were recently duplicated by rresearchers in France.

CharlieRN · Jul 21, 2005

How quickly we get to the personal insults. I gather you are a TT practioner, Bear. Are you willing to put your talents to the test?

Nurse Ratched, RN · Jul 21, 2005

No personal attacks, please. The comments have already been addressed.

DRTCBear · Jul 21, 2005

Sorry Charlie,

I am not a TT practitioner, I am a nurse-statistician. Invitations to Randi style challenges are responded to appropriately - with gales of laughter...

It strikes me as quite odd that a post that derogates TT practitioners and extols the virtues of what was clearly an unscientific, even fraudulent article in JAMA, is perfectly acceptable, but a post that points out that endorsing such an article is misguided is not. Pseudoscience at its worst.

bear

zenman · Jul 24, 2005

It was a student who proved that "theraputic touch" was hooey. She showed that 21 professional practitioners of TT could not even detect the supposed "human energy field" they claimed they could feel and manipulate to cure and comfort patients. The only special equipment she used was a cardboard screen and a towel. If they could not see her they scored no better than chance on guessing if she was holding her hand near them or not. Best of all her results were recently duplicated by rresearchers in France.

Charlie, you need to increase your research "readings." This study made the JAMA look silly. They were even called on the carpet by a scientist who was a member of a skeptical society who said if they wanted to debunk something they should at least do it correctly. Consider that:

1. a sixth grade student conducted the experiment

2. the girl's mother, an RN, was a co-founder of Quackwatch Inc. The president of this organzation, a Stephen Barrett, M.D., is a retired psychiatrist who writes books out of his basement...an underground publisher I'd say. LOL. He has made a fool of himself testifying in several court cases and even blew up in one and had a temper tantrum. His organization has been exposed in court for deceiving the public and lost a major lawsuit in California Superior Court where the judge made a ruling on his credibility...or lack of it! Do you think the girl's mother was an unbaised researcher?

3. Critics of the study pointed out that there were serious flaws in the study design

4. JAMA altered their peer-review process for this one article

5. and most serious of all, no "patients" were involved, making the study "null and void" because they did not use Therapeutic Touch.

There have been studies by real adults showing the efficacy of TT in wound healing, immune system function and reduction of pain.

Isn't this "energetic stuff" a great modality?

Katnip, RN · Jul 24, 2005

To get back to the OP's question:

It's very difficult these days to have the time to spend on each patient to teach nutrition, relaxation techniques, meditation, or guided imagery. They take time to teach properly and it's very difficult. There are wellness centers that hire nurses though.

And before anyone attacks any of these, take a look at Johns Hopkins, Columbia University, and University of Mass, before you call it bunk. Those and other schools have put a lot of research into the effectiveness of integrative healthcare techniques.

I personally have never heard the term "holistic health" attached to witchcraft.

DRTCBear · Jul 24, 2005

Zenman,

Yep.

But despite all this there are still people out there who feel qualified to do research on TT without ever having conducted a full literature review. They read reviews of reviews of literature, ignore anything that calls into question their biases, suggest research designs that are guaranteed to prove their null hypotheses instead of research designs that give a fair chance to their alternative hypotheses, and apparently cannot grasp why the probability of a TT practitioner passing the Rosa Test was less than 0.10 (0.30) for skills levels of 2 out of 3 or 3 out of 4 correct.

Do a web search on "emily rosa", TT, and "skeptic" and you will get hundreds of websites run by people who are either too dumb to remove their accolades, or too lacking in integrity to admit the truth as you have described it. In hundreds of exchanges with skeptics on another LS the pattern was fairly uniform. First they come on spouting nonsense. Then when questioned they suggest that you don't know what you are talking about. Then they move into the phase where they start wondering if maybe there is something to the suggestion that they open an intro to statistics book and look up how to calculate binomial probabilities, to which they have previously responded that it is unnecessary because they 'know' that TT is bunk. Then, after months they finally agree to work it out themselves and with only two exceptions, you never heard from them again - not even an apology for their arrogance and errors of the past. Larry Sarner (another of the flub four authors) actually threatened to sue me if I continued to expose their work for what it was. Real science I guess.

