A holistic hospital model

US hospitals are turning to complementary therapies to speed up patient recovery times, so could Irish hospitals follow their lead?

THERE HAS been huge growth in the use of complementary therapies such as acupuncture, massage and guided imagery alongside conventional medicine in US hospitals over the past two years.

And Mary Jo Kreitzer, the director of the Centre for Spirituality and Healing and a professor at the University of Minnesota's School of Nursing, points out that there is a growing body of research which shows that many of these complementary therapies are safe, effective and may even be cost effective.

The US government has now established a National Centre for Complementary and Alternative Medicine which receives €120 million a year in research funding.

Kreitzer explains: "Consumers in the US clearly want more holistic experiences. They want the best of high-tech and high-touch therapies. They don't want to use complementary therapies as an alternative but to combine them with the best of what's on offer in conventional medicine.

"For example, a woman with breast cancer will want the best surgery, chemotherapy or radiotherapy available but she may also use acupuncture to cope with nausea, possibly mind/body interventions to reduce anxiety and lavender oil to help her sleep."

She says that more and more hospitals in the US are realising the importance of creating the optimal healing environment for both patients and staff.

The Woodlands Health Campus in Minnesota is one hospital that was purpose-built with the idea in mind of creating the optimal healing environment.

"From a physical space point of view, all the patients have private rooms and we are seeing this more and more in new hospitals in the US. It's important to do everything we can to give patients privacy as well as to reduce noise and create the perfect environment for healing," says Kreitzer.

She explains that a huge body of research drawn from 600 US hospitals shows that giving patients access to nature, for example a window or even just a picture of a nature scene, can be very healing.

While the Woodlands hospital paid a lot of attention to the physical space, Kreitzer acknowledges that this is not as easy to do in existing hospitals, particularly older buildings. However, she says that more important than the physical surroundings of the patients is the competency and "heart and mind" of the care givers.

"It's become more typical in US hospitals to provide patients with the choice of therapies, like acupuncture, massage, healing touch, the use of essential oils and guided imagery. In many of our hospitals, nurses have taken a real leadership role in this area and some of the more successful ones are nurse-led."

In the US, most nursing education programmes now teach students about holistic care and there are nurse graduate programmes specifically designed in integrated care.

At the University of Minnesota, such training is included in the required curriculum, not only for nurses, but for physicians and pharmacists with additional training offered to graduate level.

The Centre for Spirituality and Healing website (www.csh.umn.edu) offers 35 hours of free online training in complementary therapies for healthcare professionals and many hospitals are now using this information to begin training their staff in the area.

The website also has a large amount of information for consumers with advice on how to take charge of their health. For example, somebody who wants to learn about acupuncture can view the latest research in the area on the site and watch a video explaining the therapy in detail.

It may sound like a great idea but could complementary therapies possibly be integrated into Ireland's overcrowded and under-staffed hospitals?

Kreitzer believes it is possible to do it on a smaller scale than the US, as many of the interventions don't take an enormous amount of time and can simply be included in the patient's care.

During a recent visit to Ireland - where she addressed a national conference held by the Department of Nursing and Midwifery at Sligo General Hospital on this topic - she spent some time in Sligo General and got an idea of some of the challenges faced by Irish nurses.

"My sense is that Ireland has an excellent system for educating nurses and does provide some very good care. There are a lot of challenges but the most important thing is not the physical environment, even though it would be lovely to build new hospitals from the ground up. What's most important is the care providers and there are simple ways that the nurses I met at the conference could put integration into practice in their hospitals."

For example, Kreitzer points out that there is strong research which shows that using music with patients on ventilators in intensive-care units can help to reduce the amount of drugs they need, speed up their recovery and get them out of ICU quicker.

Other research shows the benefits of giving post-surgery patients certain essential oils and stimulating acupressure points to reduce nausea instead of using drugs. Nurses caring for oncology patients find guided imagery very helpful in relaxing their patients and preparing them for procedures.

One of the most dramatic examples of the use of a complementary therapy in a hospital setting is the carrying out of three orthopaedic surgeries on patients under hypnosis at the University of Minnesota Hospital without any anaesthesia.

Kreitzer points out that noise is a huge issue for patients who are trying to rest in multi-bedded wards with staff and visitors coming and going and trolleys rattling along the corridors outside day and night. She says it's an issue that particularly needs to be addressed in neonatal units where babies are all kept in one large bay as all of the noise and light can put stress on the body.

The Centre for Healing and Spirituality is not advising people to use complementary therapies as an alternative to conventional medicine, as it could pose risks to, for example, abandon conventional cancer treatment for a "miracle" botanical cure.

It believes the best goal is to move towards integrative healthcare where the best of both conventional and complementary therapies are available to all and providers from both work together for the best patient outcome.