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A Nurse’s Guide to Complementary and Alternative Medicine (CAM)
- Learn the main categories of Complementary and Alternative Medicine (CAM) and each category’s philosophy.
- How CAM can be used in hospital environments/clinical settings in order to best meet the needs of the patient.
- Offer CAM resources for continued insight into the history and effectiveness.
Tracy Long
PhD, MS, MSN, RN, APRN-BC, CDCES, CCRN, CNE
Complementary and Alternative Medicine (CAM) usage varies widely across different countries and cultures. According to the National Center for Complementary and Integrative Health (NCCIH), in 2017, 42% of adults in the United States had used some form of CAM in the past year. The most common forms of CAM in the United States are natural products such as dietary supplements, followed by deep breathing, yoga, and meditation.
The World Health Organization (WHO) estimates that 80% of people worldwide use herbal medicine as a primary form of healthcare. In many countries, traditional medicine and CAM are used alongside conventional medicine.
Traditional Chinese Medicine (TCM) is one of the most widely used forms of CAM globally, with acupuncture, herbal medicine, and massage being some of its most popular modalities. Ayurvedic medicine, which originated in India, is the second most popular form of CAM used globally. It includes herbs, food combinations, meditation, and body work. African, Native American, and Latin-based countries and cultures have high rates of CAM use in households and use their traditional medicine for generations.
Categories of Complementary and Alternative Medicine
Complementary and Alternative Medicine (CAM) includes a wide range of therapies and practices that may be effective in treating certain health conditions and ailments. Examples of the main categories of CAM include the following:
Biologically Based Approaches
Homeopathy: This practice involves using very small doses of natural substances to stimulate the body’s natural healing abilities.
Naturopathy: This practice focuses on using natural remedies and therapies, such as herbal medicine, nutrition, and lifestyle changes, to promote health and prevent disease.
Manipulative and Body-Based Treatments
This practice includes a variety of physical manipulations to the body to realign the skeletal system, promote muscle relaxation, and healing. A common type of body work includes chiropractic care. Reiki is an ancient system that involves the use of the practitioner’s hands to transfer energy to the patient, with the goal of promoting relaxation and healing.
Mind-Body Interventions
This category includes those that focus on the mind and body by restoring energy (known as chi, chakra, or vital energy) through meditation, yoga, and spiritual practices.
Whole systems
This includes ancient systems such as Traditional Chinese Medicine, Ayurvedic medicine, Native American, or Latin medicine practices. They have been taught and passed down for generations and include a variety of other types of CAM therapies including herbs, foods, ceremonies, energy healing, prayer, and rituals with amulets.
Energy Systems
This includes various practices and treatments that can be incorporated into all the above categories and focuses on the core belief that energy is vital and affects all body systems and impacts health and disease.
Uses of Complementary and Alternative Medicine
CAM is gradually being incorporated inside clinical settings. The growing use of CAM within hospitals is being introduced by nurses who see improvements in vital signs, decreased pain and anxiety, and overall increased well-being when patients have access to meditation, guided imagery, pet, music, and art therapy, aromatherapy, and reflexology.
Anecdotal evidence supports the use of aromatherapy in clinical settings to decrease pain and promote sleep. It is important for one to share information with unit managers or supervisors to determine if incorporating such therapies in local hospitals or clinical settings may be an option.
Nurse’s Role in Complementary and Alternative Medicine
While some CAM practices have been scientifically proven to be effective in treating certain health conditions such as stress, hypertension, and anxiety, others have not been rigorously studied. Therefore they have not been accepted as standard guidelines for clinical practice. As a healthcare professional, it is important to encourage patients to do their own research and make informed decisions about their health care.
It is also crucial for patients to talk to their healthcare provider before trying any new CAM practices. Practices that involve homeopathy, herbs, tinctures, or products may interact with medications or pose a risk to their health.
One example of how CAM may adversely interact with other medications is that herbs such as garlic, ginseng, or ginkgo biloba should not be injected when taking a blood thinner, as they can enhance anticoagulant properties and create a bleeding risk. Pre-existing conditions such as heart disease, diabetes, or cancer could be helped with CAM, but need the approval of their primary care provider.
Individuals who are breastfeeding or pregnant should be extremely cautious about consuming herbs and products without FDA approval and without the approval of the medical provider.
Resources in Complementary and Alternative Medicine
If one has an interest in using CAM as a part of one’s health care, it is important to do research and make informed decisions. Unfortunately, there is less information about CAM therapies than traditional pharmaceuticals due to low funding. Research on pharmaceuticals is funded largely by the pharmaceutical company investing in a drug, which will recover their investment in future sales. CAM therapies are difficult to trademark and therefore difficult to fund research.
The following are resources to help one learn more about CAM and find qualified practitioners:
- National Center for Complementary and Integrative Health (NCCIH): This government-funded organization provided evidence-based information on various CAM practices, including acupuncture, herbal medicine, and chiropractic care. Their website includes fact sheets, research studies, and information on finding a qualified practitioner.
- American Holistic Health Association (AHHA): This non-profit organization provides information on holistic health care and offers a directory of practitioners who use CAM practices. Their website also includes resources for patients who are interested in learning more about CAM.
- National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM): If one is interested in trying acupuncture, this organization can help one find a qualified practitioner. Their website includes a directory of licensed acupuncturists, as well as benefits.
- American Chiropractic Association (ACA): If one is interested in chiropractic care, this organization can help one find a qualified practitioner. Their website includes a directory of licensed chiropractors, as well as information on benefits.
- American Holistic Nurses Association (AHNA): This national specialty organization focuses on providing education and support for over 5,500 nurses who seek to treat patients as holistic beings.
The Bottom Line
CAM therapies have been used for centuries and by people throughout the entire world. Nurses serve a diversified population and need to know about CAM therapies that patients may be using.
Nurses have a unique trust with patients which places them in a position to share valuable information regarding the safety and resources for CAM use. It is important to be open-minded while learning about CAM therapies as patients may benefit from many therapies beyond what western medicine can offer.
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