Now, going back to the original question - is there a place for alternative and complementary practices in nursing? Of course there is. It is what nursing has always been about. The non-alternative and non-complementary aspects of nursing can be done by robots and semi-skilled workers - the bringing of one's whole self to the encounter in behalf of a patient: The tenderness, empathy, healing presence, ability to put oneself in the shoes of the other and care for them is the non-rational but traditional core of nursing. TT practices as do many other alternative and complementary practices bring a sense of wholeness and healing to nursing encounters that could, in some people's opinions, in efforts to constrain costs, be eliminated from 'nursing' practice. We could, of course, hook patients up to telemetry, sedate them, and warehouse them in cubicles like items in a Walmart supply depot, to be picked up and delivered to stationary nurses for the few procedures that couldn't more efficiently be provided by robots - and we may yet get there, but I don't think of that as 'nursing' care.

Alternative and complementary care practices are add-ons for nurses - not substitutes for core nursing skills, yet skeptics tend to fantasize that they are routinely used instead of core nursing skills. I have certainly seen the difference between the two different modalities of practice - but skeptics see something very different than I see even when viewing the same situation.

bear

krisssy · Sep 30, 2005

I am an RN who has been very ill for the last four years both physically (two very painful abdominal surgeries) and mentally (first major depression and now post traumatic stress disorder. ) I just came back from a spa in Arizona where I was treated holistically and traditionally. The doctors and nurses were amazing. They helped me outline a specific program for me there and a program to continue at home. Accupuncture was used for stomach pain and Percoset Withdrawal. Finding a practitioner who does EMDR for Post Traumatic Stresss Disorder was highly recommended. My psychiatrist and psychologist at home never heard of it. I also experienced The Healing Touch given by a nurse plus massage therapy, a form of water therapy called Watsu, and many stretch and yoga classes. Extra blood tests wete taken which would be considered untraditional. Fish Oil and Niacin was suggested for a hereditary cholesterol/heart problem that runs in my family. One day I was crying, which I do easily, and the desk secretary sat and talked to me and gave me a hug. I cried when explaining what caused my trauma and the interviewing nurse gave me a hug too. In one week, i felt a million times better physically and mentally. I just made appointments for next week for a massage, EMDR, accupuncture, and yoga/stretch. In four years and since my surgeries, nothing has helped. In one week, i felt soooo much better. So i am going to continue where I live, and i will let you know how I am doing. I was never a great believer in holistic medicine, but after last week my feelings are changing. The accupuncture took my stomach pain away 90%, and i didn't feel any withdrawal until a few days after the treatment. So who knows? Holistic health certainly can't cure alll diseases, but it can cure some and it can certainly make the patient feel and cope better-in my opinion and personal experience.

DRTCBear · Oct 1, 2005

Hi Krissy,

Sorry to hear of your past problems but it is great that you found your way to a way of healing.

I am color blind - so there are things I will never appreciate or 'know' that involve colors - e.g. I will never, ever see what non red-green color blind people see when presented with a standardized test. Instead, I see what red-green color blind people see. The rub is that normally sighted people will never see what we see so if you were a skeptic who was normally sighted - you would never be able to get evidence that there were red green color blind people who were accurately reporting what they saw rather than delusion.

Pretty much the same with skeptics and holism - they just do not get it and it runs counter to their beliefs that modern science has explained all there is to know about health, healing, and illness. They are as wrong as they were when they stood by the shore and laughed at robert fulton (steamboat), the Wright brothers at kitty hawk (airplanes), and Edison in his lab (electric lightbulb.)

The less well informed skepts exhibit the typical response patterns or religious fundamentals and fanatics - they 'believe' they know science the way some believe they know 'god'.

on the other hand, it is pretty inexpensive to find out for yourself, as you have. based on your past knowledge you know that surgery cause as many problems, if not more, that it solves. if skeptics looked at modern surgery, pharmacology, and vaccination programs with the same degree of blind, ill-informed, doubt, they would close down the entire health care system.

What has always been most curious to me is that skeptics rarely, if ever, address the shift from physicians and hospitals assuming the roles of insurers by entering capitation agreements, propsective payment systems, and managed care agreements. Under such systems, health care providers make more money when they provide less service - banking more of the difference between what they are paid and what it costs for them to provide service. Yet skeptics are unifromly silent with regard to "professional caregiver insurance risk" even though it represents one of the greatest threats to health and our system of health care delivery.

Go figure.

Enjoy the healing experiences - sadly, most skeptics will never experience them...